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Ray JG, Fu L, Austin PC, Park AL, Brown HK, Grandi SM, Vandermorris A, Boblitz A, Cohen E. Teen Pregnancy and Risk of Premature Mortality. JAMA Netw Open 2024; 7:e241833. [PMID: 38483391 PMCID: PMC10940968 DOI: 10.1001/jamanetworkopen.2024.1833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/15/2024] [Indexed: 03/17/2024] Open
Abstract
Importance Unintentional injury, suicide, and homicide are leading causes of death among young females. Teen pregnancy may be a marker of adverse life experiences. Objective To evaluate the risk of premature mortality from 12 years of age onward in association with number of teen pregnancies and age at pregnancy. Design, Setting, and Participants This population-based cohort study was conducted among all females alive at 12 years of age from April 1, 1991, to March 31, 2021, in Ontario, Canada (the most populous province, which has universal health care and data collection). The study period ended March 31, 2022. Exposures The main exposure was number of teen pregnancies between 12 and 19 years of age (0, 1, or ≥2). Secondary exposures included how the teen pregnancy ended (birth or miscarriage vs induced abortion) and age at first teen pregnancy. Main Outcomes and Measures The main outcome was all-cause mortality starting at 12 years of age. Hazard ratios (HRs) were adjusted for year of birth, comorbidities at 9 to 11 years of age, and area-level education, income level, and rurality. Results Of 2 242 929 teenagers, 163 124 (7.3%) experienced a pregnancy at a median age of 18 years (IQR, 17-19 years). Of those with a teen pregnancy, 60 037 (36.8%) ended in a birth (of which 59 485 [99.1%] were live births), and 106 135 (65.1%) ended in induced abortion. The median age at the end of follow-up was 25 years (IQR, 18-32 years) for those without a teen pregnancy and 31 years (IQR, 25-36 years) for those with a teen pregnancy. There were 6030 deaths (1.9 per 10 000 person-years [95% CI, 1.9-2.0 per 10 000 person-years]) among those without a teen pregnancy, 701 deaths (4.1 per 10 000 person-years [95% CI, 3.8-4.5 per 10 000 person-years]) among those with 1 teen pregnancy, and 345 deaths (6.1 per 10 000 person-years [95% CI, 5.5-6.8 per 10 000 person-years]) among those with 2 or more teen pregnancies; adjusted HRs (AHRs) were 1.51 (95% CI, 1.39-1.63) for those with 1 pregnancy and 2.14 (95% CI, 1.92-2.39) for those with 2 or more pregnancies. Comparing those with vs without a teen pregnancy, the AHR for premature death was 1.25 (95% CI, 1.12-1.40) from noninjury, 2.06 (95% CI, 1.75-2.43) from unintentional injury, and 2.02 (95% CI, 1.54-2.65) from intentional injury. Conclusions and Relevance In this population-based cohort study of 2.2 million female teenagers, teen pregnancy was associated with future premature mortality. It should be assessed whether supports for female teenagers who experience a pregnancy can enhance the prevention of subsequent premature mortality in young and middle adulthood.
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Affiliation(s)
- Joel G. Ray
- Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
- Department of Obstetrics and Gynaecology, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
| | | | | | | | - Hilary K. Brown
- ICES, Toronto, Ontario, Canada
- Department of Health and Society, University of Toronto Scarborough, Scarborough, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sonia M. Grandi
- ICES, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Ashley Vandermorris
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- Division of Adolescent Medicine, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | | | - Eyal Cohen
- ICES, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Edwin S. H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
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Jämiä L, Piispanen N, Kylmä J, Haavisto E, Harju E. Contents, Methods, and Outcomes of Adolescent Sexual Health Promotion in School Environments: A Scoping Review . THE JOURNAL OF SCHOOL HEALTH 2024; 94:184-199. [PMID: 37723616 DOI: 10.1111/josh.13393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/28/2023] [Accepted: 08/29/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Schools play a significant role in adolescent sexual health (SH) promotion. Although adolescents' SH has improved, growing challenges still exist in some areas. Previous studies have noted a lack of knowledge about SH promotion implementation in school environments. The purpose of this review is to describe the contents, methods, and outcomes of adolescent SH promotion in school environments. METHODS Three databases (Cinahl, ERIC, Medline) were searched for peer-reviewed articles published in 2011 to 2022, to identify SH promotion in school environments for adolescents aged 12 to 19 years old. After critical appraisal, inductive content analysis was conducted. RESULTS After screening, 25 studies from 8 countries were included. Sexually transmitted diseases and contraception were emphasized in the contents of the methods. Five SH promotion methods were identified: traditional, virtual, interactive, practical skills supporting, and creative. The outcomes were advancement in SH abilities, changes in sexual behavior, and the strengthening of sexual identity. CONCLUSIONS The contents mostly considered negative consequences of sexual behavior, whereas positive aspects were less discussed. Traditional methods were emphasized, yet positive outcomes were identified regardless of the method. SH promotion should aim to better support adolescents' sexual identity reinforcement.
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Affiliation(s)
- Lotta Jämiä
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
| | - Niina Piispanen
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
| | - Jari Kylmä
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
| | - Elina Haavisto
- Faculty of Social Sciences, Health Sciences, Tampere University; Nurse Director (part-time), Tampere University Hospital, Tampere, Finland
| | - Eeva Harju
- Department of Surgery, Tampere University Hospital; Senior Research Fellow, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Clarke R, Heath G, Ross J, Farrow C. Interventions supporting engagement with sexual healthcare among people of Black ethnicity: a systematic review of behaviour change techniques. Sex Health 2024; 21:NULL. [PMID: 38163758 DOI: 10.1071/sh23074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Black ethnic groups are disproportionately affected by sexually transmitted infections (STIs). This review aimed to identify interventions designed to increase engagement with sexual healthcare among people of Black ethnicity as determined by rates of STI testing, adherence to sexual health treatment, and attendance at sexual healthcare consultations. The behaviour change techniques (BCTs) used within identified interventions were evaluated. METHOD Four electronic databases (Web of science; ProQuest; Scopus; PubMed) were systematically searched to identify eligible articles published between 2000 and 2022. Studies were critically appraised using the Mixed Methods Appraisal Tool. Findings were narratively synthesised. RESULTS Twenty one studies across two countries were included. Studies included randomised controlled trials and non-randomised designs. Behavioural interventions had the potential to increase STI/HIV testing, sexual healthcare consultation attendance and adherence to sexual health treatment. Behavioural theory underpinned 16 interventions which addressed barriers to engaging with sexual healthcare. Intervention facilitators' demographics and lived experience were frequently matched to those of recipients. The most frequently identified novel BCTs in effective interventions included information about health consequences, instruction on how to perform behaviour, information about social and environmental consequences, framing/reframing, problem solving, and review behavioural goal(s). DISCUSSION Our findings highlight the importance of considering sociocultural, structural and socio-economic barriers to increasing engagement with sexual healthcare. Matching the intervention facilitators' demographics and lived experience to intervention recipients may further increase engagement. Examination of different BCT combinations would benefit future sexual health interventions in Black ethnic groups.
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Affiliation(s)
- Rebecca Clarke
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Gemma Heath
- School of Psychology, Aston University, Birmingham, UK
| | - Jonathan Ross
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Claire Farrow
- School of Psychology, Aston University, Birmingham, UK
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Mohamed S, Chipeta MG, Kamninga T, Nthakomwa L, Chifungo C, Mzembe T, Vellemu R, Chikwapulo V, Peterson M, Abdullahi L, Musau K, Wazny K, Zulu E, Madise N. Interventions to prevent unintended pregnancies among adolescents: a rapid overview of systematic reviews. Syst Rev 2023; 12:198. [PMID: 37858208 PMCID: PMC10585784 DOI: 10.1186/s13643-023-02361-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 09/25/2023] [Indexed: 10/21/2023] Open
Abstract
Risks associated with unintended pregnancy include unsafe abortions, poor maternal health-seeking behaviour, poor mental health, and potentially, maternal and infant deaths. Adolescent girls with unintended pregnancies are particularly vulnerable as they are at higher risk of eclampsia, premature onset of labour, and increased neonatal morbidity and mortality. Unintended pregnancy, with the right combination of interventions, can be avoided. Evidence-based decision-making and the need for a robust appraisal of the evidence have resulted in many systematic reviews. This review of systematic reviews focuses on adolescent pregnancy prevention and will seek to facilitate evidence-based decision-making. Two review authors independently extracted data and assessed the methodological quality of each review according to the AMSTAR 2 criteria. We identified three systematic reviews from low- and middle-income countries and high-income counties and included all socioeconomic groups. We used vote counting and individual narrative review summaries to present the results. Overall, skill-building, peer-led and abstinence programmes were generally effective. Interventions focused on information only, counselling and interactive sessions provided mixed results.In contrast, exposure to parenting and delaying sexual debut interventions were generally ineffective. Adolescent pregnancy prevention interventions that deploy school-based primary prevention strategies, i.e. strategies that prevent unintended pregnancies in the first place, may effectively reduce teenage pregnancy rates, improve contraceptive use, attitudes and knowledge, and delay sexual debut. However, the included studies have methodological issues, and our ability to generalise the result is limited.
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Affiliation(s)
- Sahra Mohamed
- African Institute for Development Policy (AFIDEP), 13/41 Presidential Way, Public Service Pension Fund Building, P.O Box 31024, Lilongwe, Malawi
| | - Michael G Chipeta
- African Institute for Development Policy (AFIDEP), 13/41 Presidential Way, Public Service Pension Fund Building, P.O Box 31024, Lilongwe, Malawi.
| | | | - Lomuthando Nthakomwa
- African Institute for Development Policy (AFIDEP), 13/41 Presidential Way, Public Service Pension Fund Building, P.O Box 31024, Lilongwe, Malawi
| | - Chimwemwe Chifungo
- African Institute for Development Policy (AFIDEP), 13/41 Presidential Way, Public Service Pension Fund Building, P.O Box 31024, Lilongwe, Malawi
| | - Themba Mzembe
- African Institute for Development Policy (AFIDEP), 13/41 Presidential Way, Public Service Pension Fund Building, P.O Box 31024, Lilongwe, Malawi
| | - Ruth Vellemu
- African Institute for Development Policy (AFIDEP), 13/41 Presidential Way, Public Service Pension Fund Building, P.O Box 31024, Lilongwe, Malawi
| | - Victor Chikwapulo
- African Institute for Development Policy (AFIDEP), 13/41 Presidential Way, Public Service Pension Fund Building, P.O Box 31024, Lilongwe, Malawi
| | - Maame Peterson
- African Institute for Development Policy (AFIDEP), 13/41 Presidential Way, Public Service Pension Fund Building, P.O Box 31024, Lilongwe, Malawi
| | - Leyla Abdullahi
- African Institute for Development Policy (AFIDEP), 13/41 Presidential Way, Public Service Pension Fund Building, P.O Box 31024, Lilongwe, Malawi
| | - Kelvin Musau
- The Children's Investment Fund Foundation, Nairobi, Kenya
| | - Kerri Wazny
- The Children's Investment Fund Foundation, London, UK
| | - Eliya Zulu
- African Institute for Development Policy (AFIDEP), 13/41 Presidential Way, Public Service Pension Fund Building, P.O Box 31024, Lilongwe, Malawi
| | - Nyovani Madise
- African Institute for Development Policy (AFIDEP), 13/41 Presidential Way, Public Service Pension Fund Building, P.O Box 31024, Lilongwe, Malawi
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5
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Abrams R, Nordmyr J, Forsman AK. Promoting sexual health in schools: a systematic review of the European evidence. Front Public Health 2023; 11:1193422. [PMID: 37469692 PMCID: PMC10352496 DOI: 10.3389/fpubh.2023.1193422] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction Sexual ill-health is an urgent public health issue with subsequent social and economic costs. There is, therefore, a need for more effective sexual health promotion interventions in an early stage of life. Previous research has focused on preventive sexual health interventions applying a risk perspective, and the limited and scattered evidence concerning school-based sexual health promotion interventions employing a health-resource perspective has not been compiled and synthesized. Hence, this study aimed to systematically review the current evidence on the effects of sexual health promotion interventions conducted in schools in Europe. Method A systematic review based on the JBI and PRISMA standards was performed, encompassing searches in seven databases to identify sexual health promotion interventions conducted in European schools between 2012 and 2022. Data coding was performed according to a predetermined protocol and included information on study characteristics, intervention content, methods, and outcomes relevant to the current review. A narrative synthesis of the included studies was performed, highlighting the collective results. Result Seventeen records were included in the review, reporting on 16 individual studies conducted in 7 European countries. Of the 16 included studies, 13 had a quantitative research design, and three had a qualitative design. All three studies with a qualitative research design described positive effects experienced by the participants. Six of thirteen quantitative studies showed statistically significant positive effects on at least one of the outcomes of interest. The outcomes of interest were grouped into five areas, and most studies focused on the area of attitudes toward sexual health. Conclusion The findings indicate promising evidence of effect for interventions with a health promotion approach, highlighting the importance of strengthening sexual health resources related to respect, communication skills, attitudes, and other positive psycho-social aspects of sexual health. Most sexual health promotion intervention studies have focused on sexual health resource outcomes connected to attitudes and skills, whereas a comprehensive focus on the multi-dimensional sexual health literacy concept is less common and can be recommended to be included in future intervention research.
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Kachingwe ON, Lewis Q, Offiong A, Smith BD, LoVette A, Powell TW. Using the intervention mapping for adaption framework to adapt an evidence-based sexual health intervention for youth affected by trauma. BMC Public Health 2023; 23:1052. [PMID: 37264451 PMCID: PMC10233545 DOI: 10.1186/s12889-023-15984-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Children exposed to household challenges (i.e., parental substance use, incarceration, and mental illness) are among the groups most vulnerable to sexual risk-taking in adolescence. These behaviors have been associated with a range of negative outcomes later in life, including substance abuse, low educational attainment, and incarceration. Adapting an evidence-based intervention (EBI) to be suitable for this population is one strategy to address the needs of this group. METHODS In this study, we describe the use of the Intervention Mapping for Adaption (IM-Adapt) framework to adapt an evidence-based, sexual health intervention (Focus on Youth with Informed Children and Parents). We describe the actions taken at each step of the IM-Adapt process which are to assess needs, search for EBIs, assess fit and plan adaptions, make adaptions, plan for implementation and plan for evaluation. RESULTS Key changes of the adapted intervention include the incorporation of trauma-informed principles and gender inclusive language, standardization of the session length, and modernization of the content to be more appropriate for our priority population. CONCLUSIONS The adapted intervention shows promise toward meeting the behavioral health needs of Black youth exposed to household challenges. Our process and approach can serve as a model for researchers and practitioners aiming to extend the reach of EBIs.
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Affiliation(s)
- Olivia N Kachingwe
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Quiana Lewis
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Asari Offiong
- Child Trends, Washington, DC, United States of America
| | - Bianca D Smith
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Ashleigh LoVette
- College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Terrinieka W Powell
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
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Robbins T, Szucs LE, Trujillo L, Young E. AIDS or HIV Education and Sexual Behaviors Among Adolescent Sexual Minority Males: National HIV Behavioral Surveillance, 3 U.S. Cities, 2015. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:201-212. [PMID: 37410370 PMCID: PMC11057022 DOI: 10.1521/aeap.2023.35.3.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
In the U.S., HIV transmission rates have increased among male-male sexual contacts. Sex education reduces HIV-related risks; yet impacts for adolescent sexual minority males (ASMM) are less known. Data from a sample (n = 556) of ASMM (aged 13-18) in three U.S cities were used to examined associations between HIV education in school and sexual behaviors. Outcomes of interest included: sexually transmitted infection (STI), multiple sex partners, and condomless anal intercourse (CAI) with a male (all past 12 months). Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were calculated. Of 556 ASMM, 84% reported received HIV education. Among sexually active ASMM (n = 440) who received HIV education, fewer reported an STI (10% vs. 21%, aPR: 0.45, CI [0.26, 0.76]) and CAI (48% vs. 64%, aPR: 0.71, CI [0.58, 0.87]) than ASMM who did not receive HIV education. Protective effects of school HIV education on sexual behaviors are promising and suggest prevention education is vital to reducing HIV- and STI-related risks among ASMM.
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Affiliation(s)
- Taylor Robbins
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Leigh E Szucs
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta
| | - Lindsay Trujillo
- ICF International, Fairfax, Virginia. Emily Young is also affiliated with the Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Emily Young
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta
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Woolweaver AB, Drescher A, Medina C, Espelage DL. Leveraging Comprehensive Sexuality Education as a Tool for Knowledge, Equity, and Inclusion. THE JOURNAL OF SCHOOL HEALTH 2023; 93:340-348. [PMID: 36404494 DOI: 10.1111/josh.13276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/21/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sexual education programs in the United States are rooted in inequitable structures and are often inadequate at educating marginalized student groups such as students of color, Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+), women, and disabled students. CONTRIBUTIONS TO THEORY Current sexual education is irregularly implemented and often excludes or misrepresents the experiences of students with marginalized identities. This theoretical paper specifically discusses ways that sexual education has been harmful or exclusionary for marginalized student groups and how a shift toward making sexual education inclusive and equitable will improve outcomes for students of all identities. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY This paper discusses several recommendations on improving access to equitable sexual health education for all students including reviewing and improving sexual education curriculum and delivery, as well as the need for additional research focused on this topic. CONCLUSIONS This article provides an overview on the current sexual education system, its inadequacies, and how comprehensive sexuality education programs can be leveraged as a tool for equity for students of all backgrounds, but particularly those who are underrepresented in sexual education curricula.
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Affiliation(s)
- Ashley B Woolweaver
- School of Education, University of North Carolina at Chapel Hill, 100 East Cameron Avenue, Chapel Hill, NC 7514-3916, USA
| | - Anne Drescher
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Courtney Medina
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Chernick LS, Konja A, Gonzalez A, Stockwell MS, Ehrhardt A, Bakken S, Westhoff CL, Dayan PS, Santelli J. Designing illustrative social media stories to promote adolescent peer support and healthy sexual behaviors. Digit Health 2022; 8:20552076221104660. [PMID: 35707267 PMCID: PMC9189520 DOI: 10.1177/20552076221104660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 05/14/2022] [Indexed: 12/31/2022] Open
Abstract
Objective Adolescent females in the United States continue to have unmet sexual and reproductive healthcare needs. Research shows that interventions incorporating peer support can augment perceived self-efficacy and reinforce healthy behaviors. Yet, few user-centered digital sexual health interventions incorporate peer support, and aim to change perceptions of peer norms and model social skills. The objective of this study was to design and demonstrate the receptivity of adolescent females to illustrated digital social media stories that promote healthy sexual behaviors and peer social support. Methods We conducted a three-phase study approved by our Institutional Review Board. In Phase 1, we presented sexually active adolescent female emergency department patients aged 14-19 with eight sexual health scenarios via a survey study. Participants wrote three text messages addressed to the protagonist of each scenario which motivated and encouraged her to consider the use of contraceptives. Messages were scored based on the construct of peer support (emotional, tangible, informational, and belonging). In Phase 2, we worked with a professional artist and screenwriter to design digital sexual health comics using the gathered messages. In Phase 3, we gathered feedback on the comics from adolescent female emergency department patients. Results Females (n = 22) provided 352 messages. Using top rated messages, we designed five digital visualizations in a running story called Mari tells it like it is. Each story incorporated 5-12 peer-authored quotes. We inserted the final images into Instagram®. Additional females (n = 39) found the images "relatable," "super-realistic," and "educational." Conclusion Collecting peer-authored texts from our local adolescent community led to the creation of well-received sexual health visualizations. This novel method of design incorporated adolescent voices to promote peer support and healthy behaviors.
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Affiliation(s)
- Lauren S Chernick
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University Medical Center, New York, NY, USA,Lauren S Chernick, Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University Medical Center, 3959 Broadway, CHN 1-116, New York, NY, USA.
| | - Alexis Konja
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Ariana Gonzalez
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University Medical Center, New York, NY, USA
| | - Melissa S Stockwell
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA,Department of Child and Adolescent Health, Columbia University Medical Center, New York, NY, USA
| | - Anke Ehrhardt
- Department of Psychology, Columbia University Medical Center, New York, NY, USA
| | - Susanne Bakken
- Department of Nursing and Bioinformatics, Columbia University Medical Center, New York, NY, USA
| | - Carolyn L Westhoff
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA,Department of Obstetrics-Gynecology, Columbia University Medical Center, New York, NY, USA
| | - Peter S Dayan
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University Medical Center, New York, NY, USA
| | - John Santelli
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA,Department of Child and Adolescent Health, Columbia University Medical Center, New York, NY, USA
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10
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Kamke K, Stewart JL, Widman L. Multilevel Barriers to Sexual Health Behavior Among Vulnerable Adolescent Girls in the USA. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 19:822-833. [PMID: 36212514 PMCID: PMC9542138 DOI: 10.1007/s13178-021-00594-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/23/2021] [Indexed: 06/03/2023]
Abstract
Introduction Most sexual health interventions focus on individual-level predictors of sexual behavior. Given the considerable influence of environmental factors on adolescent girls' sexual health, current interventions may be insufficient to promote safer sex. In this study, we aimed to understand adolescent girls' anticipated barriers to engaging in safer sex behavior after completing a brief, web-based sexual health intervention called HEART. Methods This study used qualitative interviews with 50 adolescent girls who were recruited from community-based organizations that serve vulnerable youth. All participants were 12 to 19 years old (mean age=15.62, SD=1.83), and identified with a marginalized racial/ethnic group (58% Black; 18% Latinx; 24% Asian, biracial, or multiracial). Further, 24% identified as LGBTQ+, and 58% were sexually active. Results Guided by the social ecological model, we delineate six unique barriers to safer sex discussed by adolescents: partner manipulation, slut shaming, unclear sexual values, present time orientation, embarrassment, and access to sexual and reproductive health services. Discussion We conclude with recommendations for addressing these barriers to optimize adolescent girls' sexual health.
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Affiliation(s)
- Kristyn Kamke
- Department of Psychology, North Carolina State University, Raleigh, NC, USA
| | - J. L. Stewart
- Department of Psychology, North Carolina State University, Raleigh, NC, USA
| | - Laura Widman
- Department of Psychology, North Carolina State University, Raleigh, NC, USA
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Chaves AFL, Tavares TT, Costa EC, Maciel NDS, Ferreira DDS, Martins FVDA, Costa CCD. Conhecimento, atitude e prática de universitários intercambistas africanos acerca das Infecções Sexualmente Transmissíveis. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0455pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo avaliar o conhecimento, a atitude e a prática de universitários intercambistas provenientes do continente africano acerca das Infecções Sexualmente Transmissíveis. Método estudo transversal, realizado de dezembro de 2019 a março de 2020, em universidade pública internacional brasileira localizada no Ceará. A amostra foi constituída por 150 estudantes africanos de diferentes cursos de graduação. Utilizou-se do inquérito de Conhecimento, Atitude e Prática. Resultados os universitários apresentaram conhecimento satisfatório acerca da forma de transmissão das Infecções Sexualmente Transmissíveis, porém, com deficiências a respeito das hepatites virais. Identificou-se associação entre sexo e atitude acerca do uso de preservativo em relação sexual com parceria fixa (p=0,042). No que se refere às práticas, houve associação entre sexo e uso do preservativo na primeira relação sexual (p=0,001), ter mais que um parceiro (p=0,001) e mais que dez parceiros em toda a vida (0,007). No que se relaciona às práticas sexuais nos últimos 12 meses, observou-se associação estatística entre ter relações sexuais com mais de um parceiro sexual e sexo do participante (p=0,001). Conclusão e implicações para a prática enfatiza-se a importância de a universidade pesquisada realizar atividades de educação em saúde que abordem Infecções Sexualmente Transmissíveis, bem como de extensão universitária, que envolvam alunos imigrantes africanos.
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Affiliation(s)
| | | | - Edmara Chaves Costa
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Brasil
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12
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Chaves AFL, Tavares TT, Costa EC, Maciel NDS, Ferreira DDS, Martins FVDA, Costa CCD. Knowledge, attitude and practice of African university exchange students about Sexually Transmitted Infections. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0455en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective to evaluate the knowledge, attitude and practice of university exchange students from the African continent about Sexually Transmitted Infections. Method a cross-sectional study, conducted from December 2019 to March 2020, in a public international Brazilian university located in Ceará. The sample consisted of 150 African students from different undergraduate courses. It was used the survey of Knowledge, Attitude and Practice. Results the students showed satisfactory knowledge about the form of transmission of Sexually Transmitted Infections, however, with deficiencies regarding viral hepatitis. An association between sex and attitude about condom use in sexual intercourse with a fixed partner was identified (p=0.042). Regarding the practices, there was an association between sex and condom use in the first sexual relation (p=0.001), having more than one partner (p=0.001) and more than ten partners in the whole life (0.007). Regarding sexual practices in the last 12 months, there was a statistical association between having sex with more than one sexual partner and the participant's sex (p=0.001). Conclusion and implications for practice the importance of the university researched carrying out health education activities that address Sexually Transmitted Infections, as well as university extension activities that involve African immigrant students, is emphasized.
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Affiliation(s)
| | | | - Edmara Chaves Costa
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Brasil
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13
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Abboud S, Flores D, Redmond L, Brawner BM, Sommers MS. Sexual attitudes and behaviours among Arab American young adults in the USA. CULTURE, HEALTH & SEXUALITY 2021; 23:1591-1607. [PMID: 32744471 DOI: 10.1080/13691058.2020.1788163] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
While the sexual behaviours of different racial and ethnic groups have been studied extensively in the USA, Arab Americans are relatively understudied. The purpose of our study is to describe sexual attitudes and behaviours of Arab American young adults, to explore gender differences and the factors associated with five primary sexual behaviours (solo and partnered masturbation, oral, vaginal and anal sex). We conducted a cross-sectional quantitative study using a self-administered survey, which included measures of Arab ethnic identity, religiosity and sexual attitudes and behaviours. The survey was completed by 100 Arab American young adults (18-25 years old). Almost half of the sample reported being engaged in at least one of the five primary sexual behaviours in the past six months. In bivariate analysis, there were significant gender differences in sexual attitudes and all the primary sexual behaviours except for anal sex. Sexual attitudes and religiosity were significant predictors of partnered masturbation, oral and vaginal sex. Our findings challenge Arab societal assumptions that unmarried Arab American young adults do not engage in sexual behaviours, including risky behaviours, warranting further research to prevent unintended sexual health outcomes.
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Affiliation(s)
- Sarah Abboud
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Dalmacio Flores
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Leni Redmond
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, College of Nursing, Chicago, IL, USA
| | - Bridgette M Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Marilyn S Sommers
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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Brown E, Lo Monaco S, O’Donoghue B, Nolan H, Hughes E, Graham M, Simmons M, Gray R. Improving the Sexual Health of Young People (under 25) in High-Risk Populations: A Systematic Review of Behavioural and Psychosocial Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179063. [PMID: 34501652 PMCID: PMC8430747 DOI: 10.3390/ijerph18179063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022]
Abstract
Background: Ensuring young people experience good sexual health is a key public health concern, yet some vulnerable groups of young people remain at higher risk of poor sexual health. These individuals require additional support to achieve good sexual health but the best way to provide this remains needs to be better understood. Methods: We searched for randomised controlled trials of behavioural and psychosocial interventions aimed at promoting sexual health in high-risk young populations. Outcomes of interest were indicators of sexual health (e.g., condom use, attitudes to contraception, knowledge of risk). Participants were under 25 years old and in one of the following high-risk groups: alcohol and other drug use; ethnic minority; homeless; justice-involved; LGBTQI+; mental ill-health; or out-of-home care. Results: Twenty-eight papers from 26 trials met our inclusion criteria, with all but one conducted in North America. Condom use was the most frequently reported outcome measure along with knowledge and attitudes towards sexual health but considerable differences in measures used made comparisons across studies difficult. Change in knowledge and attitudes did not consistently result in long-term change in behaviours. Conclusions: There remains a dearth of research undertaken outside of North America across all high-risk groups of young people. Future interventions should address sexual health more broadly than just the absence of negative biological outcomes, with LGBTQI+, homeless and mental ill-health populations targeted for such work. An international consensus on outcome measures would support the research field going forward, making future meta-analyses possible.
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Affiliation(s)
- Ellie Brown
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; (S.L.M.); (B.O.); (H.N.); (M.S.)
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052, Australia
- Correspondence: ; Tel.: +61-3-9966-9100
| | - Samantha Lo Monaco
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; (S.L.M.); (B.O.); (H.N.); (M.S.)
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052, Australia
| | - Brian O’Donoghue
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; (S.L.M.); (B.O.); (H.N.); (M.S.)
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052, Australia
| | - Hayley Nolan
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; (S.L.M.); (B.O.); (H.N.); (M.S.)
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052, Australia
| | - Elizabeth Hughes
- School of Healthcare University of Leeds, Woodhouse, Leeds LS2 9JT, UK;
| | - Melissa Graham
- College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3086, Australia; (M.G.); (R.G.)
| | - Magenta Simmons
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; (S.L.M.); (B.O.); (H.N.); (M.S.)
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052, Australia
| | - Richard Gray
- College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3086, Australia; (M.G.); (R.G.)
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15
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Voisin DR, Takahashi LM. The Relationship Between Violence Syndemics and Sexual Risk Behaviors Among African American Adolescents: Implications for Future Research. J Adolesc Health 2021; 68:937-944. [PMID: 33431249 DOI: 10.1016/j.jadohealth.2020.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/28/2020] [Accepted: 11/15/2020] [Indexed: 01/20/2023]
Abstract
PURPOSE We present a conceptual framework based on a review of the literature to highlight the interconnecting and reinforcing elements of a violence syndemic and how this syndemic influences sexual risk behaviors among African American heterosexual adolescents. METHODS We review existing peer-reviewed published research from 2000 to 2020 that links a violence syndemic (i.e., racism and race-related stress, neighborhood and police violence, peer violence, and family violence and disruptions) to adolescent sexual risk behaviors. Empirical findings and theoretical underpinnings are used to document this relationship and illuminate the factors that mediate this relationship. RESULTS Empirical studies support the links between specific types of violence and sexual risk behaviors among African American adolescents. Further, existing studies point to the important relationships among the specific types of violence, supporting a violence syndemic approach. CONCLUSIONS While more researchers are examining socio-ecological contextual factors as important predictors for sexual risk behaviors, there remains inadequate understanding about how violence types reinforce one another to heighten sexual risk behaviors among African American heterosexual adolescents. This article presents new directions for adolescent research, especially how a violence syndemic approach can be used to explain sexual risk, but also to refocus intervention design on the complex burdens experienced by this population.
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Affiliation(s)
- Dexter R Voisin
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
| | - Lois M Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, California.
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16
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Davis T, DiClemente RJ, Prietula M. Using ADAPT-ITT to Modify a Telephone-Based HIV Prevention Intervention for SMS Delivery: Formative Study. JMIR Form Res 2020; 4:e22485. [PMID: 32831178 PMCID: PMC7576465 DOI: 10.2196/22485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/18/2020] [Accepted: 08/23/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND African American adolescent females are disproportionately affected by sexually transmitted infections (STIs) and HIV. Given the elevated risk of STIs and HIV in African American women, there is an urgent need to identify innovative strategies to enhance the adoption and maintenance of STI and HIV preventive behaviors. Texting is a promising technology for creating preventive maintenance interventions (PMIs) that extend the efficacy of the original intervention. However, little guidance in public health literature is available for developing this type of application. OBJECTIVE This paper describes a formative pilot study that incorporates user experience methods to design and test PMI texts for Afiya, an original evidence-based intervention (EBI) specifically designed for African American adolescent females. This study aims to describe the adaptation process of health educator-led phone calling to text-based communication. METHODS The formative process followed the assessment, decision, adaptation, production, topical experts-integration, training, testing (ADAPT-ITT) framework for adapting EBIs and using them in a new setting, for a new target population or a modified intervention strategy. This study presents the details of how the phases of the ADAPT-ITT framework were applied to the design of the adaptation. An advisory board was constituted from the target population, consisting of 6 African American women aged 18-24 years, participating in formative activities for 12 weeks, and involving components of the PMI design. As Afiya included a telephone-based PMI, developers of the original Afiya phone scripts crafted the initial design of the SMS-based texts and texting protocol. The advisory board participated in the 1-day Afiya workshop, followed by 4 weeks of texting PMI messages and a midcourse focus group, followed by 4 more weeks of texting PMI messages, ultimately ending with a final focus group. At the advisory board's request, this phase included an optional, additional week of text-based PMI messages. RESULTS The methods provided a rich source of data and insights into the fundamental issues involved when constructing SMS-based PMI for this target population and for this EBI. Prior contact and context are essential as the health educator was identified as a key persona in the process and the messages were situated in the original (workshop) context. Narrative adaptations for personas emerged from advisory board discussions. Suggestions on how to expand the PMI to current, specific social contexts indicated that the use of narrative analysis is warranted. CONCLUSIONS The use of existing EBIs incorporating telephone-based PMI scripts facilitated the initial design of the texts, with a subsequent narrative analysis of the advisory board data providing additional adjustments given the actual context. Additional examination of the advisory board feedback revealed that personas would offer insight into and opportunities for a persona-specific modification of texting narratives.
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Affiliation(s)
- Teaniese Davis
- Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA, United States
| | - Ralph Joseph DiClemente
- Department of Social & Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Michael Prietula
- Goizueta Business School & Hubert Department of Global Health, Emory University, Atlanta, GA, United States
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Evans R, Widman L, Javidi H, Adams ET, Cacace S, Prinstein MJ, Desmarais SL. Preliminary Evaluation of a Prescription Opioid Misuse Prevention Program Among Rural Middle School Students. J Community Health 2020; 45:1139-1148. [PMID: 32785872 DOI: 10.1007/s10900-020-00899-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Adolescent opioid misuse, addiction, and overdose have emerged as national health crises. Nearly 17% of high school students have misused prescription opioids. The purpose of this study was to evaluate the reach and acceptability of a widely-used prescription opioid misuse prevention program, This Is (Not) About Drugs© (TINAD), and its preliminary efficacy at improving opioid misuse knowledge, opioid misuse attitudes, self-efficacy to avoid opioid misuse, and intentions to misuse opioids. Participants were 576 7th grade students (Mage = 11.8; 51% boys; 39% Hispanic, 31% White, 20% Black) from a rural county in the southeastern U.S. All participants received the TINAD program and completed pretest and immediate posttest assessments. The program was school-based and implemented in collaboration with school teachers and administrators. Over 91% of all eligible students in the school district participated in the TINAD program. Most participants found the program acceptable-over 83% of students liked the program. Approximately 9% of participants reported prior misuse of prescription opioids. After participating in TINAD, students self-reported higher knowledge and self-efficacy as well as safer attitudes. However, there was no change in intentions to misuse opioids in the future. Effects of the program were consistent across gender, socioeconomic status, race/ethnicity, and previous opioid misuse. TINAD is acceptable and shows promise for improving opioid-related cognitions. However, more rigorous experimental and longitudinal research is needed to understand whether TINAD reduces opioid misuse over time. Given the limited research on adolescent opioid misuse prevention, this study lays the ground work for future randomized control trials.
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Affiliation(s)
- Reina Evans
- Department of Psychology, North Carolina State University, 640 Poe Hall, Campus Box 7650, Raleigh, NC, 27695, USA.
| | - Laura Widman
- Department of Psychology, North Carolina State University, 640 Poe Hall, Campus Box 7650, Raleigh, NC, 27695, USA
| | - Hannah Javidi
- Department of Psychology, North Carolina State University, 640 Poe Hall, Campus Box 7650, Raleigh, NC, 27695, USA
| | - Elizabeth Troutman Adams
- School of Journalism and Media, University of North Carolina at Chapel Hill, Carroll Hall, CB 3365, Chapel Hill, NC, 27599, USA
| | - Sam Cacace
- Center for Family and Community Engagement, North Carolina State University, 2700 Katharine Stinson Dr., Raleigh, NC, 27695, USA
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, 240 Davie Hall, Campus Box 3270, Chapel Hill, NC, 27599, USA
| | - Sarah L Desmarais
- Department of Psychology, North Carolina State University, 640 Poe Hall, Campus Box 7650, Raleigh, NC, 27695, USA
- Center for Family and Community Engagement, North Carolina State University, 2700 Katharine Stinson Dr., Raleigh, NC, 27695, USA
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Evans R, Widman L, Stokes M, Javidi H, Hope E, Brasileiro J. Sexual Health Programs for Latinx Adolescents: A Meta-analysis. Pediatrics 2020; 146:peds.2019-3572. [PMID: 32522785 DOI: 10.1542/peds.2019-3572] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2020] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Latinx adolescents are at risk for negative sexual health outcomes, and many interventions have been developed to reduce this risk. OBJECTIVE In this meta-analysis, we synthesized the literature on sexual health interventions for Latinx adolescents and examined intervention effects on 3 behavioral outcomes (abstinence, condom use, number of sex partners) and 3 psychological outcomes (safer sex knowledge, intentions, self-efficacy). Moderators of intervention success were explored. DATA SOURCES A systematic search of studies published through January 2019 was conducted by using PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature databases. STUDY SELECTION All studies included a US-based sample of Latinx adolescents, evaluated sexual health intervention by using an experimental or quasiexperimental design, included a behavioral outcome, and were in English. DATA EXTRACTION Standardized mean difference (d) and 95% confidence intervals (CIs) were meta-analyzed by using random-effects models. RESULTS Effect sizes from 12 studies, sampling 4673 adolescents, were synthesized. Sexual health interventions improved abstinence (d = 0.15, 95% CI: 0.02 to 0.28), condom use (d = 0.44, 95% CI: 0.18 to 0.70), number of sex partners (d = -0.19, 95% CI: -0.37 to -0.001), and sexual health knowledge (d = 0.40, 95% CI: 0.10 to 0.70), compared with control conditions. Effects were consistent across a number of demographic and clinical characteristics, although culturally tailored interventions produced greater change in condom use than nontailored interventions. LIMITATIONS There was variation across studies in measures of sexual behavior, and some elements of individual study quality were unclear. CONCLUSIONS Sexual health interventions have a small but significant impact on improving safer sexual behavior among Latinx adolescents. Health educators should consider the importance of cultural tailoring to program success.
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Affiliation(s)
- Reina Evans
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | - Laura Widman
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | - McKenzie Stokes
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | - Hannah Javidi
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | - Elan Hope
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | - Julia Brasileiro
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
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Widman L, Evans R. Adolescent Sexual Health Interventions: Innovation, Efficacy, Cost, and the Urgent Need to Scale. Pediatrics 2020; 145:peds.2020-0392. [PMID: 32345684 DOI: 10.1542/peds.2020-0392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Laura Widman
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | - Reina Evans
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
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