Pilot study in the development of an interactive multimedia learning environment for sexual health interventions: a focus group approach

A review of mobile health interventions for public private mix in tuberculosis care

BACKGROUND

The World Health Organization (WHO) recommends the use of mobile health (mHealth) technologies as emerging opportunities to closing the gaps in Tuberculosis (TB) care through enhancing Public Private Mix (PPM). However, little is known about mHealth interventions that have been used for enhancing PPM in TB care, those that worked and those that did not.

OBJECTIVE

This review summarizes the published evidence on the utilization and effectiveness of mHealth interventions for public private mix in TB care from literature.

METHODS

Google scholar, PUBMED, IEEE Xplore and ScienceDirect databases were searched for peer reviewed literature from 1st January 2003 to 31st December 2020 for studies about the mHealth interventions for public private mix in TB care. This was guided by the scoping review methodology proposed by Arksey and O' Malley. In order to assess the quality of the selected studies, mHealth evidence reporting and assessment (mERA) checklist was utilized. Studies that discussed the utilization of mHealth interventions for implementing PPM in TB care were included. Nine studies met the inclusion criteria and were analyzed for review.

RESULTS

The review found out the application of mHealth in Public Private Mix in TB care through the following ways; 1) TB screening, 2) TB case notification 3) TB treatment adherence 4) data collection and management 5) patient referral and follow up, and 6) education. This resulted into high user experience, significant time reduction in data aggregation, increased case notification and referrals and proactive tracking and provision of follow up care hence reduced treatment and completion gaps. One study yielded suboptimal utilization due to the technical and operational challenges encountered by the healthcare workers.

CONCLUSION

Although this scoping review highlights the role of mHealth technologies in enhancing PPM in TB care, its utilization is still limited in African settings. No Africa-based study was identified by this review. Future studies should focus on assessing the utilization of mHealth for PPM in Africa.

Children and young people's participation in developing interventions in health and well-being: a scoping review

BACKGROUND

Greater interest is being shown in participatory approaches, especially in research on interventions that concern children and young people's health and well-being. Although participatory approaches have user involvement in common, they differ in terms of the explicit guidance on how to actually involve and engage children and young people in health research. The aim of this scoping review was to systematically map recent research involving children and young people in the development of interventions targeting issues of health and well-being.

METHODS

An interpretative scoping literature review based on: a scientific literature search in (health and social science) databases, reference lists, a manual search in key journals and contact with existing networks was conducted. A total of 4458 references were identified through the literature search, of which 41 studies published between 2000 and 2017 were included in the review. The target population was children and young people under 25 years old. Level of participation was categorized according to Shier's Pathways to Participation Model.

RESULTS

The review showed that participatory approaches were most often used in the development of interventions in school settings and in community and healthcare settings and on issues concerning support in lifestyle or in managing illness or disease. The level of participation varied from children and young people taking part just as active informants, through stages of greater participation both in quantitative and qualitative terms, to children and young people becoming an active agent involved as a co-researcher where the research process was shaped by views of a higher level of mutuality. Most of the studies were categorised at a medium level and only three studies were judged to involve the children and young people at the highest level.

CONCLUSIONS

This scoping review showed that work remains in enabling children and young people to influence the development of interventions targeting health and well-being. In relation to level of sustainability in the interventions, it is relevant that goals, strategies and processes are formulated by those who can gain from the interventions. Participatory approaches aiming for a higher level of participation where children and young people work together with the researchers in partnerships are thus warranted.

Sexual health promotion for young people delivered via digital media: a scoping review

Background

Young people are at risk of poor sexual health and are, therefore, in need of comprehensive, effective sexual health education. Young people are confident and constant users of digital technology, such as the internet and mobile phones, and there are many innovative possibilities for sexual health education involving these technologies.

Objectives

To summarise evidence on effectiveness, cost-effectiveness and mechanism of action of interactive digital interventions (IDIs) for sexual health; optimal practice for intervention development; contexts for successful implementation; research methods for digital intervention evaluation; and the future potential of sexual health promotion via digital media.

Design

Literature review of evidence on digital interventions for sexual health for young people, integrating the findings with the views of young people, parents and experts in digital media/sexual health. IDIs are defined as digital media programmes that provide health information and tailored decision support, behaviour-change support and/or emotional support. We focus on sexual well-being for young people aged 13–24 years in the UK.

Results

There are many imaginative IDIs for sexual health promotion, but few interventions address issues that are important to young people, such as sexual pleasure and relationships. It is vital to collaborate with young people and to use Behaviour-Change Theory in designing interventions. We located 19 randomised controlled trials of IDIs for sexual health promotion for young people, finding a moderate effect on sexual health knowledge [standardised mean difference (SMD) 0.54, 95% confidence interval (CI) 0.17 to 0.92], a small effect on confidence (self-efficacy) (SMD 0.11, 95% CI 0.02 to 0.20) and a positive effect on sexual behaviour (odds ratio 1.28, 95% CI 1.01 to 1.61), but no significant effects on safer sex intention or biological outcomes. One study suggests that IDIs may be as good as face-to-face interventions for sexual health knowledge and safer sex intention. There are no existing data on the cost-effectiveness of IDIs for sexual health promotion. The impact of an IDI will be determined by the proportion of the target population reached, intervention efficacy, adoption in a setting, how well it is delivered and maintenance/sustainability. All of these elements must be addressed for IDIs to be successful. More collaboration is needed to capitalise on the knowledge of users and stakeholders, the design and software skills of the commercial sector and the theoretical expertise and evaluation skills of academia.

Conclusions

IDIs are effective for knowledge acquisition and sexual behaviour, and could usefully contribute to sexual health education in schools, in clinic settings and online; however, there are obstacles to overcome, such as access to information technology and ensuring the quality and safety of interventions.

Future work

More evidence is needed on the best designs for interventions (e.g. choice of behaviour-change mechanisms and interactive features) and the best models of delivery (e.g. setting, modes of delivery, methods of facilitation and support for engagement) to improve sexual behaviour, biological outcomes and sexual well-being in a cost-effective way.

Funding

The National Institute for Health Research Public Health Research programme.

Exploring the role of computers in sex and relationship education within British families

In this study, we aimed to identify the impact that computers can have in relation to sex and relationship education, as well as to provide a communication model that can be used within British families. We used a mixed-methods approach to explore the factors that influence communication of sexual matters within British families. Twenty families from the northeast of England were recruited through purposive sampling. First, semistructured interviews were conducted to identify how sexual matters were discussed within families. Interviews were recorded, transcribed verbatim, and then analyzed using the grounded theory approach. The second part of the research involved identifying the impact of using a computer program on knowledge and confidence within families to enhance communication about sexual matters. Although the majority of parents and their children were found to discuss sexual matters, the computer program was found to increase knowledge and confidence, which led to greater communication within families. The results highlighted the beneficial role that computer programs can have when educating and increasing communication within families. Future research needs to focus on improving access to information relating to sex and relationship education for parents so they can educate and talk openly about sexual matters with their children. A resource that does exactly this is www.safecoolsex.com.

Message framing with respect to decisions about vaccination: The roles of frame valence, frame method and perceived risk

People respond differently when information is framed either positively or negatively (frame valence). Two prominent models propose that the effects of valence are moderated by (1) the method of framing (attributes vs. goals: Levin, Schneider, & Gaeth, 1998) and (2) perceived risk (Rothman & Salovey, 1997). This experiment (N=200) explores the joint influence of both of these moderators with respect to decisions about a flu vaccination. The study extends previous work by integrating these two models and exploring the moderating effects of two different aspects of perceived risk (personal outcome effectiveness and procedural risk). The results show that personal outcome effectiveness indirectly links frames to intentions. Procedural risk moderates the relationship between valence and method in a manner consistent with predictions from Levin et al.. Partial support for the model proposed by Rothman and Salovey are observed for goal frames only.

Sexual dysfunction--a silent hurt: issues on treatment awareness

BACKGROUND

The magnitude of sexual health problems and availability of treatment options in the local environment is yet to be documented; thus, there is an urgent need for this, as sexual dysfunction may be a real social and psychological problem, needing urgent attention.

OBJECTIVE

The aim of this study was to investigate the prevalence of sexual dysfunction and pattern of sexual health seeking behavior, among secondary school teachers in Ilorin, Kwara State Nigeria.

METHODS

450 teachers were invited to complete an anonymous self-administered sociodemographic questionnaire, as well as three other instruments measuring human sexuality and general mental health status.

MAIN OUTCOME MEASURES

The survey instrument used were the International Index of Erectile Function (IIEF-5), a modified Sexual Activity Questionnaire (SAQ), and the General Health Questionnaire -30 (GHQ -30). Result were compared with established normative data, and validated cut-off scores that were available.

RESULTS

A total of 417 teachers (93%) responded to the questionnaire. The following prevalence rates were found: female anorgasmia (40%), lubrication failure (30%), dyspareunia (12%), erectile dysfunction, premature ejaculation and male orgasmic disorder (23% each), loss of sexual desire (24%), sexual life dissatisfaction, and relationship dissatisfaction six months prior to interview (10% each), and GHQ-30 scores were significant in sexual dysfunction in both genders, except for female anorgasmia and premature ejaculation in males. However, a presence of psychiatric morbidity was significantly found in overall sexual life dissatisfaction, as well as relationship dissatisfaction. The pattern of sexual health help-seeking behavior showed that majority (53%) do not seek treatment. Of these 53%, many (44%) gave the reason that they thought it transient, ignorance of hospital treatment service (30%), and fear of stigma (26%); also, among those that sought treatment, 46% chose alternative medicine.

CONCLUSION

The prevalence of sexual dysfunctions found in this study is comparable to those reported in earlier Nigerian studies. Despite this and the significant "psychiatric morbidity" experienced in sexual difficulties, apparently no health services have been specially designed to address sexual dysfunction among the teacher's group or the general population at large. This study therefore draws urgent attention to the need for services geared towards alleviating sexual problems, more professional and patient education are recommended.