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Objectives
There is a real resource problem in helping people to reduce their risk of sexually transmitted diseases. People’s sex lives are complicated and their needs, motivations and ideas vary hugely
from person to person. To stand any chance of helping people to reduce their risks we need to find out what drives them personally and then work with them to produce specific solutions tailored to their personal
lifestyles. But that raises a real problem. There just aren’t enough traned staff around to meet the needs of even a small proportion of people who get sexually transmitted diseases. That’s so in rich
developed countries. It is even more so in poor developing countries.
The aim of SHIFT is to evaluate an internet-based intervention to help people to reduce their risk of getting sexually transmitted diseases. We also want to try to help people to improve their sexual
health generally so the site has a wide range of resources about sexual health problems generally, as well as resources for health issues commonly seen in sexual health clinics such as mood problems and substance
misuse.
The site is intended as a resource for sexually transmitted disease clinics and other settings in which people with sexual health risks are being seen. It is intended to supplement existing treatment
and interventions not to replace them.
Most websites are really just electronic books. That is not, in our view, enough to be able to make this sort of intervention work. You can learn more about how we have gone about trying to give the
site the functionality we need in Technology
Study Design
The study is in two parts. In the first part, now more or less complete, we worked with users to develop the modules. At each stage we took back materials to users retaining those which they
identified as useful, modifying those they felt should be changed, and discarding those they felt were not helpful.
The current stage is a feasibility study. GUM clinic attenders with new incident sexually transmitted diseases are randomised either to treatment as usual or treatment as usual plus access to the
website.There are several endpoints for the study:
Usage - the extent to which people will make use of a site like this is unknown.
Which modules and pages the users make use of While we are clear what clinics want to tell patients, we are less clear about what the key issues are for users. This
makes their choices of particular interest when they have a free choice of many different issues to look at.
User ratings of the website and its modules
Behaviour change Ultimately the objective of the intervention is to help people to make behaviour changes which will reduce their risks of contracting sexually
transmitted diseases. The study is not powered to detect a statistically significant difference between conditions. Instead the study will, we hope, provide information on the parameters necessary to run a
randomised controlled outcome trial in the future if other outcomes are favourable..
Other outcomes. There are other expected outcomes from the study. The website allows collection of data from users on process in a way which is very difficult to collect in one-to-one clinical practice. This has implications beyond this immediate study since internet interventions, particularly for treatment of psychological conditions and for behaviour change, will inevitably become more frequent. We are also hoping to gather information on the optimal way to follow up clinic attenders, a notoriously difficult task to achieve.
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