Young People’s Views of Participating in the Sexunzipped Online Trial
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Abstract
Background:
The Internet has great potential for sexual health promotion, given its high usage among young people, anonymity, and ease of access. Online randomized controlled trials (RCTs) are increasingly being used to evaluate online interventions, but whilst there are many advantages to online methodologies, they can be associated with a number of problems, including poor engagement with online interventions, poor trial retention and concerns about the validity of data collected through self-report. We conducted an online feasibility trial that tested the effect of the Sexunzipped website for sexual health in comparison with an information-only website. This study reports on a qualitative evaluation of the trial procedures, reporting participants’ experiences and views of the Sexunzipped online trial including methods of recruitment, incentives, methods of contact, and sexual health outcome measurement.
Objective: To determine participants’ views of the acceptability and validity of the online trial methodology used in the RCT of the Sexunzipped intervention.
Methods: We used three qualitative data sources to assess the acceptability and validity of the online RCT methodology: 1) individual interviews with 22 participants from the feasibility RCT; 2) 133 participant emails concerning trial procedures; and 3) 217 free-text comments from the baseline and follow-up questionnaires. Interviews were audio-recorded and transcribed verbatim. An iterative, thematic analysis of all three data sources was conducted to identify common themes related to the acceptability and feasibility of the online trial methodology.
Results: Interview participants found the online trial design highly acceptable. Participants generally enjoyed taking part in sexual health research online, and were comfortable with the procedures for recruitment via Facebook, online registration, email communication with the researchers, and online completion of sexual health questionnaires. The online medium was often preferred to traditional (face-to-face or postal) research methods, and the privacy of the online environment encouraged honest responses to the sexual health questions. Participants found the sexual health questionnaire itself thought-provoking, with some participants reporting behavior change after participation in the research. Most thought that receiving and returning a urine sample for Chlamydia testing by post was acceptable.
Conclusions: These findings provide strong support for the use of online research methods for sexual health research, emphasizing the importance of careful planning and execution of all trial procedures including recruitment, trial related communication, and methods to maximize follow up. Our findings suggest that measuring sexual health outcomes can encourage participants to reflect on their behavior. Potential measurement effects should be accounted for in the design of randomized controlled trials.
The Internet has great potential for sexual health promotion, given its high usage among young people, anonymity, and ease of access. Online randomized controlled trials (RCTs) are increasingly being used to evaluate online interventions, but whilst there are many advantages to online methodologies, they can be associated with a number of problems, including poor engagement with online interventions, poor trial retention and concerns about the validity of data collected through self-report. We conducted an online feasibility trial that tested the effect of the Sexunzipped website for sexual health in comparison with an information-only website. This study reports on a qualitative evaluation of the trial procedures, reporting participants’ experiences and views of the Sexunzipped online trial including methods of recruitment, incentives, methods of contact, and sexual health outcome measurement.
Objective: To determine participants’ views of the acceptability and validity of the online trial methodology used in the RCT of the Sexunzipped intervention.
Methods: We used three qualitative data sources to assess the acceptability and validity of the online RCT methodology: 1) individual interviews with 22 participants from the feasibility RCT; 2) 133 participant emails concerning trial procedures; and 3) 217 free-text comments from the baseline and follow-up questionnaires. Interviews were audio-recorded and transcribed verbatim. An iterative, thematic analysis of all three data sources was conducted to identify common themes related to the acceptability and feasibility of the online trial methodology.
Results: Interview participants found the online trial design highly acceptable. Participants generally enjoyed taking part in sexual health research online, and were comfortable with the procedures for recruitment via Facebook, online registration, email communication with the researchers, and online completion of sexual health questionnaires. The online medium was often preferred to traditional (face-to-face or postal) research methods, and the privacy of the online environment encouraged honest responses to the sexual health questions. Participants found the sexual health questionnaire itself thought-provoking, with some participants reporting behavior change after participation in the research. Most thought that receiving and returning a urine sample for Chlamydia testing by post was acceptable.
Conclusions: These findings provide strong support for the use of online research methods for sexual health research, emphasizing the importance of careful planning and execution of all trial procedures including recruitment, trial related communication, and methods to maximize follow up. Our findings suggest that measuring sexual health outcomes can encourage participants to reflect on their behavior. Potential measurement effects should be accounted for in the design of randomized controlled trials.
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