Sexual Health & Teenage
Pregnancy Professionals
Campaign Launch Event
5 th November 2009

Claire Everett, Public Health Campaign
Team Leader, Department of Health

Andrea Duncan, Sexual Health
Programme Lead, Department of Health

• Implementation of the Sexual Health and HIV Strategy (2001) and Strategy
Review (2008)
• Implementation of the Teenage Pregnancy Strategy (1999)
• Key indicators : Vital Signs 2008/9 – 2010/11
• Reduce the prevalence of chlamydia in the under 25 year old population
(currently measured through screening volumes)
• Reduce under 18 conception by 50% by 2010 (using 1998 as a baseline year)

• There has been an overall decline in the under 18 conception rate of 10.7%
(1998 – 2007) with some areas showing declines of over 25%
• This reverses the previous upward trend demonstrating the strategy is working
• Chlamydia screening volumes are also increasing with 15.9% of 15-24 year olds screened outside of GUM clinics in 2008/9

• Overall, we are significantly behind the trajectory needed to achieve the challenging target to halve the under-18 conception rate by 2010
• Abortion and repeat abortion rates remain high, particularly amongst those aged under 25
• We need to embed the routine offer of a chlamydia test to all under 25s when they visit the NCSP core primary care services of GP, pharmacy and
CaSH services
• And, we are looking for your support to work towards these ambitious targets

Contraception
• Significant new funding to improve access to contraception
• New QOF points on contraceptive advice
• New specification for abortion services being developed including requirement for all methods to be provided at TOP
Chlamydia
• Focus on core services
• NAO and Hussey reviews
SRE
• Statutory provision of SRE from September 2011

• Create a genuine culture change where stakeholders and consumers are equipped and confident in engaging in conversations about sexual health and relationships
• Encourage ‘one conversation’ where sexual health including contraception choice and chlamydia screening are discussed holistically
• Where we are now is to focus on helping women to choose contraception that best suits their lifestyle, and all young people - men and women - to accept a chlamydia test when it is offered to them

We need to respond to demand from young people
• They have told us they want:
– Greater dialogue to increase their knowledge and understanding
– Friendly, approachable staff and service providers they trust
– More open and informed discussions about sexual health and relationships
• And, we know that talking to young people about contraceptive choice and sexual health is critical to helping them make well-informed decisions

• We have spoken to many of you and your staff to help shape the new campaign and you have said you would like:
– To be better equipped with tools and training to speak to young people about contraception choice and to offer them chlamydia tests
– More information about the contraceptive choices available - some nonspecialists aren’t aware of the full range available so default to prescribing certain methods they are familiar with
– A tool or way to distil the wealth of information available about contraception to quickly and easily highlight the contraception that best suits an individual

• We in the Department of Health are working with the Department for
Children, Schools and Families and the National Chlamydia Screening
Programme to create an integrated campaign to facilitate joined-up conversations
• Research into other sexual health campaigns in the UK and abroad, as well as campaigns in other sectors, have demonstrated that everyday conversations will be critical to the success of our strategy
• The campaign is designed to create a culture of open, mature and informed discussion about safer sex and relationships
• This campaign aims to reach a broader range of stakeholders than ever before, to complement the work you are already doing, to improve sexual health and help deliver against our targets

• Exciting opportunity to broaden marketing work on sexual health and teenage pregnancy in a more holistic joined up way
• The new strategy introduces areas we haven’t traditionally focused on in sexual health marketing, such as contraception and chlamydia screening
•
Crucial to work together to ensure the campaign is a success

Kate Waters, Planning Partner,
Partners Andrews Aldridge

Previous campaigns targeted discrete audiences and focused mainly on condom use

A thorough review of the marketing and communications strategy has been conducted
Academic evidence: behaviour change & audience understanding
Best practice: stakeholder interviews, international & regional experience
Review of current campaigns
& associated market research
Development of quantitative framework and social influence model

Academic evidence identifies the many influences on behaviour
Demographics / background Self esteem and confidence
Other relevant behaviours e.g. alcohol misuse
Relationship with parents Engagement in education Aspirations for the future

Academic evidence identifies the many influences on behaviour
Demographics/ background Self esteem and confidence
Other relevant behaviours e.g. alcohol misuse
Personal attitudes and beliefs e.g. perception of risk, attitudes to contraception
Perceived behavioural control
The degree to which I can control the situation (e.g. Do I have a condom?
Do I have the confidence to negotiate?)
Social norms & peer pressure i.e. what I believe others around me are doing and the degree of importance
I attach to their attitudes
Risk images i.e. my image / perceptions of people who
Indulge in particular behaviours
Relationship with parents Engagement in education Aspirations for the future

Academic evidence identifies the many influences on behaviour
Demographics / background Self esteem and confidence
Other relevant behaviours e.g. alcohol misuse
Personal attitudes and beliefs e.g. perception of risk, attitudes to contraception
Perceived behavioural control
The degree to which I can control the situation (e.g. do I have a condom?
Do I have the confidence to negotiate?)
Social norms & peer pressure i.e. what I believe others around me are doing and the degree of importance
I attach to their attitudes
Risk images i.e. my image / perceptions of people who
Indulge in particular behaviours
Preparatory
Behaviours
Communication
Contraceptive access
& carrying
Screening
Safer sexual
Practice
(Delay, use of contraception, sex post screening)
Relationship with parents Engagement in education Aspirations for the future

Successful approaches in other countries have addressed multiple factors
The Netherlands:
“the major public health goal is to ensure that everyone…has the necessary skills to behave responsibly when sexually active”
“the general philosophy (of SRE) is not to teach but to talk about sex. Teachers emphasise communication and negotiation skills”
New Zealand:
Increasing knowledge among parents, children and teachers
US:
Peer:peer education, increasing access
Massachusetts:
The role of better communication

The most vulnerable young people require more intense intervention
• Often present with multiple vulnerabilities and risk factors
• Successful interventions often tackle multiple factors and combine communication with other approaches

• Multiple influences on behaviour not just attitudes
• Importance of preparatory behaviours
• The role of multiple audiences: parents, HCPs, youth workers
• Marketing, not just communication

The overall vision for marketing is to act as a catalyst for cultural change
Prevailing culture:
‘stigma, shame, embarrassment’
New culture:
‘Open, positive, supportive, respectful’

There are four key audiences to address in communication
11-16 year olds
Authoritative and accurate information about all aspects of sex and relationships
The skills and confidence to negotiate safe sex when they feel ready for it .
16-24 year olds
Better ways to minimise the risks to which they’re exposed.
Parents
The knowledge and confidence to discuss sex and relationships with their children and practical help to get them started.
HCPs & youth workers
The skills and confidence to discuss sex and relationships with children and adults and to offer appropriate advice.

Three marketing objectives have been defined to support this overall aim
1. Prevention:
Building the attitudes, knowledge and skills that make safe sex more likely
3. Intervention:
Intensive support for the most at risk
2. Protection:
Encouraging protective behaviours that make sex safer

There will be six strands of activity within the marketing programme
1. Prevention:
Knowledge & education
Communications & negotiation skills
3. Intervention:
Integrated education & service delivery
2. Protection:
Contraceptive choice
Chlamydia screening
Condom access/ carrying

An umbrella campaign identity will provide salience and increase integration
‘More communication = safer sex & better relationships’

• More conversations
• More joined-up conversations
• More honest and respectful conversations
• More overheard conversations

Michael Lee, Head of Planning,
VCCP

• The campaign aims to raise the importance of teenage pregnancy and sexual health issues amongst a broader audience than ever before
• Key to this is creating a culture of open, mature and informed discussion about sex and relationships
• At the heart of this campaign is the belief that talking plays an integral role in driving safer sexual attitudes and behaviours

Umbrella identity
SEX. WORTH TALKING ABOUT.
“Overall, content and execution of brand strapline is strong campaign property that appears likely to deliver to requirements as a unifying marque as well as contributing directly to communications.”
“Everyone is talking about it because it‟s worth it...”
[Female pair, 16-17, Higher Risk, London]
“It gives you a choice if you want to talk about sex. So you think, well, I might as well...it says
„worth‟ talking about, so you might get something out of it.”
[Male Pair, 17-21, Higher Risk, Leeds]
“I like the „Sex worth talking about‟ it suggests there are advantages from talking about it‟”
[PSHE Teacher, Slough]

The branding device of two over-lapping speech bubbles has talking at the heart of it
Sex. Worth Talking About
Chlamydia. Worth Talking About Contraception. Worth Talking About
• Each strand is clearly signposted & grounded by „worth talking about‟
• Branding cohesion allows for fluidity of campaign phasing

Everyday
Straightforward
Action
– Small bitesized conversations everyday vs the one ‘big chat’
– Cold de-sexualised incidental environments versus hot
„ heat of the moment’ (living room vs bedroom) places
– Matter of fact, factual tone de-stigmatises and disarms the audience, makes it feel like no big deal
– Straightforward design ensures enduring, universal appeal
– Every piece of communication triggers the start of a conversation (e.g. parents), or removes a barrier to action (e.g. chlamydia screening acceptance)

• We have deliberately avoided using people as it’s impossible to cast to appeal to everyone
• Instead, speech bubbles bring to life the personality of the individual which brings a lightness of touch without allowing the audience to de-select
•
All audiences enjoyed the boldness of the words in everyday situations that they could identify with, which allowed them to step into the scenario

“With NHS logo and relaxed conversations, tone of the creative work is of distinct benefit to the campaign…many in the audience naturally gravitating towards it”
“speech bubbles device can work in a very wide variety of locations/settings….helpful with variety but also targeting”
“I like the way it‟s spoken about casually, the way you talk about shopping or whatever. It is not a big deal...”
[Female pair, 16-17, Higher Risk, London]
“It‟s light ... It‟s not daunting
... To me it just felt kind of natural.”
[Male Trio, 25-30, Higher
Risk, London]
“They‟ve got all different scenarios and situations, they‟ll strike up more conversations those will ….
[Male Pair, 18-
21, Lower Risk,”
Birmingham]
“It‟s not outing anybody, getting the message across to lots of people”
[Female, Trio, 22-24, Higher
Risk, Leeds]
“I like the anonymity of the bubble. I can be anyone, anyone could be in the situation”
[Female Trio, 17-18, Higher
Risk, Slough]

Campaign structure – which logo to use?
Sex. Worth Talking About
Umbrella identity
 Used to sign off against any broad contextual pieces, for example non-specific partnership and PR activity
Contraception.
Worth Talking About
Chlamydia.
Worth Talking About
Sub-brands
 Firmly rooted in the umbrella identity, but given their own look and feel which helps distinguish each specific strand of activity
 These logos should be used as a sign-off for communications with a specific focus on these subjects

Sex. Worth Talking About
The Voice of Authority
• This style of speech bubble represents the voice of the campaign
•
This should be used to sign off the campaign and the text within it replaced by the relevant strap line: i.e.) Sex. Worth talking about /
Contraception worth talking about /
Chlamydia worth talking about etc…
The Voice of the Individual
• This style of speech bubble represents the different characters who are having the conversation
• These speech bubbles should only be used when representing two people having a conversation

November
9/11 16/11 23/11 30/11 26/10 2/11
December
7/12 14/12 21/12 28/12
PR
Radio Partnership
Radio
Digital
Magazines
TV
Partnership
Information cascade
Stakeholders

Contraception-specific communications
Launch : PR Activity starts w/c 16 November, paid for activity w/c 30
November
Key objective
• Raise awareness of the range of contraception options available including LARCs
Desired outcome :
• Target audience is able to make a more informed personal choice of contraception method
All paid-for communications will feature the message :
“Remember using a condom as well helps protect against STIs” Contraception.
Worth Talking About

Chlamydia-specific communications
• Launching Jan 2010
• Activity includes TV, radio, magazines, PR and digital partnerships
Key objectives:
• Desired Action – accept the test when offered
• Increase Awareness – a normal and routine offer
All paid-for communications will feature the message :
“Remember condoms are the best protection against STIs”
Chlamydia.
Worth Talking About

Alison Hadley
Teenage Pregnancy Unit
Department for Children Schools and Families

• The campaign will support you to continue progress to date
• You are the first to be shown the new strategy
• Your opportunity to ask questions directly to the Departments managing the campaign
• Start a dialogue and co-create activity and information that is relevant for you

Sex. Worth Talking About

• You can use the logo on local marketing materials:
– Posters
– Leaflets
– Websites

• A website that will build over time to make the conversations possible:
• Essential information and campaign materials
• Monthly updates
• Case studies
• Forums for debate and discussion
• Submit your network details to get regular updates

• Advertising on TV, radio, online and press from 30 th
November
• Media stories to support the campaign and fuel discussion
• Starting with a focus on contraception choice
• Drive consumers to find out more through campaign website hosted by NHS Choices – details of local services

• Packs of information from leading organisations are being distributed to c.23,000 healthcare professionals in advance of the campaign launching to consumers
• Aim to help service providers answer questions from the public and have joined-up conversations

• This is supported by materials that help you disseminate campaign information to your networks:
– Template Powerpoint presentation
– Template copy for newsletters and/or websites
– Copies of the presentations today

• Use real voices from peers and build on experiences from health professionals, teachers, school nurses, pharmacists and youth workers who understand your challenges
• Use case studies, specialist media relations, conferences and materials to make the campaign work for you