Co-Design of a Sexuality Support Training Program for Practitioners Supporting People With Mental Illness (RIKASEKU-SAPOPRO): Protocol for a Randomized Controlled Trial.

Abstract

Holistic health care includes sexuality. For people with mental illness, sexuality is an essential element of recovery. However, sexuality is often overlooked in mental health settings in Japan and elsewhere. Therefore, practitioners need to recognize sexuality as a legitimate area of care and acquire the skills and attitudes required to provide appropriate support. To address this gap, we developed a training program for practitioners through coproduction among peers with mental illness, researchers, and practitioners. This randomized controlled trial (RCT) in Japan compares an intervention group that participates in the program with a control group that does not and evaluates the program's effectiveness in improving practitioners' knowledge, attitudes, and confidence in providing sexuality-related support to clients with mental illnesses. The study participants are qualified practitioners aged 18 years or older who provide community-based support to people with mental illness. This 4-hour program combines comprehensive sexuality education with content specific to mental illness and deepens participants' knowledge and skills through textbooks and case studies. The program is delivered in small groups of up to 8 participants by 2 facilitators: a practitioner and a peer with mental illness. Peer facilitators have experience facilitating sexuality-related group programs. The study design is a 2-arm parallel group RCT. After a baseline assessment, participants will be randomly assigned to an intervention or control group. Participants in the intervention group will complete an online questionnaire at baseline (T1), immediately after the program (T2), and 1 month after the program (T3). Participants in the control group will not receive the program during the study period and will complete the same 3 assessments (T1 to T3). Outcomes focus on participant competence rather than client condition. The primary outcome is confidence in providing sexuality-related support, measured using the self-assessment scale (lack of quality for sexuality education). Secondary outcomes include attitudes regarding sexuality (Attitudes Toward Sexuality Scale), knowledge of sexuality education, and knowledge of preconception care for people with mental illness. The target sample size is 76. Funding was awarded in April 2023. Recruitment began in June 2025, and as of March 12, 2026, 57 participants had enrolled, 46 of whom had completed the final assessment. Analysis has not yet been conducted, and final data collection is anticipated by December 2026. To our knowledge, this will be the first RCT on a sexuality support training program for mental health practitioners. If effective, the program may help practitioners provide better support to people with mental illness and, in the long term, contribute to their recovery.