eprintid: 10156448 rev_number: 7 eprint_status: archive userid: 699 dir: disk0/10/15/64/48 datestamp: 2022-09-30 09:41:23 lastmod: 2022-09-30 09:41:23 status_changed: 2022-09-30 09:41:23 type: article metadata_visibility: show sword_depositor: 699 creators_name: Free, Caroline creators_name: Palmer, Melissa J creators_name: McCarthy, Ona L creators_name: Jerome, Lauren creators_name: Berendes, Sima creators_name: Knight, Megan creators_name: Carpenter, James R creators_name: Morris, Tim P creators_name: Jamal, Zahra creators_name: Dhaliwal, Farandeep creators_name: French, Rebecca S creators_name: Hickson, Ford Colin Ian creators_name: Gubijev, Anasztazia creators_name: Wellings, Kaye creators_name: Baraitser, Paula creators_name: Roberts, Ian creators_name: Bailey, Julia V creators_name: Clayton, Tim creators_name: Devries, Karen creators_name: Edwards, Phil creators_name: Hart, Graham creators_name: Michie, Susan creators_name: Macgregor, Louis creators_name: Turner, Katy ME creators_name: Potter, Kimberley title: Effectiveness of a behavioural intervention delivered by text messages (safetxt) on sexually transmitted reinfections in people aged 16-24 years: randomised controlled trial ispublished: pub divisions: UCL divisions: J38 divisions: D65 divisions: B02 note: © 2022 BMJ Publishing Group Ltd. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license (http://creativecommons.org/licenses/by/4.0/). abstract: OBJECTIVE: To quantify the effects of a series of text messages (safetxt) delivered in the community on incidence of chlamydia and gonorrhoea reinfection at one year in people aged 16-24 years. DESIGN: Parallel group randomised controlled trial. SETTING: 92 sexual health clinics in the United Kingdom. PARTICIPANTS: 92 sexual health clinics in the United Kingdom. INTERVENTIONS: 3123 participants assigned to the safetxt intervention received a series of text messages to improve sex behaviours: four texts daily for days 1-3, one or two daily for days 4-28, two or three weekly for month 2, and 2-5 monthly for months 3-12. 3125 control participants received a monthly text message for one year asking for any change to postal or email address. It was hypothesised that safetxt would reduce the risk of chlamydia and gonorrhoea reinfection at one year by improving three key safer sex behaviours: partner notification at one month, condom use, and sexually transmitted infection testing before unprotected sex with a new partner. Care providers and outcome assessors were blind to allocation. MAIN OUTCOMES MEASURES: The primary outcome was the cumulative incidence of chlamydia or gonorrhoea reinfection at one year, assessed by nucleic acid amplification tests. Safety outcomes were self-reported road traffic incidents and partner violence. All analyses were by intention to treat. RESULTS: 6248 of 20 476 people assessed for eligibility between 1 April 2016 and 23 November 2018 were randomised. Primary outcome data were available for 4675/6248 (74.8%). At one year, the cumulative incidence of chlamydia or gonorrhoea reinfection was 22.2% (693/3123) in the safetxt arm versus 20.3% (633/3125) in the control arm (odds ratio 1.13, 95% confidence interval 0.98 to 1.31). The number needed to harm was 64 (95% confidence interval number needed to benefit 334 to ∞ to number needed to harm 24) The risk of road traffic incidents and partner violence was similar between the groups. CONCLUSIONS: The safetxt intervention did not reduce chlamydia and gonorrhoea reinfections at one year in people aged 16-24 years. More reinfections occurred in the safetxt group. The results highlight the need for rigorous evaluation of health communication interventions. TRIAL REGISTRATION: ISRCTN registry ISRCTN64390461. date: 2022 date_type: published publisher: BMJ official_url: https://doi.org/10.1136/bmj-2022-070351 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1979318 doi: 10.1136/bmj-2022-070351 lyricists_name: Morris, Timothy lyricists_id: TNMOR17 actors_name: Morris, Timothy actors_id: TNMOR17 actors_role: owner full_text_status: public publication: BMJ volume: 378 article_number: e070351 citation: Free, Caroline; Palmer, Melissa J; McCarthy, Ona L; Jerome, Lauren; Berendes, Sima; Knight, Megan; Carpenter, James R; ... Potter, Kimberley; + view all <#> Free, Caroline; Palmer, Melissa J; McCarthy, Ona L; Jerome, Lauren; Berendes, Sima; Knight, Megan; Carpenter, James R; Morris, Tim P; Jamal, Zahra; Dhaliwal, Farandeep; French, Rebecca S; Hickson, Ford Colin Ian; Gubijev, Anasztazia; Wellings, Kaye; Baraitser, Paula; Roberts, Ian; Bailey, Julia V; Clayton, Tim; Devries, Karen; Edwards, Phil; Hart, Graham; Michie, Susan; Macgregor, Louis; Turner, Katy ME; Potter, Kimberley; - view fewer <#> (2022) Effectiveness of a behavioural intervention delivered by text messages (safetxt) on sexually transmitted reinfections in people aged 16-24 years: randomised controlled trial. BMJ , 378 , Article e070351. 10.1136/bmj-2022-070351 <https://doi.org/10.1136/bmj-2022-070351>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10156448/1/2022%20-%20Free%20-%20safetxt%20trial%20-%20bmj.pdf