Institute of Epidemiology & Health Care


The Sexunzipped website and online trial

Principal investigator Julia Bailey

Cochrane systematic review: Interactive Computer-Based Interventions for Sexual Health Promotion

Our systematic review of randomised controlled trials of interactive computer-based interventions for sexual health promotion shows that computer-based interventions have a moderate effect in improving people's knowledge about sexual health in comparison to minimal interventions (such as 'usual practice' or a leaflet). We also found a small effect on safer sex self-efficacy (a person's belief in their capacity to carry out a specific action), a small effect on safer-sex intentions, and also an effect on sexual behaviour (such as condom use for sexual intercourse). Computer-based interventions seem better than face-to-face interventions at improving sexual health knowledge. More research is needed to establish whether computer-based interventions can change outcomes such as sexually transmitted infections and pregnancy, to understand how interventions might work, and to assess whether they are cost-effective.

The review is available here

The Sexunzipped project

Sexunzipped logo
The website: The Sexunzipped website is for teenagers focusing on sexual pleasure, relationships, and safer sex (www.sexunzipped.co.uk). The site is underpinned by psychological theory and is interactive and tailored, aiming to help young people achieve a healthier sex life through giving them the tools to make informed decisions about sexual wellbeing. The research team worked in partnership with young people to decide the content and design of website.

Online trial: We conducted a feasibility pilot online randomised controlled trial to establish the best way to conduct an online trial for sexual health with young people (registration number ISRCTN55651027). 2,006 participants were recruited online and randomised to either the Sexunzipped intervention site or to an information-only control website. We measured sexual wellbeing with the Sexunzipped online outcome measurement instrument - the questions covered knowledge, self-efficacy (confidence), safer sex intentions, sexual behaviour (condom and contraception use, use of services, partner numbers), sexually transmitted infections, pregnancy, sexual problems, partner abuse, regretted sex, sexual pleasure, relationship satisfaction and sexual satisfaction. The survey proved popular with young people despite being quite long and detailed.

We tested the effect of incentive payments on retention, finding that a £20 incentive (instead of £10) increased response rates. Researchers are always keen to measure biological outcomes - we tested the feasibility of postal urine sample testing for Chlamydia, but the response rates were poor, and the one-off prevalence of Chlamydia was low in this population of young people, so one-off urine sampling was not a good way to capture the effect of the intervention.

Our qualitative evaluation of trial procedures showed that recruitment via Facebook worked well and that online sexual health research is popular with young people. The Sexunzipped online trial procedures generally worked very well (recruitment, online consent, participant identity verification, randomization and concealment of allocation, online data collection and participant contact by email).

For more details, please see the publications cited below:

This project was funded by the Medical Research Council

MRC logo

Bailey JV, Pavlou, M, Copas A, Mccarthy O, Carswell K, Rait G, Hart G, Nazareth I, Free C, French R, Murray E. The Sexunzipped trial: optimizing the design of online randomized controlled trials. In press. J Med Internet Res. doi:10.2196/jmir.2668

Nicholas A, Bailey JV, Stevenson F, Murray E. Young People's Experiences of Participating in an Online Trial of the Sexunzipped Website. In press. J Med Internet Res. doi:10.2196/jmir.2647

Carswell K, McCarthy O, Murray E, Bailey JV. Integrating psychological theory into the design of an online intervention for sexual health: the Sexunzipped website. J Med Internet Res JMIR Res Protoc 2012;1(2):e16. doi:10.2196/jmir.2114

McCarthy O, Carswell K, Murray E, Free C, Stevenson F, Bailey JV. What young people want from a sexual health website: design and development of 'Sexunzipped'. J Med Internet Res 2012;14(5):e127. doi: 10.2196/jmir.2116