BACKGROUND There is a strong interest in the use of social media to spread positive sexual health messages through social networks of young people. However, research suggests that this potential may be limited by a reluctance to be visibly associated with sexual health content on the web or social media and by the lack of trust in the veracity of peer sources. OBJECTIVE The aim of this study was to investigate opportunities and challenges of using social media to facilitate peer-to-peer sharing of sexual health messages within the context of STASH (Sexually Transmitted Infections and Sexual Health), a secondary school-based and peer-led sexual health intervention. METHODS Following training, and as a part of their role, student-nominated peer supporters (aged 14-16 years) invited school friends to trainer-monitored, private Facebook groups. Peer supporters posted curated educational sex and relationship content within these groups. Data came from a feasibility study of the STASH intervention in 6 UK schools. To understand student experiences of the social media component, we used data from 11 semistructured paired and group interviews with peer supporters and their friends (collectively termed students; n=42, aged 14-16 years), a web-based postintervention questionnaire administered to peer supporters (n=88), and baseline and follow-up questionnaires administered to students in the intervention year group (n=680 and n=603, respectively). We carried out a thematic analysis of qualitative data and a descriptive analysis of quantitative data. RESULTS Message sharing by peer supporters was hindered by variable engagement with Facebook. The trainer-monitored and private Facebook groups were acceptable to student members (peer supporters and their friends) and reassuring to peer supporters but led to engagement that ran parallel to-rather than embedded in-their routine social media use. The offline context of a school-based intervention helped legitimate and augment Facebook posts; however, even where friends were receptive to STASH messages, they did not necessarily engage visibly on social media. Preferences for content design varied; however, humor, color, and text brevity were important. Preferences for social media versus offline message sharing varied. CONCLUSIONS Invitation-only social media groups formed around peer supporters' existing friendship networks hold potential for diffusing messages in peer-based sexual health interventions. Ideally, interactive opportunities should not be limited to single social media platforms and should run alongside offline conversations. There are tensions between offering young people autonomy to engage flexibly and authentically and the need for adult oversight of activities for information accuracy and safeguarding.

中文翻译：

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校本干预中性健康社交媒体信息的点对点共享：STASH 可行性试验中确定的机遇和挑战（预印本）

背景技术人们对使用社交媒体通过年轻人的社交网络传播积极的性健康信息有着浓厚的兴趣。然而，研究表明，这种潜力可能会受到限制，因为人们不愿将其与网络或社交媒体上的性健康内容明显联系起来，并且对同行来源的真实性缺乏信任。目标 本研究的目的是调查在 STASH（性传播感染和性健康）的背景下使用社交媒体促进点对点性健康信息共享的机会和挑战，STASH 是一个中学和同伴领导性健康干预。方法 在培训之后，作为他们角色的一部分，学生提名的同伴支持者（14-16 岁）邀请学校朋友加入由培训师监督的私人 Facebook 群组。同伴支持者在这些群组中发布了精心策划的性教育和关系内容。数据来自对 6 所英国学校进行 STASH 干预的可行性研究。为了解学生对社交媒体的体验，我们使用了来自 11 次半结构化配对和小组访谈的数据，这些访谈对象是同伴支持者及其朋友（统称为学生；n=42，年龄在 14-16 岁之间），这是一项基于网络的干预后调查问卷，旨在同伴支持者 (n=88)，以及对干预年组学生进行的基线和后续问卷调查（分别为 n=680 和 n=603）。我们对定性数据进行了主题分析，对定量数据进行了描述性分析。结果 与 Facebook 的不同参与度阻碍了同伴支持者的消息共享。培训师监控的私人 Facebook 群组为学生成员（同伴支持者和他们的朋友）所接受，并让同伴支持者放心，但导致参与与他们的日常社交媒体使用平行，而不是嵌入。基于学校的干预的线下环境有助于合法化和增加 Facebook 帖子；然而，即使朋友们愿意接受 STASH 消息，他们也不一定会在社交媒体上明显地参与进来。内容设计的偏好各不相同；然而，幽默、色彩和文字简洁很重要。对社交媒体与线下消息共享的偏好各不相同。结论 围绕同伴支持者现有的友谊网络形成的仅限邀请的社交媒体团体具有在基于同伴的性健康干预中传播信息的潜力。理想情况下，互动机会不应仅限于单一的社交媒体平台，而应与线下对话同时进行。在为年轻人提供灵活和真实参与的自主权与成人监督活动以确保信息准确性和安全性之间存在紧张关系。