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., Lugg-Widger, Fiona ORCID: https://orcid.org/0000-0003-0029-9703, Pallmann, Philip ORCID: https://orcid.org/0000-0001-8274-9696, Brown, Rachel ORCID: https://orcid.org/0000-0002-4475-1733, 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). Public Health Research 10.3310/AHDP8546

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Abstract

Background: Adverse sexual health, dating and relationship violence, and sexual harassment are significant public health concerns, especially among young people. Sexually transmitted infection rates are at a 10-year high, and dating and relationship violence affects nearly half of young people. Further education provides a population-wide setting for delivering dating and relationship violence and sexual health interventions, but only a few interventions have been shown to be effective in further education. Objectives: 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 dating and relationship violence and sexual harassment among young people attending further education. Optimised materials were used in a pilot cluster randomised controlled trial of SaFE. SaFE had three components: (1) onsite access to sexual health and relationship services in further education settings provided by sexual health nurses for 2 hours, 2 days per week; (2) publicity about onsite services and (3) further education staff training on how to promote sexual health and recognise and respond to dating and relationship violence and sexual harassment. This paper reports on the optimisation of the SaFE intervention materials. Design and methods: A multistage iterative process was used to optimise further education 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. Stage 2 involved: (1) two focus groups; one with four further education staff and one with three further education students at one further education institution and (2) 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 further education safeguarding and well-being teams. Stage 5 comprised a final review of intervention material by the Trial Management Group. Stage 6 gained online feedback from a young people’s advisory group. The study was conducted in England and Wales. Results: In Stage 1, Trial Management Group reviewers recommended improving clarity and factual accuracy, reducing the length of slide decks and adding content on sending explicit images. Stage 2 feedback from further education 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 Trial Steering Committee in Stage 3 advised on managing participant disclosures and reordering content. Stage 4’s trial run with further education staff identified redundancy in content, the incorporation of task-based exercises and varied learning approaches. Stage 5’s Trial Management Group 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, Trial Steering Committee, stakeholder advisory group and further education 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 further education 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.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Research Institutes & Centres > Centre for Trials Research (CNTRR) Research Institutes & Centres > Centre For Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer) Schools > Medicine Schools > Social Sciences (Includes Criminology and Education)
Publisher:	NIHR Journals Library
ISSN:	2050-4381
Date of First Compliant Deposit:	11 July 2025
Date of Acceptance:	11 July 2025
Last Modified:	16 Dec 2025 11:20
URI:	https://orca.cardiff.ac.uk/id/eprint/179763

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