The SPORTSMART study: a pilot randomised controlled trial of sexually transmitted infection screening interventions targeting men in football club settings

Abstract

BackgroundUptake of chlamydia screening by men in England has been substantially lower than by women. Non-traditional settings such as sports clubs offer opportunities to widen access. Involving people who are not medically trained to promote screening could optimise acceptability.MethodsWe developed two interventions to explore the acceptability and feasibility of urine-based sexually transmitted infection (STI) screening interventions targeting men in football clubs. We tested these interventions in a pilot cluster randomised control trial. Six clubs were randomly allocated, two to each of three trial arms: team captain-led and poster STI screening promotion; sexual health adviser-led and poster STI screening promotion; and poster-only STI screening promotion (control/comparator). Primary outcome was test uptake.ResultsAcross the three arms, 153 men participated in the trial and 90 accepted the offer of screening (59%, 95% CI 35% to 79%). Acceptance rates were broadly comparable across the arms: captain-led: 28/56 (50%); health professional-led: 31/46 (67%); and control: 31/51 (61%). However, rates varied appreciably by club, precluding formal comparison of arms. No infections were identified. Process evaluation confirmed that interventions were delivered in a standardised way but the control arm was unintentionally ‘enhanced’ by some team captains actively publicising screening events.ConclusionsCompared with other UK-based community screening models, uptake was high but gaining access to clubs was not always easy. Use of sexual health advisers and team captains to promote screening did not appear to confer additional benefit over a poster-promoted approach. Although the interventions show potential, the broader implications of this strategy for UK male STI screening policy require further investigation.

Who tests whom? A comprehensive overview ofChlamydia trachomatistest practices in a Dutch region among different STI care providers for urogenital, anorectal and oropharyngeal sites in young people: a cross-sectional study

“…Strategies to increase the reach of these self-taken samples, and thereby lower barriers to accessing STI care for both patients and providers,26 27 include the use of internet-based programmes, e-health strategies and home-collection 28 29…”

Examining the potential public health benefit of offering STI testing to men in amateur football clubs: evidence from cross-sectional surveys

“…The development and evaluation of the SPORTSMART intervention has been reported elsewhere [ 12 ]. Briefly, we developed two interventions to explore the acceptability and feasibility of urine-based STI (chlamydia and gonorrhoea) screening interventions targeting men in amateur football clubs in London, United Kingdom.…”

“…Although healthcare settings may be preferred [ 9 ], previous research suggests that young men are open to STI testing in a range of settings, including non-healthcare settings, such as in sports venues [ 9 – 11 ]. As such, we developed, piloted, and evaluated two feasible, replicable interventions to promote and deliver STI screening targeting young men in amateur football clubs – ‘SPORTSMART’ [ 12 ]. The hypothesis being that this approach to STI screening may reach men who would not otherwise use sexual health services and could provide a generalisable solution for other health promotion interventions in young men such as drug, smoking, and alcohol awareness.…”

“…The hypothesis being that this approach to STI screening may reach men who would not otherwise use sexual health services and could provide a generalisable solution for other health promotion interventions in young men such as drug, smoking, and alcohol awareness. Uptake of the SPORTSMART intervention was high at almost 60 % implying high acceptability of screening in this setting [ 12 ]. This paper examines the potential public health benefit of offering STI testing to men in this setting by assessing club members’ sociodemographic characteristics, sexual behaviours, and sexual healthcare behaviour and comparing them to men in the general population.…”

Exploring the costs and outcomes of sexually transmitted infection (STI) screening interventions targeting men in football club settings: preliminary cost-consequence analysis of theSPORTSMARTpilot randomised controlled trial

“…The methods and results of the pilot trial are reported in detail elsewhere. 5 In brief, a cluster randomised control trial (RCT) design was used involving the allocation of clubs, each with two teams, to one of three trial arms: (1) captain-led and poster STI screening promotion arm; (2) sexual health advisor-led and poster STI screening promotion arm and (3) poster-only STI screening promotion control/comparator arm. The participants were men aged 18 years and over within six amateur football clubs in London.…”