Optimisation of a sexual health and healthy relationships intervention for Further Education in England and Wales (SaFE)

Aslam, Rabeea'h Waseem ORCID: https://orcid.org/0000-0002-0916-9641, Williams-Thomas, Rhys, Townson, Julia ORCID: https://orcid.org/0000-0001-8679-3619, Lewis, Ruth, Madan, Jason, Melendez-Torres, G.J., Brown, Rachel ORCID: https://orcid.org/0000-0002-4475-1733, Lugg-Widger, Fiona ORCID: https://orcid.org/0000-0003-0029-9703, Pallmann, Philip ORCID: https://orcid.org/0000-0001-8274-9696, Bonnell, Chris, Morgan, Gemma S., White, James and Young, Honor ORCID: https://orcid.org/0000-0003-0664-4002 2025. Optimisation of a sexual health and healthy relationships intervention for Further Education in England and Wales (SaFE). National Institute of Health Research Journals Library Item availability restricted.

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Abstract

Background Adverse sexual health, dating and relationship violence (DRV), and sexual harassment are significant public health concerns, especially among young people. STI rates are at a 10-year high, and DRV affects nearly half of young people. Further education (FE) provides a population-wide setting for delivering DRV and sexual health interventions, but only a few interventions have been shown to be effective in FE. Objective(s) To optimise intervention materials and identify refinements for the Sexual Health and Healthy Relationships for Further Education (SaFE) intervention , an intervention to improve sexual health and reduce DRV and sexual harassment among young people attending FE. Optimised materials were used in a pilot cluster randomised control trial of SaFE. SaFE had three components: (1) onsite access to sexual health and relationship services in FE settings provided by sexual health nurses for two hours, two days per week; (2) publicity about onsite services; and (3) FE staff training on how to promote sexual health, and recognise and respond to DRV and sexual harassment. This paper reports on the optimisation of the SaFE intervention materials. Design and methods A multi-stage iterative process was used to optimise FE staff training and publicity materials. This involved a series of consultation and focus group feedback sessions. Setting and participants In Stage 1, feedback was collected from the SaFE Trial Management Group (TMG). Stage 2 involved, i) two focus groups; one with four FE staff and one with three FE students at one FE institution, and ii) stakeholder consultation with seven experts. Stage 3 saw consultation with the Trial Steering Committee who had independent oversight of the study. The operational feasibility of the training was evaluated in Stage 4 through a trial run with FE safeguarding and wellbeing teams. Stage 5 comprised a final review of intervention material by the TMG. Stage 6 gained online feedback from a young people's advisory group. The study was conducted in England and Wales. Results In Stage 1, TMG reviewers recommended improving clarity and factual accuracy, reducing the length of slide decks and adding content on sending explicit images. Stage 2 feedback from FE staff and students focused on training content addressing comprehensiveness, structure, and visual design, and training delivery addressing preferred training formats and opportunities for scenario-based learning. The TSC in Stage 3 advised on managing participant disclosures and reordering content. Stage 4’s trial run with FE staff identified redundancy in content, the incorporation of task-based exercises and varied learning approaches. Stage 5’s TMG review led to the integration of multimedia elements and case studies. Stage 6 feedback from young people improved clarity and accessibility in publicity materials. Limitations Low participation and self-selection in focus groups may limit the generalisability of the findings. The move to online engagement during COVID-19 may have hindered the depth of interaction. Recruiting from a single institution could introduce sampling bias. Conclusions Fully optimised staff training and publicity materials were produced that were considered acceptable and consistent with the theory of change as agreed by the research team, TSC, stakeholder advisory group, and FE students, staff and young people. Future work After the optimisation phase, the SaFE intervention was delivered in a pilot cluster randomised controlled trial with high fidelity to six FE settings in England and Wales. Future work could explore strategies to evaluate the effectiveness as well as improve scalability and sustainability of interventions like SaFE. Study registration The study registration is ISRCTN54793810.

Item Type:	Article
Status:	In Press
Schools:	Research Institutes & Centres > Centre For Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer) Schools > Social Sciences (Includes Criminology and Education)
Date of First Compliant Deposit:	11 July 2025
Date of Acceptance:	11 July 2025
Last Modified:	16 Jul 2025 14:43
URI:	https://orca.cardiff.ac.uk/id/eprint/179763

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