A Social-Ecological Approach to Understanding Adolescent Sexting Behavior

Process evaluation of comprehensive sexuality education programme in Zambia: a focus on contextual factors, mechanisms of impact, quality of development and implementation process

BACKGROUND

Comprehensive sexuality education (CSE) is critical in addressing negative sexual and reproductive health (SRH) outcomes among adolescents. Yet in many low- and middle-income countries (LMICs) including Zambia, little is known about the impact, realities of CSE implementation, the quality of teaching and the comprehensiveness of the content covered.

METHODS

Our approach was informed by a process evaluation incorporating recommendations by the European Expert Group guidance on evaluating sexuality education programmes and the Medical Research Council (MRC) guidelines on process evaluation. The development process and quality of CSE implementation were assessed using eight and six quality criteria respectively. In-depth interviews (IDIs), focus group discussions (FGDs), document analysis and classroom observation were employed to assess contextual factors, implementation process and mechanisms of impact of CSE. In-depth interviews (50) and focus group discussions (2) with seven pupils in each group were conducted among 64 purposefully selected participants. The sample comprised pupils (35), parents (4) and teachers (17) from nine secondary schools (four peri-urban, four urban and one rural), policymakers (4), and religious leaders (4). We employed deductive content analysis to analyse the data.

RESULTS

Contextual factors that influenced the implementation of CSE included: (1) piecemeal funding for the CSE programme; (2) lack of monitoring programmes in schools; (3) lack of community engagement; (4) religious and socio-cultural barriers; (5) lack of skills and competency to teach CSE; and (6) insufficient time allocation for CSE. The assessment of the quality of the development of CSE revealed: (1) a lack of sexual diversity; (2) no meaningful participation of pupils in programme implementation; (3) a lack of stakeholder engagement during programme implementation; (4)  lack of gender sensitivity; and (5) lack of human rights approach. Assessment of the quality of the implementation of CSE revealed: (1) no evidence of skill-based CSE teaching; (2) no linkage between CSE and SRH services in the communities; and (3) a lack of incorporation of multiple delivery methods during CSE teaching. The mechanisms of impact of CSE were related to the acceptability and positive changes in pupils' SRH practices.

CONCLUSION

The complex influences of contextual factors during CSE implementation highlight the need for contextual analysis during the interventional design. Co-creation of the CSE programme through stakeholder participation could reduce social opposition and enable a culturally sensitive CSE. Comprehensive teacher training, a guiding curriculum as well as setting of appropriate monitoring tools and indicators are likely to enhance the quality of CSE implementation.

Experiences of a digital health intervention for young people exposed to technology assisted sexual abuse: a qualitative study

BACKGROUND

There is growing evidence that Technology Assisted Sexual Abuse (TASA) represents a serious problem for large numbers of children. To date, there are very few evidence-based interventions available to young people (YP) after they have been exposed to this form of abuse, and access to support services remains a challenge. Digital tools such as smartphones have the potential to increase access to mental health support and may provide an opportunity for YP to both manage their distress and reduce the possibility of further victimization. The current study explores the acceptability of a digital health intervention (DHI; the i-Minds app) which is a theory-driven, co-produced, mentalization-based DHI designed for YP aged 12-18 who have experienced TASA.

METHODS

Semi-structured interviews were conducted with 15 YP recruited through Child and Adolescent Mental Health Services, a Sexual Assault Referral Centre and an e-therapy provider who had access to the i-Minds app as part of a feasibility clinical trial. Interviews focused on the acceptability and usability of i-Minds and were coded to themes based on the Acceptability of Healthcare Interventions framework.

RESULTS

All participants found the i-Minds app acceptable. Many aspects of the app were seen as enjoyable and useful in helping YP understand their abuse, manage feelings, and change behavior. The app was seen as usable and easy to navigate, but for some participants the level of text was problematic and aspects of the content was, at times, emotionally distressing at times.

CONCLUSIONS

The i-Minds app is useful in the management of TASA and helping change some risk-related vulnerabilities. The app was designed, developed and evaluated with YP who had experienced TASA and this may account for the high levels of acceptability seen.

TRIAL REGISTRATION

The trial was registered on the ISRCTN registry on the 12/04/2022 as i-Minds: a digital intervention for young people exposed to online sexual abuse (ISRCTN43130832).

Estimating the Prevalence and Identifying the Correlates of Sexting Behaviors Among Cambodian Male Adolescents

Male youths are more likely to experience peer pressure that encourages them to engage in risky behaviors than female youths, and this pressure can lead to an increased risk of sexting among male youths. This study aimed to investigate the prevalence of and factors associated with sexting among Cambodian male youths. The correlational cross-sectional study design was utilized. This study surveyed 647 Cambodian male youths aged 15 to 24 years. The measurement included sending or receiving messages (sexts) that contain sexually explicit messages, images, or videos, and affecting factors to sexting. Around 32.5% of participants sent sexts, and 38.9% received them. Open relationships, pornographic website use, perception of friends' sexual activity, frequent thoughts about sex, higher sexual sensation-seeking tendencies, positive attitudes toward sex, and sexual experience were associated with increased likelihood of sending and receiving sexts. Based on the findings of this study, by offering suitable education, guidance, and intervention programs, we can effectively mitigate the adverse repercussions of sexting while fostering healthy sexual behaviors among youths.

Sexting Among Australian Adolescents: Risk and Protective Factors

Although consensual sending of sexts between adolescents is considered developmentally appropriate, it may also entail a range of negative consequences. Current sexting research lacks a comprehensive theoretical framework identifying a range of risk and protective factors underpinning adolescent consensual sending of sexts across individual, interpersonal, and distal levels. Further, there is a lack of systematic evaluation of how the importance of these factors may vary across adolescent age. This study investigated the utility of the Social Development Model to predict a range of risk and protective factors across individual, family, peer, school, and community-level factors. The sample included 1302 teenagers from Victoria, Australia (M_age = 14.54, SD = 1.14, 50.8% girls). Results indicated that 146 (11.7%) participants sent a sext (76 boys and 70 girls). Logistic regression analyses revealed that the Social Development Model accounted for 45.8% of variance in sexting, with greater likelihood of sending sexts being associated with older age, prior sexual activity, school sector, physical activity, lifetime substance use, greater depressive symptoms, sensation seeking, and perceived substance availability in the community. Multigroup analyses revealed that lifetime substance use was associated with a greater likelihood of sending sexts among younger teens. Among older adolescents, adaptive coping was associated with reduced engagement in sexting, while higher parental overcontrol and family conflict increased the odds of sending sexts. Overall, sexting is associated with a range of modifiable factors potentially amenable to intervention.

Evaluating Mentors in Violence Prevention: A Longitudinal, Multilevel Assessment of Outcome Changes

There is a need to increase understanding of the effectiveness of bystander programmes targeting gender-based violence in the United Kingdom. There is also a need to utilise a robust theoretical models of decision-making while doing so. Changes were examined in bystanders' attitudes, beliefs, motivations towards intervening, and intervention behavior in situations of gender-based violence. To achieve this, a quantitative examination of Mentors in Violence Prevention was conducted. There were 1396 participants (50% female, 50% male) who were aged 11 to 14 years old (M = 12.25, SD = 0.84) attending high school at the first time point. Participants were attending 17 schools (53% Mentors in Violence Prevention and 47% control) in Scotland. Outcome variables were assessed approximately one year apart using questionnaires. Multilevel linear regressions revealed that Mentors in Violence Prevention did not change outcomes reflecting bystanders' attitudes, beliefs, motivations towards intervening, or intervention behavior in gender-based violence. Discrepancies between the current findings and those of other evaluations may be due to other studies including small numbers of schools that may be more motivated to implement the program. This study also identified two key issues that need to be addressed at stakeholder level before concluding that Mentors in Violence Prevention is ineffective at targeting gender-based violence. That the program has moved towards a more gender-neutral approach in the United Kingdom could explain the null results of this study. Furthermore, the current findings could be attributed to a failure to adequately address the theoretical model underpinning the program in practice.

The experiences of practitioners working with young people exposed to online sexual abuse

Introduction

This qualitative study explored healthcare professionals' current understanding of, and clinical practices related to, Online Child Sexual Abuse (OCSA).

Methods

Data were collected across two UK sites (Manchester and Edinburgh). Interviews and one focus group were held with 25 practitioners working in services offering clinical support to young people who have experienced OCSA. Thematic analysis of the data identified three overarching themes and 10 subthemes related to the research questions: (1) the breadth of the problem; (2) working with OCSA; and (3) the emotionally charged nature of OCSA.

Results

While practitioners recognized OCSA as problematic, they differed in how they conceptualized it. There was a heightened awareness of the role that sexual images played in OCSA and concerns about first-person-produced imagery by Children and Young People (CYP). Practitioners described a generational gap related to their technology use and that of the young people they worked with. Practitioners also described a paucity of referral pathways and concerns that there was no training available to them. Organizational barriers meant that questions about technology use were not routinely included in assessments and often there was reliance on young people making disclosures.

Discussion

Novel findings from this study were the psychological impacts that such cases had on practitioners, which may indicate a need for organizational support for staff as well as further training needs. Existing frameworks that help conceptualize and assess the role of technology as part of the ecology of the child may have great utility for practitioners.

Evaluating the Mentors in Violence Prevention Program: A Process Examination of How Implementation Can Affect Gender-Based Violence Outcomes

Gender-based violence is a global public health issue and major human rights concern. It is also a type of violence that is disproportionately experienced by women and girls. This study is the first to examine multiple implementation process (dosage, fidelity, and adaptation) effects on changes in anticipated outcomes of a school-based bystander program targeting gender-based violence, Mentors in Violence Prevention (MVP). Data were collected from two participant groups: mentees (students receiving MVP) and mentors (students delivering MVP), across nine participating high schools. The mentee sample comprised 698 students (about 48.9% males and 49.7% females), aged 11 to 14 years old (M = 11.86, SD = 0.64). The mentor sample comprised 118 students (17.80% males, 82.20% females), aged 15 to 18 years old (M = 16.42, SD = 0.60). Anticipated outcomes were changes in bystanders' attitudes, social influences, control perceptions, intentions, willingness, and intervention behavior, measured using mentees' self-reports at two time points approximately 1 year apart. Implementation processes were measured using mentors' self-reports. Analyses revealed no effects for any of the implementation variables across changes in any of the outcomes measured. These results highlight important implications for the implementation of the MVP program going forward, given its widespread implementation in the United Kingdom. Possible ways that MVP may be enhanced in future are discussed. For example, furthering understanding into how gender-based violence and bystander intervention are addressed and framed during MVP lessons would give more insight into how the current implementation of the program can be improved to maximize its potential benefits.

What are the predictors of sexting behavior among adolescents? The positive youth development approach

INTRODUCTION

Research supporting adolescent sexual health and empowerment is needed. The study investigates sexting among adolescents using the resources that characterized the Positive Youth Development Approach (PYD) and considering the impact of parental monitoring. The study aims to describe sexting among three different groups of adolescents (i.e., Non Sexters [NS], Passive Sexters [PS], and Active Sexters [AS]) considering age and sex (first aim). It also seeks to identify predictors among the PYD's resources and parental monitoring that explain the probability of falling into the sexter or the non sexter groups (second aim) as well as the probability of falling into the active or the passive sexter groups (third aim).

METHOD

The national representative sample was composed of 1866 Italian adolescents: 980 girls and 886 boys aged between 13 and 19 years old (M = 16.26; SD = 1.49). Participants completed a questionnaire that measured sexting behavior, PYD resources, and parental monitoring scales. Chi-squared and multivariate logistic regressions were performed.

RESULTS

Almost half of the participants (46.0%) were NS, 36.2% were PS, and 17.8% were AS. Results show that sex, age, Connection, and Child Disclosure are significant predictors of sexting behavior.

CONCLUSIONS

Results highlighted that sexting can be seen as a relational activity that adolescents use to establish connections as part as their sexual exploration. A parenting approach that promotes disclosure may help adolescents explore safely their sexuality and be accountable. Results also indicate that parents need to build educational alliances with schools to promote sexual health and empowerment among teenagers while preventing risk of harm.