1. Basingstoke Contraceptive and Sexual Health (CASH) Service 1 Department of Health (2001) Better prevention, better services, better sexual health – the national strategy for sexual health and HIV. London: The Stationery Office. 2 Scriven, A. (2010) Promoting health, a practical guide. 6 th Edition. London: Elsevier. 3 Lloyd, C., Handsley, S., Douglas, J., Earle, S. and Spurr, S. (2007) Policy and practice in promoting public health. Sage: London. 4 www.hampshirecash.org.uk 5 Department of Health (2009) Moving forward: progress and priorities - working together for high quality sexual health: Government response to the Independent Advisory Group's review of the Sexual Health and HIV Strategy. London: The Stationery Office. 6 Press Association (2012) Teenage pregnancy rate drops 7.3%. Basingstoke Gazette. Available at: www.basingstokegazette.co.uk/uk_national_news/9558263.Teenage_pregnancy_rate_drops_7_3_/. (Accessed: 12 June 2012) 7 Office for National Statistics (2012) Conceptions in England and Wales 2010. Available at: www.ons.gov.uk/ons/rel/vsob1conception-statistics--england-and-wales/2010/2010-conceptions-statistical-bulletin.html#tab-Conceptions-in-England-andWales-2010 (Accessed: 12 June 2012). Evidence of need  National Strategy for Sexual Health & HIV 1 aims: reducing the transmission of HIV and STIs reducing the prevalence of undiagnosed HIV and STIs reducing unintended pregnancy rates improving health and social care for people living with HIV reducing the stigma associated with HIV and STIs  The need to develop the evidence base  DOH’s Public Service Agreement 5 ‘to reduce the under-18 conception rate by 50 per cent by 2010 as part of a broader strategy to improve sexual health’ CASH provides… 4 An accessible sexual health service Clinics in five colleges during term time Contraceptive advice Genito-urinary medicine advice Free condoms for all young people Chlamydia screening for under 25s With thanks to the staff at Basingstoke CASH clinic. 8 UK Youth Parliament (2007) SRE: Are you getting it? Available at http://www.ukyouthparliament.org.uk/wpcontent/uploadsAreYouGettingIt.pdf. (Accessed 12 June 2012) 9 FPA and Brook (2012) Joint Statement from FPA and Brook on STI data released on 30 May 2012. Available at www.fpa.org.uk/pressarea/pressreleases/2012/may/joint-statement-from-fpa-and-brook-on-sti-data-released-on-30may-2012. (Accessed 12 June 2012) 10 Department of Health (2010) Healthy lives, healthy people: Our strategy for public health in England. Available at: www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_127424.pdf (Accessed: 12 June 2012). 11 Bailey, J.V., Murray, E., Rait, G., Mercer, C.H., Morris, R.W., Peacock, R., Cassell, J. and Nazareth, I. (2010) Interactive computer-based interventions for sexual health promotion. Cochrane Database of Systematic Reviews 2010, Issue 9. Art. No.: CD006483. DOI10.1002/14651858.CD006483.pub2. 12 Ross, J. D. C., Copas, A., Stephenson, J., Fellows, L. and Gilleran, G. (2007) Optimizing information technology to improve sexual health-care delivery: public and patient preferences. International Journal of STD and AIDs, 18, pp 440-445. Images: www.hampshirecash.org.uk; blog.jericho.co.nz; www.plannerslounge.com; ww1.prweb.com; images.bigdug.co.uk; images.hayneedle.com; www.zephyrsouthwest.com; www.pvrdirect.co.u k CASH Aims & Objectives  To modernise sexual health and HIV services in light of the growing prevalence of sexually transmitted infections (STIs) and HIV 1  To promote the location of local sexual health services  To offer sex education, health promotion and contraception to enable people to improve their health  To reduce the teenage conception rate in young women aged 15-17 Health promotion is said to only be successful if it advocates the best interests of individuals, and society as a whole 2 Basingstoke CASH Service uses a ‘high-risk’ approach, prioritising people at particular risk in the community, rather than a whole-population approach 2 “In England, and in other developed countries, the burden of sexual illness is borne, in particular, by the most vulnerable in society.” 3 Bringing sexual health services into the Internet era A Cochrane review of sexual health promotion concluded that computer based interventions:  have a moderate effect in improving people's knowledge about sexual health in comparison to ‘usual practice' leaflet giving  have a small effect on safer-sex intentions  have an effect on sexual behaviour (such as condom use for sexual intercourse)  appeared better than face-to-face interventions at improving sexual health knowledge However, no studies measured potential harm of computer based interventions - more research is required to establish whether they have an effect on outcomes such as STIs and pregnancy and to assess whether they are cost-effective 11 Does the service work? Whilst local media 6 reported a nationwide decrease in teenage pregnancies in 2010, there was actually a 7.8% increase in the South East area compared to the previous year 7 CASH service staff identify several barriers to providing an effective service to young people: Providing services at times that are accessible to young adults of school/college age 8 Lack of signposting – the CASH service cannot be seen to publicly ‘promote’ sex to young people The service does not have a budget for targeted advertising in the local area 49% of young people in the UK reported that they don’t know where their local sexual health clinic is 9 Every secondary school in North East Hants is offered a free education and advice session for Year 11 pupils, however the uptake rate is currently approximately 10% Improved education in schools is vital to improve sexual health amongst young people 10 CASH is now under the umbrella of Solent NHS Trust, moving towards a service offered under “one roof” in place of the previous referral service