A peer-led,social media-delivered,safer sex intervention for Chinese college students: Randomized controlled trial

Background: the peer-led,social media-delivered intervention is an emerging method in sexual health promotion. however,no research has yet investigated its effectiveness as compared with other online channels or in an asian population. objective: the objective of this study is to compare a peer-led,social media-delivered,safer sex intervention with a sexual health website. both conditions target chinese college students in hong kong. methods: a randomized controlled trial was conducted with a peer-led,safer sex facebook group as the intervention and an existing online sexual health website as the control. the intervention materials were developed with peer input and followed the information-motivation-behavioral skills model; the intervention was moderated by peer educators. the participants filled out the online questionnaires before and after the 6-week intervention period. outcome evaluations included safer sex attitudes,behavioral skills,and behaviors,while process evaluation focused on online experience,online-visiting frequency,and online engagement. the effect of online-visiting frequency and online engagement on outcome variables was investigated. results: of 196 eligible participants-100 in the control group and 96 in the intervention group-who joined the study,2 (1.0%) control participants joined the facebook group and 24 of the remaining 194 participants (12.4%) were lost to follow-up. for the process evaluation,participants in the intervention group reported more satisfying online experiences (p<.001) and a higher level of online-visiting frequency (p<.001). they also had more positive comments when compared with the control group. for outcome evaluation,within-group analysis showed significant improvement in condom use attitude (p=.02) and behavioral skills (p<.001) in the intervention group,but not in the control group. no significant between-group difference was found. after adjusting for demographic data,increased online-visiting frequency was associated with better contraceptive use behavioral intention (p=.05),better behavioral skills (p=.02),and more frequent condom use (p=.04). conclusions: a peer-led,social media-delivered,safer sex intervention was found to be feasible and effective in improving attitudes toward condom use and behavioral skills,but was not significantly more effective than a website. future research may focus on the long-term effectiveness and cost-effectiveness of this popular method,as well as the potential cultural differences of using social media between different countries. © wai han sun,carlos king ho wong,william chi wai wong.