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Cara Serrano L, Salas Mora CM. [Critical considerations on the approach to sexually transmitted infections: towards a broader vision]. Aten Primaria 2024; 56:103010. [PMID: 38936329 PMCID: PMC11259690 DOI: 10.1016/j.aprim.2024.103010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 06/29/2024] Open
Affiliation(s)
- Lorena Cara Serrano
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, España.
| | - Carlos Matías Salas Mora
- Servicio de Medicina Interna, Hospital Universitari Sagrat Cor, Grupo Quirón Salud, Barcelona, España
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Aguilar-Quesada A, Sierra-Yagüe A, González-Cano-Caballero M, Zafra-Egea JA, Lima-Serrano M. Effectiveness of digital interventions to reduce school-age adolescent sexual risks: A systematic review. J Nurs Scholarsh 2024. [PMID: 39118266 DOI: 10.1111/jnu.13015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 07/17/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
INTRODUCTION The increase in risky sexual behaviors among adolescent students has sparked alarm and has become an area of research interest. As adolescents prioritize confidentiality and accessibility, digital interventions are becoming increasingly relevant in sex education. We therefore posed the following research question: Are digital application interventions effective to prevent risky sexual behaviors in school adolescents? DESIGN A systematic peer review was conducted between January and December 2023 in five databases (PubMed, Web of Science, Scopus, EMBASE, and PsycINFO) without restricting for language or year of publication. METHOD We included randomized control trials or quasi-experimental studies that measured the effectiveness of interventions targeting young people aged 10-19 years or their parents and developed in a school setting. Interventions aimed at young people with intellectual disabilities, learning difficulties, or any disease requiring a specific intervention were excluded. RESULTS The search ultimately yielded 27 studies covering a total of 18 digital interventions that demonstrated positive effects, not maintained over time, on knowledge, attitudes, and behaviors, although the latter to a lesser extent. DISCUSSION We have found very interesting digital interventions with effects, among others, on knowledge, attitudes, and contraceptive use in adolescents. In general, digital interventions have positive effects on knowledge and attitudes, but it is more difficult to modify behaviors with strictly digital interventions or combined with complementary face-to-face sessions or group class activities. CONCLUSION We thus believe that digital interventions are adequate to reduce adolescent sexual risk behaviors, and our systematic review facilitates the implementation of these interventions by sharing existing digital interventions that have had positive effects, as well as the main characteristics a digital intervention should possess to reduce sexually risky behaviors in adolescents. CLINICAL RELEVANCE Digital interventions with adolescents improve sexual behaviors and can be a valuable resource in education on this topic due to their accessibility and confidentiality, two key points for young people.
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Affiliation(s)
| | | | | | - José Antonio Zafra-Egea
- Department of Nursing of the Faculty of Health Sciences of UManresa, Fundació Universitària del Bages, University of Vic, Central University of Catalonia, Barcelona, Spain
| | - Marta Lima-Serrano
- Department of Nursing, School of Nursing, Physiotherapy, and Podiatry, University of Seville, Seville, Spain
- Institute of Biomedicine of Seville (IBiS), Sevilla, Spain
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Nadarzynski T, Knights N, Husbands D, Graham CA, Llewellyn CD, Buchanan T, Montgomery I, Khlafa N, Tichackova J, Odeyemi R, Johnson S, Jesuthas N, Tahia S, Ridge D. The impact of Chatbot-Assisted Self Assessment (CASA) on intentions for sexual health screening in people from minoritised ethnic groups at risk of sexually transmitted infections. Sex Health 2024; 21:SH24058. [PMID: 39052859 DOI: 10.1071/sh24058] [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: 03/18/2024] [Accepted: 06/28/2024] [Indexed: 07/27/2024]
Abstract
Background Sexually transmitted infections (STIs) present a significant global public health issue, with disparities in STI rates often observed across ethnic groups. The study investigates the impact of Chatbot-Assisted Self Assessment (CASA) on the intentions for sexual health screening within minoritised ethnic groups (MEGs) at risk of STIs as well as the subsequent use of a chatbot for booking STI screening. Methods A simulation within-subject design was utilised to evaluate the effect of CASA on intentions for STI/HIV screening, concern about STIs, and attitudes towards STI screening. Screening intentions served as the dependent variable, while demographic and behavioural factors related to STI/HIV risk were the independent variables. ANCOVA tests were conducted to measure the impact of CASA on these perceptions. Results Involving 548 participants (54% women, 66% black, average age=30years), the study found that CASA positively influenced screening intentions t (547)=-10.3, P t (544)=-4.96, P t (543)=-4.36, P Conclusion CASA increased motivations for STI screening intentions among ethnically diverse communities. The intervention's non-judgemental nature and the chatbot's ability to emulate sexual history-taking were critical in fostering an environment conducive to behavioural intention change. The study's high acceptability indicates the potential for broader application in digital health interventions. However, the limitation of not tracking actual post-intervention behaviour warrants further investigation into CASA's real-world efficacy.
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Affiliation(s)
- Tom Nadarzynski
- School of Social Sciences, University of Westminster, London, UK
| | - Nicky Knights
- School of Social Sciences, University of Westminster, London, UK
| | - Deborah Husbands
- School of Social Sciences, University of Westminster, London, UK
| | | | | | - Tom Buchanan
- School of Social Sciences, University of Westminster, London, UK
| | | | - Nuha Khlafa
- School of Social Sciences, University of Westminster, London, UK
| | - Jana Tichackova
- School of Social Sciences, University of Westminster, London, UK
| | - Riliwan Odeyemi
- School of Social Sciences, University of Westminster, London, UK
| | - Samantha Johnson
- School of Social Sciences, University of Westminster, London, UK
| | - Neomi Jesuthas
- School of Social Sciences, University of Westminster, London, UK
| | - Syeda Tahia
- School of Social Sciences, University of Westminster, London, UK
| | - Damien Ridge
- School of Social Sciences, University of Westminster, London, UK
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Vamos CA, Puccio JA, Griner SB, Logan RG, Piepenbrink R, Richardson Cayama M, Lovett SM, Mahony H, Daley EM. Health literacy needs and preferences for a technology-based intervention to improve college students' sexual and reproductive health. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:477-486. [PMID: 35298353 DOI: 10.1080/07448481.2022.2040517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 01/13/2022] [Accepted: 02/06/2022] [Indexed: 06/14/2023]
Abstract
Objective: To explore health literacy needs and preferences for a technology-based intervention (app) to improve sexual and reproductive health (SRH) among college students. Participants: In Spring 2019, in-depth interviews were conducted with 20 participants (10 male, 10 female) from a large, public university. Methods: Interview guide was developed based on Integrated Model of Health Literacy domains and Diffusion of Innovation constructs. Data were analyzed in MaxQDA using applied thematic analysis. Results: Dominant themes included accessing health information and services, evaluating options to make decisions, intervention utility and characteristics, and the emergent theme of credibility. Specific topics included accessing STI testing, contraceptive decision making, information on human papillomavirus (HPV) and the HPV vaccine, patient-provider communication, app design and function elements, and modifying the app to meet the SRH needs of diverse college students. Conclusions: Findings identified areas where an app could address college students' SRH literacy, ultimately improving SRH outcomes among this population.
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Affiliation(s)
- Cheryl A Vamos
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - Joseph A Puccio
- University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Stacey B Griner
- University of North Texas Health Science Center at Fort Worth, School of Public Health, Fort Worth, TX, USA
| | | | | | | | - Sharonda M Lovett
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - Helen Mahony
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - Ellen M Daley
- University of South Florida, College of Public Health, Tampa, FL, USA
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Saragih ID, Imanuel Tonapa S, Porta CM, Lee BO. Effects of telehealth interventions for adolescent sexual health: A systematic review and meta-analysis of randomized controlled studies. J Telemed Telecare 2024; 30:201-214. [PMID: 34903065 DOI: 10.1177/1357633x211047762] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Telehealth interventions to advance adolescent sexual health have evolved and are being used to promote adolescent sexual health knowledge and healthy sexual behaviors. However, as this area of intervention modality expands, there is a need to pause and examine the effects of telehealth interventions on adolescent sexual health outcomes. Addressing this knowledge gap will inform researchers and practitioners on the current state of evidence of telehealth interventions and inform further intervention development and testing. This study aimed to explore the meta-effects of telehealth interventions on self-efficacy of using condoms, condom use practices, and sexually transmitted infection testing behaviors among adolescents. METHODS A systematic review and meta-analysis of randomized controlled trials were conducted. Seven databases (Academic Search Complete, CINAHL, EMBASE, MEDLINE, PubMed, OVID (UpToDate), and Web of Science) were searched for relevant full-text articles from the inception to May 2021. The revised Cochrane risk-of-bias tool for randomized trials was used to assess the methodological quality of the included studies. A meta-analysis was performed using a random effects model to calculate the pooled effects of telehealth interventions for adolescents. Stata 16.0 was used for statistical analysis. RESULTS A total of 15 studies (N = 5499) that used telehealth interventions with adolescents were included in the analysis. Telehealth interventions were found to increase self-efficacy for condom use (standardized mean difference: 0.22; 95% confidence interval: 0.08-0.36), practice for condom use (standardized mean difference: 0.35; 95% confidence interval: 0.23-0.47), and being screened/tested for sexual transmitted infections (standardized mean difference: 0.61; 95% confidence interval: 0.31-0.92). DISCUSSION Telehealth interventions show promise as effective intervention delivery solutions for improving self-efficacy and certain sexual health behaviors among adolescents. These telehealth strategies could be important alternatives to in-person visits to accessing sexual health information or services near where they live. Future research should consider testing telehealth strategies where there is evidence of impact to move the field forward.
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Affiliation(s)
| | - Santo Imanuel Tonapa
- College of Nursing, Kaohsiung Medical University, Kaohsiung
- School of Nursing, Sam Ratulangi University, Manado, Indonesia
| | - Carolyn M Porta
- School of Nursing, University of Minnesota, Minneapolis, USA
| | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung
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Mmari K, Gayles J, Lundgren R, Barker K, Austrian K, Levtov R, Kato-Wallace J, van Reeuwijk M, Richardson L, Green J, Kågestan AE, Ramaiya A. Implementing Interventions to Address Gender and Power Inequalities in Early Adolescence: Utilizing a Theory of Change to Assess Conditions for Success. J Adolesc Health 2023; 73:S5-S14. [PMID: 37330821 DOI: 10.1016/j.jadohealth.2022.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/26/2022] [Accepted: 10/26/2022] [Indexed: 06/19/2023]
Abstract
PURPOSE To create a set of criteria to assess facilitators and barriers to implementation among gender transformative interventions that target very young adolescents (VYAs) across different cultural settings. METHODS Interventionists and researchers involved in the Global Early Adolescent Study created a Theory of Change (ToC) based on summarizing intervention components from five different gender transformative intervention curricula. Embedded within the ToC is a set of criteria labeled, 'Conditions of Success' which were developed to illustrate that change cannot happen unless interventions are implemented successfully. To test the feasibility of these criteria, implementation data collected across the five interventions in Global Early Adolescent Study were mapped onto the 'Conditions for Success' criteria and used to identify common facilitators and barriers to implementation. RESULTS Using the 'Conditions for Success' criteria, we found that gender transformative interventions targeting VYAs were most challenged in meeting program delivery and facilitation conditions and needed to build more multisectoral support to shift rigid gender norms. Parents and caregivers also needed to be engaged in the program either as a separate target population or as codesigners and implementers for the interventions. DISCUSSION The Conditions for Success criteria provide a useful framework for assessing facilitators and barriers to implementation among gender transformative interventions for VYAs. Additional research is underway to examine whether interventions that meet more conditions of success result in greater program impact, which will be used to further refine the overall ToC.
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Affiliation(s)
- Kristin Mmari
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | | | - Rebecka Lundgren
- Department of Medicine, Infectious Disease and Global Public Health, Center on Gender Equity and Health, University of California San Diego, La Jolla, California
| | - Katherine Barker
- Department of Medicine, Infectious Disease and Global Public Health, Center on Gender Equity and Health, University of California San Diego, La Jolla, California
| | | | - Ruti Levtov
- Prevention Collaborative, Amherst, Massachusetts
| | | | | | - Lisa Richardson
- Institute of Women and Ethnic Studies, University of New Orleans Research and Technology Foundation, New Orleans, Louisiana
| | - Jakevia Green
- Institute of Women and Ethnic Studies, University of New Orleans Research and Technology Foundation, New Orleans, Louisiana
| | - Anna E Kågestan
- Department of Global Public Health Tomtebodavägen, Karolinska Institute, Stockholm, Sweden
| | - Astha Ramaiya
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Tse DMS, Kiu OTW, Yeo VA, Kiu ECY, Yip P, Ip P, Choi EPH, Wong WCW. Impacts of electronic device use on adolescents' sexual knowledge, attitude and perception during the COVID-19 pandemic: A representative sexuality survey. Front Public Health 2023; 11:1034155. [PMID: 37064680 PMCID: PMC10098194 DOI: 10.3389/fpubh.2023.1034155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/20/2023] [Indexed: 04/01/2023] Open
Abstract
BackgroundCOVID-19 pandemic has led to school closure and social distancing measures for infection control. Many young people thus spent more time on electronic devices and the Internet. This study aimed to determine if and how sexual knowledge, perception and behavior as well as sexuality among Hong Kong adolescents were affected as a result.MethodsYouth Sexuality Study conducted by The Family Planning Association of Hong Kong (FPAHK) evaluated the sexual knowledge, attitudes and behaviors and sexual health of youth every 5 years since 1981 with adaptations made to the changing environment. We analyzed this cross-sectional data on sexual knowledge, attitude, and experiences as well as the impacts of COVID-19 on daily life, health and relationships. Univariate analysis was conducted to investigate the relationships between the time spent on electronic devices and sexuality, while mediation analyses using the PROCESS procedure were performed to further explore differences in time spent on electronic devices.ResultsDuring the COVID-19 pandemic, the majority of our participants spent more time on social media and browsing the Internet on electronic devices with less time for extracurricular activities and learning. Nonetheless, there was better overall sexual knowledge and a lower degree of sexual stigma with a higher overall acceptance of sexual minorities. The mediation analyses found that sexual content [Conditional effect = 0.024 (95% CI 0.008, 0.043)] and engagement online [Conditional effect = 0.036 (CI 0.021, 0.053)] could indirectly influence the effect of screen time on the frequency of sexual practices.ConclusionPolicymakers and frontline professionals should re-examine the pedagogy of the present sex education and consider online sex education as the key mode of delivery while guiding the proper use of electronic devices in the learning and exploration of sexual knowledge.
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Affiliation(s)
- Desiree Man-Sik Tse
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Omar Tsui Wai Kiu
- School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Victoria Anna Yeo
- School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Elkie Chan Yu Kiu
- School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Paul Yip
- Centre for Suicide Research and Prevention, Hong Kong Jockey Club, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Kowloon, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - William Chi Wai Wong
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: William Chi Wai Wong
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Martínez-García G, Ewing AC, Olugbade Y, DiClemente RJ, Kourtis AP. Crush: A Randomized Trial to Evaluate the Impact of a Mobile Health App on Adolescent Sexual Health. J Adolesc Health 2023; 72:287-294. [PMID: 36424332 PMCID: PMC11036548 DOI: 10.1016/j.jadohealth.2022.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE Mobile technology allows delivery of sexual and reproductive health (SRH) information directly to youth. We tested the efficacy of Crush, a mobile application aimed at improving sexual health by promoting the use of SRH services and contraception among female adolescents. METHODS We recruited 1,210 women aged 14-18 years through social media advertising and randomized them into a Crush intervention group and a control group that received a wellness app. At 3 and 6 months post randomization, we compared changes from baseline in behaviors, attitudes, self-efficacy, perceived social norms, birth control knowledge, perceived control and use intentions, and SRH service utilization. Odds ratios were estimated with multivariable logistic regression and adjusted for baseline outcome, age, race/ethnicity, mother's education, and sexual experience. RESULTS There was no difference in accessing SRH services according to study group. Three months post baseline, Crush users had higher odds (p < .05) than control participants of reporting confidence in accessing SRH services (adjusted odds ratio [aOR] = 1.6, 95% confidence interval [CI]: 1.1-2.3) and of believing that it is a good thing to use birth control consistently (aOR = 2.3, 95% CI: 1.4-3.8). Six months after baseline, Crush users had higher odds than control participants of reporting they can control whether birth control is used every time they have sex (aOR = 1.8, 95% CI: 1.2-2.6) and perceiving they would get pregnant if they did not use birth control (aOR: 1.5, 95% CI: 1.1-2.2). Impacts on other behavioral constructs were also found. DISCUSSION Crush was associated with improvements in knowledge, attitudes, and self-efficacy related to key SRH behaviors and may be a strategy to deliver SRH education to adolescent women. Studies including larger numbers of sexually active adolescents are needed to demonstrate behavioral impacts.
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Affiliation(s)
| | - Alexander C Ewing
- Division of Reproductive Health, Maternal and Infant Health Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia
| | - Yewande Olugbade
- Department of Innovation & Research, Healthy Teen Network, Baltimore, Maryland
| | - Ralph J DiClemente
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, New York
| | - Athena P Kourtis
- Epidemiology Branch, Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta Georgia
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Sewak A, Yousef M, Deshpande S, Seydel T, Hashemi N. The effectiveness of digital sexual health interventions for young adults: a systematic literature review (2010-2020). Health Promot Int 2023; 38:7033126. [PMID: 36757346 DOI: 10.1093/heapro/daac104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
There has been a proliferation of digital sexual health interventions targeting adolescents; however, limited evaluative reviews have compared the effectiveness of multiple digital tools for sexual health literacy and behaviour change. This study conducted a systematic literature review, screened 9881 records and analysed 61 studies. Findings suggest that websites and mobile phones dominate digital sexual health interventions, with a majority effectively delivering cognitive (e.g. awareness and attitudes about sexual and reproductive health) and behavioural outcomes (e.g. abstinence and use of contraception). The most popular sexual health promotion mechanisms were interactive websites, text messaging and phone calls, and online education programmes, followed by mobile applications-fewer studies in this review utilized social media, games and multimedia. Previous reviews focused on single outcome measures (e.g. sexually transmitted infection testing) to assess interventions' effectiveness. The current review moves beyond single outcome measures to cover a wider range of behavioural and non-behavioural sexual health issues and contexts covered in the literature. Four main categories were analysed as outcomes: cognitive perceptions, promoting sexual health-related behaviours, promoting sexual health-related products and services, and impact (viral load). Seventy-nine per cent of interventions focused on preventive sexual health behaviours and products (e.g. condoms) and services (e.g. HIV testing). Overall, 75% of studies effectively changed sexual health behaviour and cognitive perceptions. However, the digital-only tools did not vary from the blended formats, in influence outcomes, even after categorizing them into behavioural or non-behavioural outcomes. Compared to previous systematic reviews, more studies from the last decade used rigorous research design in the form of randomized controlled trials, non-randomized control trials, and quasi-experiments and lasted longer.
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Affiliation(s)
- Aarti Sewak
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Queensland 4111, Australia
| | - Murooj Yousef
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Queensland 4111, Australia
| | - Sameer Deshpande
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Queensland 4111, Australia
| | - Tori Seydel
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Queensland 4111, Australia
| | - Neda Hashemi
- School of Medicine, Griffith University, Gold Coast Campus, Building G01, Gold Coast, Queensland 4215, Australia
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Pourgholamamiji N, Shahsavari H, Manookian A, Soori T, Zandkarimkhani M, Zare Z. Using theory of reasoned action to reduce high-risk sexual behaviors among patients with HPV: A randomized controlled trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:4. [PMID: 37034848 PMCID: PMC10079193 DOI: 10.4103/jehp.jehp_1136_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 05/14/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND Sexually transmitted diseases are a major health problem in all countries. Human papillomavirus (HPV) infection is the most common viral sexually transmitted disease in both genders. High-risk sexual behaviors (HRSBs) are among the major risk factors for HPV infection. Lack of knowledge can contribute to HRSBs and hence, education can potentially reduce HRSB risk. This is a study using theory of reasoned action to reduce the high-risk sexual behaviors among patients with HPV. MATERIALS AND METHODS This study was a two-grouped, randomized, controlled trial. The educational program was developed based on the results of a survey into the most important components of the theory of reasoned action contributing to HRSBs among 100 patients recruited from Razi hospital, Tehran, Iran. Then, 110 patients from the same hospital were consecutively recruited and randomly allocated to a control (n = 55) and an intervention (n = 55) group. Then, each participant in the intervention group was provided with the developed educational program. Their counterparts in the control group solely received routine care services. Three months after the first educational session, HRSBs were reassessed in both groups. Data were analyzed via the SPSS software (v. 21.0). RESULTS After the intervention, the mean score of HRSBs significantly decreased in the intervention group (P < 0.001) but did not significantly change in the control group (P = 0.70). The post-test mean score of HRSBs in the intervention group was significantly less than the control group (P = 0.015). CONCLUSION Education based on the theory of reasoned action is effective in significantly reducing HRSBs. Nurses can develop and use educational interventions based on this theory to reduce HRSBs and HPV infection.
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Affiliation(s)
- Nima Pourgholamamiji
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hooman Shahsavari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Arpi Manookian
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- USERN CARE (TUMS) Office, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Soori
- Department of Infectious Disease, Razi Skin Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Zandkarimkhani
- Research Center of Razi Skin Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Zare
- Department of Operating Room, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
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Bergam S, Sibaya T, Ndlela N, Kuzwayo M, Fomo M, Goldstein MH, Marconi VC, Haberer JE, Archary M, Zanoni BC. "I am not shy anymore": A qualitative study of the role of an interactive mHealth intervention on sexual health knowledge, attitudes, and behaviors of South African adolescents with perinatal HIV. Reprod Health 2022; 19:217. [PMID: 36457044 PMCID: PMC9713189 DOI: 10.1186/s12978-022-01519-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/21/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND South Africa has one of the highest burdens of adolescents with perinatally-acquired HIV (APHIV) in the world. APHIV in South Africa have limited access to sexual and reproductive health (SRH) education and services specific to their HIV status. When lacking comprehensive SRH education, APHIV are prone to sexual risk behaviors that can lead to unintended pregnancy, sexually transmitted infections, and HIV transmission. The use of mHealth interventions has been shown to deliver information, foster social support, and improve decision-making skills. In this study, we evaluate how an mHealth intervention influences sexual health knowledge and behaviors in APHIV. METHODS We purposively enrolled adolescents from the intervention arm of a randomized clinical trial assessing a multi-module, moderated WhatsApp-based intervention-Interactive Transition Support for Adolescents Living with HIV (InTSHA)-within a government supported clinic in KwaMashu, an urban township of KwaZulu-Natal, South Africa. We conducted in-depth interviews based on World Health Organization guidelines for asking adolescents about SRH. We thematically analyzed data through an iterative, team-based coding approach combining deductive and inductive elements to contextualize SRH attitudes, knowledge, and behaviors before and after receiving the InTSHA intervention. RESULTS Of the 21 participants, 13 (61.9%) were female and the mean age was 16.6 years. Most participants reported first learning about SRH as young teenagers in school through non-targeted and negative ways, seeking clarification through peers and the internet rather than clinicians or caregivers. Participants reported that InTSHA provided a holistic perspective on relationships, gender, and sexuality specific to growing up with HIV in South Africa. They praised the ability to give and receive information from peers in a moderated setting through the mHealth intervention, building their confidence, decision-making skills, and communication with partners and caregivers throughout their everyday lives. Despite reporting some technological challenges, adolescents agreed that InTSHA was convenient, confidential, and user-friendly. CONCLUSIONS South African APHIV receive incomplete and conflicting sexual education from peers, caregivers, teachers, and technology that can be supplemented by mHealth curricula targeted for the unique needs of APHIV. Future, scaled-up mHealth interventions can lower SRH stigma by expanding access to sexual education and peer support, supplementing adolescents' existing SRH education.
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Affiliation(s)
- Scarlett Bergam
- grid.16463.360000 0001 0723 4123Department of Paediatrics, Nelson Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa ,George Washington School of Medicine and Health Sciences, Washington, DC USA
| | - Thobekile Sibaya
- grid.16463.360000 0001 0723 4123Department of Paediatrics, Nelson Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Nompumelelo Ndlela
- grid.16463.360000 0001 0723 4123Department of Paediatrics, Nelson Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Mpume Kuzwayo
- grid.16463.360000 0001 0723 4123Department of Paediatrics, Nelson Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Messaline Fomo
- grid.189967.80000 0001 0941 6502Department of Global Health, Emory University’s Rollins School of Public Health, Atlanta, GA USA
| | | | - Vincent C. Marconi
- grid.189967.80000 0001 0941 6502Departments of Medicine and Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA USA ,grid.189967.80000 0001 0941 6502Department of Global Health, Emory University’s Rollins School of Public Health, Atlanta, GA USA
| | - Jessica E. Haberer
- grid.32224.350000 0004 0386 9924Massachusetts General Hospital, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Moherndran Archary
- grid.16463.360000 0001 0723 4123Department of Paediatrics, Nelson Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Brian C. Zanoni
- grid.189967.80000 0001 0941 6502Departments of Medicine and Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA USA ,grid.189967.80000 0001 0941 6502Department of Global Health, Emory University’s Rollins School of Public Health, Atlanta, GA USA ,grid.428158.20000 0004 0371 6071Children’s Healthcare of Atlanta, Atlanta, GA USA
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12
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Rea S, Zynda A, Allison B, Tolleson-Rinehart S. Adolescent Perceptions of Technology-Based Sexual and Reproductive Health Services: A Systematic Review. J Adolesc Health 2022; 71:533-544. [PMID: 35717326 DOI: 10.1016/j.jadohealth.2022.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/28/2022] [Accepted: 05/06/2022] [Indexed: 10/31/2022]
Abstract
Technology-based services, including telehealth, text messaging, and the internet are increasingly popular methods for adolescents and young adults (AYA) to access sexual and reproductive health (SRH) information and healthcare. This systematic review examined AYA perceptions of privacy and confidentiality of technology-based SRH services. The PubMed, Scopus, and PsycINFO were systematically searched in May 2021 to capture relevant qualitative or quantitative articles from the past 10 years. Included studies had AYA (i.e., mean age, 13-26-years with <10% of the sample outside this range), technology-based services for SRH, and outcomes of perceived privacy or confidentiality. Twenty-eight articles were included (N = 8638 AYA). Most studies utilized the internet and mobile apps to address human immunodeficiency virus infection (HIV), sexually transmitted infections, and general SRH topics. Most AYA reported that these services were private and confidential, with minimal differences across SRH topic addressed. More interactive services had greater concerns (e.g., family or friends seeing notifications). Most AYA considered technology-based SRH to be confidential and private. As technology will likely remain an integrated part of healthcare delivery, improving the privacy and confidentiality of these services can facilitate AYA's independent and autonomous engagement in SRH care, and potentially improve their SRH outcomes.
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Affiliation(s)
- Samantha Rea
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina.
| | - Aaron Zynda
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
| | - Bianca Allison
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Sue Tolleson-Rinehart
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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13
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Educação sexual e vulnerabilidade de usuários de aplicativos, comparações a partir da orientação sexual. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ar0001397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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14
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Decker MJ, Harrison S, Price M, Gutmann-Gonzalez A, Yarger J, Tenney R. Educators' Perspectives on Integrating Technology Into Sexual Health Education: Implementation Study. JMIR Hum Factors 2022; 9:e31381. [PMID: 35019842 PMCID: PMC8792781 DOI: 10.2196/31381] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/22/2021] [Accepted: 11/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background In the last decade, the use of technology-based sexual health education has increased. Multiple studies have shown the feasibility of technology-based interventions, while a subset has also shown efficacy in improving youths’ sexual health outcomes such as increased condom use and knowledge. However, little is known about health educators’ experiences in integrating technology to augment sexual health curricula. Objective The purpose of this study was to assess the perceptions and experiences of health educators regarding the incorporation of technology into a sexual health education program designed for underserved youth in Fresno County, California, and to identify facilitators and challenges to incorporating technology into the in-person curriculum. Methods This implementation study used data collected as part of a cluster randomized controlled trial to evaluate In the Know (ITK), an in-person sexual health education curriculum that includes technology-based content, such as a resource locator, videos, and games, which can be accessed through a mobile app or website. Data from implementation logs from each cohort (n=51) and annual interviews (n=8) with health educators were analyzed to assess the health educators’ experiences using the technology and adaptations made during the implementation. Results The health educators reported that technological issues affected implementation to some degree: 87% of the time in the first year, which decreased to 47% in the third year as health educators’ familiarity with the app increased and functionality improved. Technology issues were also more common in non–school settings. Successes and challenges in 3 domains emerged: managing technology, usability of the ITK app, and youth engagement. The health educators generally had positive comments about the app and youth engagement with the technology-based content and activities; however, they also noted certain barriers to adolescents’ use of the mobile app including limited data storage and battery life on mobile phones. Conclusions Health educators require training and support to optimize technology as a resource for engaging with youth and providing sensitive information. Although technology is often presented as a solution to reach underserved populations, educational programs should consider the technological needs and limitations of the participants, educators, and settings. International Registered Report Identifier (IRRID) RR2-10.2196/18060
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Affiliation(s)
- Martha J Decker
- Department of Epidemiology and Biostatistics, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States
| | - Salish Harrison
- Philip R. Lee Institute for Health Policy Studies, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, United States
| | - Melisa Price
- Clinical and Translational Science Center, University of California, Davis, Davis, CA, United States
| | - Abigail Gutmann-Gonzalez
- Philip R. Lee Institute for Health Policy Studies, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, United States
| | - Jennifer Yarger
- Philip R. Lee Institute for Health Policy Studies, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, United States
| | - Rachel Tenney
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
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15
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Muthmainnah M, Nurmala I, Siswantara P, Rachmayanti RD. Implementation of adolescent health programs at public schools and religion-based schools in Indonesia. J Public Health Res 2021; 10. [PMID: 34229423 PMCID: PMC8696388 DOI: 10.4081/jphr.2021.1954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 05/04/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Adolescents are a vulnerable group who have great curiosity and need access to various adolescent health information. Therefore, the government has implemented a strategy through the implementation of Youth Care Health Services (YCHS). However, some of the stakeholders and youth have limited access to YCHS especially the ones delivered in schools setting. The purpose of this study was to investigate the implementation of adolescent health programs in schools especially public schools and religion-based schools. Design and methods: This study was an analytic observational quantitative study by using a cross-sectional design. This study was conducted in public schools and religion-based schools in North Surabaya Indonesia. The sample in this study consisted of 100 students through a simple random sampling technique. Results: There was a difference in the level of knowledge of adolescent reproductive health between public schools and religion- based schools (p=0.047). Student’s attitudes (p=0.000) and environmental influences (p=0.000) both related with reproductive health contents. However, there was no difference in adolescent’s attitudes about adolescent reproductive health programs (p=0.90) and adolescent’s exposure to adolescent reproductive health policies (p=0.196). Conclusion: The implementation of adolescent health programs in two types of schools (public and religion-based) were different. Adolescents should have the same rights to obtain knowledge about adolescent health as the prelude for forming a positive attitude. Therefore, stakeholders need to conduct regular monitoring and evaluation on the implementation of standardized adolescent health programs in all types of schools. Significance for public health Adolescents are the nation's next-generation in which the rapid development of technology can cause various problems for their health especially reproductive health which is one of the major challenges for public health among adolescent. One of health programs conducted by stakeholder in Indonesia is YCHS. This program was designed to improve adolescent health through school approach. Nevertheless, there are some problems in the implementation such as unequal access to get information of adolescents health between public schools and religion based schools, the lack of stakeholders support, and the lack of students’ involvement in health adolescents programs. Through this study, we will find how the implementation and the effect of YCHS program regarding adolescents’ knowledge, attitudes, and the exposure about the policy of adolescent health. So, it can contributes to the public health.
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Manlove J, Whitfield B, Finocharo J, Cook E. Lessons Learned from Replicating a Randomized Control Trial Evaluation of an App-Based Sexual Health Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3305. [PMID: 33806809 PMCID: PMC8004824 DOI: 10.3390/ijerph18063305] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 11/19/2022]
Abstract
This study presents findings from a randomized control trial replication evaluation of Pulse, an app-based pregnancy prevention program implemented with Black and Latinx women aged 18-20, a population with high rates of unplanned pregnancy. We used social media advertisements to enroll 1013 women online across the U.S. and automatically randomized participants to either the Pulse reproductive health app or a general health control app, stratifying by age and race/Latinx ethnicity. Participants received reminder text messages to view the app as well as text messages with app-related content throughout the intervention. Linear probability models were conducted on the analytic sample of 871 participants who completed the six-week survey and 798 who completed the six-month survey and adjusted for permuted block randomization and multiple hypothesis testing. Compared to the control group, intervention group participants had higher contraceptive knowledge (p = 0.000), which replicates findings from an earlier evaluation. However, these impacts were not sustained at six-month follow-up (p = 0.162). We found no other significant program impacts. This contrasts with an earlier evaluation that found intervention participants were less likely to have had sex without a hormonal or long-acting reversible contraceptive (LARC) method and had greater self-confidence to use contraception consistently than the control group. Different demographic characteristics, lower app usage, and more negative attitudes about and usage of hormonal/LARC contraception in the current sample may help to explain fewer impacts than the earlier evaluation.
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Affiliation(s)
- Jennifer Manlove
- Child Trends, 7315 Wisconsin Avenue, Suite 1200W, Bethesda, MD 20814, USA; (B.W.); (J.F.); (E.C.)
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17
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Lameiras-Fernández M, Martínez-Román R, Carrera-Fernández MV, Rodríguez-Castro Y. Sex Education in the Spotlight: What Is Working? Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2555. [PMID: 33806507 PMCID: PMC7967369 DOI: 10.3390/ijerph18052555] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/14/2022]
Abstract
Adolescence, a period of physical, social, cognitive and emotional development, represents a target population for sexual health promotion and education when it comes to achieving the 2030 Agenda goals for sustainable and equitable societies. The aim of this study is to provide an overview of what is known about the dissemination and effectiveness of sex education programs and thereby to inform better public policy making in this area. Methodology: We carried out a systematic review based on international scientific literature, in which only peer-reviewed papers were included. To identify reviews, we carried out an electronic search of the Cochrane Database Reviews, ERIC, Web of Science, PubMed, Medline, Scopus and PsycINFO. This paper provides a narrative review of reviews of the literature from 2015 to 2020. Results: 20 reviews met the inclusion criteria (10 in school settings, 9 using digital platforms and 1 blended learning program): they focused mainly on reducing risk behaviors (e.g., VIH/STIs and unwanted pregnancies), whilst obviating themes such as desire and pleasure, which were not included in outcome evaluations. The reviews with the lowest risk of bias are those carried out in school settings and are the ones that most question the effectiveness of sex education programs. Whilst the reviews of digital platforms and blended learning show greater effectiveness in terms of promoting sexual and reproductive health in adolescents (ASRH), they nevertheless also include greater risks of bias. Conclusion: A more rigorous assessment of the effectiveness of sexual education programs is necessary, especially regarding the opportunities offered by new technologies, which may lead to more cost-effective interventions than with in-person programs. Moreover, blended learning programs offer a promising way forward, as they combine the best of face-to-face and digital interventions, and may provide an excellent tool in the new context of the COVID-19 pandemic.
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Affiliation(s)
- María Lameiras-Fernández
- Faculty of Education and Social Work, University of Vigo, 32004 Ourense, Spain; (R.M.-R.); (M.V.C.-F.); (Y.R.-C.)
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18
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Abstract
Technology is giving rise to artificial erotic agents, which we call erobots (erôs + bot). Erobots, such as virtual or augmented partners, erotic chatbots, and sex robots, increasingly expose humans to the possibility of intimacy and sexuality with artificial agents. Their advent has sparked academic and public debates: some denounce their risks (e.g., promotion of harmful sociosexual norms), while others defend their potential benefits (e.g., health, education, and research applications). Yet, the scientific study of human-machine erotic interaction is limited; no comprehensive theoretical models have been proposed and the empirical literature remains scarce. The current research programs investigating erotic technologies tend to focus on the risks and benefits of erobots, rather than providing solutions to resolve the former and enhance the latter. Moreover, we feel that these programs underestimate how humans and machines unpredictably interact and co-evolve, as well as the influence of sociocultural processes on technological development and meaning attribution. To comprehensively explore human-machine erotic interaction and co-evolution, we argue that we need a new unified transdisciplinary field of research-grounded in sexuality and technology positive frameworks-focusing on human-erobot interaction and co-evolution as well as guiding the development of beneficial erotic machines. We call this field Erobotics. As a first contribution to this new discipline, this article defines Erobotics and its related concepts; proposes a model of human-erobot interaction and co-evolution; and suggests a path to design beneficial erotic machines that could mitigate risks and enhance human well-being.
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Affiliation(s)
- Simon Dubé
- Department of Psychology, Concordia University, Montreal, QC Canada
| | - Dave Anctil
- Department of Philosophy, Jean-de-Brebeuf College, Montreal, QC Canada
- Observatoire sur les Impacts Sociétaux de l’Intelligence Artificielle et du Numérique, Laval University, Québec, QC Canada
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19
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Teadt S, Burns JC, Montgomery TM, Darbes L. African American Adolescents and Young Adults, New Media, and Sexual Health: Scoping Review. JMIR Mhealth Uhealth 2020; 8:e19459. [PMID: 33016890 PMCID: PMC7573696 DOI: 10.2196/19459] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/20/2020] [Accepted: 08/03/2020] [Indexed: 12/28/2022] Open
Abstract
Background Rates of sexually transmitted infections and unintended pregnancies are disproportionately high among African American adolescents and young adults (AYA). New media platforms such as social networking sites, microblogs, online video sites, and mobile phone applications may be a promising approach in promoting safe sex and preventing sexually transmitted infections. Objective The purpose of this scoping review was to address promising approaches in new media that may serve as valuable tools in health promotion, prevention, education, and intervention development aimed at African American AYA. Methods An electronic search was conducted using Google Scholar, Scopus, Cumulative Index to Nursing and Allied Health (CINHAL), and PubMed online databases. Concept blocks and MeSH terminology were used to identify articles around African American youth and new media. Results The search yielded 1169 articles, and 16 publications met the criteria. Studies from the review found themes in new media that included feasibility, changing attitudes, and improving knowledge related to sexual health behavior among youth of color. Conclusions New media is a promising and feasible platform for improving the sexual health of African American AYA. Further research is suggested to better understand the benefits of new media as a sexual health promotion tool among this specific population.
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Affiliation(s)
- Sierra Teadt
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Jade C Burns
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Tiffany M Montgomery
- College of Nursing & Health Professions, Drexel University, Philadelphia, PA, United States
| | - Lynae Darbes
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
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20
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Decker MJ, Gutmann-Gonzalez A, Price M, Romero J, Sheoran B, Yarger J. Evaluating the Effectiveness of an Intervention Integrating Technology and In-Person Sexual Health Education for Adolescents (In the Know): Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e18060. [PMID: 32763885 PMCID: PMC7442936 DOI: 10.2196/18060] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/04/2020] [Accepted: 05/12/2020] [Indexed: 11/23/2022] Open
Abstract
Background Access to a smartphone is nearly universal among American adolescents, and most of them have used the internet to seek health information. Integrating digital technologies into health program delivery may expand opportunities for youth to receive important health information, yet there are few rigorous studies assessing the effectiveness of this type of intervention. Objective The purpose of this study is to assess the effectiveness of In the Know (ITK), a program integrating in-person and technology-based sexual health education for underserved adolescents. Methods Youth were engaged in the development of the intervention, including the design of the digital technology and the curriculum content. The intervention focuses on 3 main areas: sexual health and contraceptive use, healthy relationships, and educational and career success. It includes an in-person, classroom component, along with a web-based component to complement and reinforce key content. A cluster randomized controlled trial is in progress among adolescents aged 13-19 years living in Fresno County, California. It is designed to examine the differences in self-reported health and behavioral outcomes among youth in the intervention and control groups at 3 and 9 months. Primary outcomes are condom and contraceptive use or no sex in the past 3 months and use of any clinical health services in the past 3 months. Secondary outcomes include the number of sexual partners in the past 3 months and knowledge of local clinical sexual health services. We will use mixed-effects linear and logistic regression models to assess differences between the intervention and control groups. Results Trial enrollment began in October 2017 and ended in March 2020 with a total of 1260 participants. The mean age of the participants is 15.73 (SD 1.83) years, and 69.98% (867/1239) of the participants report being Hispanic or Latino. Study results will be available in 2021. Conclusions ITK has the potential to improve contraceptive and clinic use among underserved youth. This trial will inform future youth-focused health interventions that are considering incorporating technology. International Registered Report Identifier (IRRID) DERR1-10.2196/18060
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Affiliation(s)
- Martha J Decker
- Department of Epidemiology and Biostatistics, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States
| | - Abigail Gutmann-Gonzalez
- Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States
| | - Melisa Price
- Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States
| | - Julio Romero
- Fresno Economic Opportunities Commission, Fresno, CA, United States
| | | | - Jennifer Yarger
- Philip R Lee Institute for Health Policy Studies, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, United States
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21
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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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22
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Widman L, Kamke K, Evans R, Stewart JL, Choukas-Bradley S, Golin CE. Feasibility, Acceptability, and Preliminary Efficacy of a Brief Online Sexual Health Program for Adolescents. JOURNAL OF SEX RESEARCH 2020; 57:145-154. [PMID: 31287336 PMCID: PMC6949421 DOI: 10.1080/00224499.2019.1630800] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/08/2019] [Accepted: 06/09/2019] [Indexed: 05/28/2023]
Abstract
This study evaluated the feasibility, acceptability, and preliminary efficacy of a 45-minute interactive, online sexual health program for adolescents, called Health Education and Relationship Training (HEART). The program was originally developed and evaluated among adolescent girls (HEART for Girls); the current project describes and evaluates a new version of the program that was adapted for boys and girls. Participants were 226 high school students (mean age = 16.3; 58% girls; 46% White; 79% heterosexual). Students were randomized to HEART or an attention-matched control and assessed at pre-test and immediate post-test. Overall, the program was feasible to administer in a school setting and youth found the program highly acceptable (83% liked the program, 87% learned new things, and 93% would use program content in the future). At post-test, students who completed HEART demonstrated improvements on every outcome we examined: sexual communication intentions, condom use intentions, HIV/STD knowledge, condom attitudes, condom norms, self-efficacy to practice safer sex, and sexual assertiveness compared to control participants (effect size ds = .23 to 1.27). Interactions by gender and sexual orientation revealed the program was equally acceptable and worked equally well for boys and girls and for heterosexual and sexual minority youth. We propose several avenues to further adapt and tailor HEART given its promise in promoting adolescent sexual health.
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Affiliation(s)
- Laura Widman
- North Carolina State University, Department of Psychology
| | - Kristyn Kamke
- North Carolina State University, Department of Psychology
| | - Reina Evans
- North Carolina State University, Department of Psychology
| | - J. L. Stewart
- North Carolina State University, Department of Psychology
| | | | - Carol E. Golin
- University of North Carolina, Chapel Hill, Gillings School of Global Public Health
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23
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Rodríguez Vargas B, Sánchez-Rubio Ferrández J, Garrido Fuentes J, Velayos R, Morillo Verdugo R, Sala Piñol F, Onteniente González A, Rodríguez Sagrado MÁ. Usability and Acceptability of a Comprehensive HIV and Other Sexually Transmitted Infections Prevention App. J Med Syst 2019; 43:175. [PMID: 31069548 DOI: 10.1007/s10916-019-1323-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/01/2019] [Indexed: 12/16/2022]
Abstract
The Preparadxs app was designed to enhace the prevention of the HIV and other sexually transmitted infections transmission through the empowerment of the user. The purpose of this study is to determine the usability and perception about the app among real users. In this prospective cross-sectional study all app end-users were asked to answer the System Usability Scale and question regarding app capability to reduce sexually transmitted infections in the future. Influence of several variables (gender identity, educational level and digital native condition) was explored. A total of 69 users answered the survey during study period. Most of them were male and had university studies. Final usability score was 80,8 points which means a good, near excellent usability. No differences in usability scores were observed regarding to gender identity, native condition or educational level. Most users were strongly agree (56,5%) or agree (28,9%) with app potential to reduce the incidence of HIV and other STIs in the future.
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Affiliation(s)
| | | | | | | | | | - Ferrán Sala Piñol
- Pharmacy Service, Germans Trias i Pujol University Hospital, Badalona, Spain
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