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Owora AH, Houghton RF, Ferrand JL, Parker E, Anderson P, Coyle K, Guinosso S, Walsh-Buhi ER. Promoting Healthy Adolescent Romantic Relationships: Results of a Multisite, Two-group Parallel Randomized Clinical Trial. J Adolesc Health 2024; 75:162-172. [PMID: 38727657 DOI: 10.1016/j.jadohealth.2024.02.025] [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: 07/03/2023] [Revised: 02/08/2024] [Accepted: 02/16/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE To examine the impact of About Us, an innovative healthy relationships intervention that promotes positive adolescent romantic relationships and the use of effective contraceptives, on improving behavior, attitudes, and intentions related to sexual intercourse, relationship communication, and conflict resolution at 3- and 9-month follow-up, compared to services as usual. METHODS This was a multi-site, two-group, parallel, randomized-controlled trial with an intervention/comparison allocation ratio of 3:2 conducted at seven high schools in California between February 2018 and May 2021. RESULTS Overall, our study did not find statistically significant evidence of improved behavior, attitudes, and intentions related to sexual intercourse, relationship communication, and conflict resolution among participants (14-18 years old) randomized to the intervention group (n = 316) compared to services as usual (n = 217) during follow-up (group x time; p > .05). Exploratory within group analyses showed that, compared to baseline, at the 3-month follow-up, the prevalence of reporting having had sex increased in the control group relative to intervention group (+19% vs. +9%, p < .01). Our sub-group analyses showed that changes in condom use intentions scores differed across school sites (group x time x school; p < .01); mixed (positive and negative) trends were observed for intervention effect, and schools with positive intervention effect trends tended to have greater program participation. DISCUSSION About Us did not show statistically significant positive impacts on primary or secondary outcomes as anticipated. Our exploratory findings show evidence of some promising trends of intervention effects at the school-level, suggesting a need for better tailored intervention components and/or delivery to address the unique environmental contexts of participants. Overall, the context of study implementation was negatively affected by the COVID-19 pandemic and challenges related to using a non-classroom delivery intervention approach. Combined, these factors may have contributed to the study null findings. Moreover, it is difficult to know (or determine) the intervention's impact under more ideal conditions (i.e., no COVID pandemic).
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Affiliation(s)
- Arthur H Owora
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana; Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Rebecca F Houghton
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - John L Ferrand
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Erik Parker
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | | | | | | | - Eric R Walsh-Buhi
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana; School of Public Health, San Diego State University, San Diego, California.
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Widnall E, Dodd S, Russell AE, Curtin E, Simmonds R, Limmer M, Kidger J. Mechanisms of school-based peer education interventions to improve young people's health literacy or health behaviours: A realist-informed systematic review. PLoS One 2024; 19:e0302431. [PMID: 38820530 PMCID: PMC11142678 DOI: 10.1371/journal.pone.0302431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 04/04/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION Peer education interventions are widely used in secondary schools with an aim to improve students' health literacy and/or health behaviours. Although peer education is a popular intervention technique with some evidence of effectiveness, we know relatively little about the key components that lead to health improvements among young people, or components that may be less helpful. This review aims to identify the main mechanisms involved in school-based peer education health interventions for 11-18-year-olds. METHODS Five electronic databases were searched for eligible studies during October 2020, an updated search was then conducted in January 2023 to incorporate any new studies published between November 2020 and January 2023. To be included in the review, studies must have evaluated a school-based peer education intervention designed to address aspects of the health of students aged 11-18 years old and contain data relevant to mechanisms of effect of these interventions. No restrictions were placed on publication date, or country but only manuscripts available in English language were included. RESULTS Forty papers were identified for inclusion with a total of 116 references to intervention mechanisms which were subsequently grouped thematically into 10 key mechanisms. The four most common mechanisms discussed were: 1) Peerness; similar, relatable and credible 2) A balance between autonomy and support, 3) School values and broader change in school culture; and 4) Informal, innovative and personalised delivery methods. Mechanisms were identified in quantitative, qualitative and mixed methods intervention evaluations. DISCUSSION This study highlights a number of key mechanisms that can be used to inform development of future school-based peer education health interventions to maximise effectiveness. Future studies should aim to create theories of change or logic models, and then test the key mechanisms, rather than relying on untested theoretical assumptions. Future work should also examine whether particular mechanisms may lead to harm, and also whether certain mechanisms are more or less important to address different health issues, or whether a set of generic mechanisms always need to be activated for success.
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Affiliation(s)
- Emily Widnall
- Centre for Public Health, University of Bristol, Bristol, United Kingdom
| | - Steven Dodd
- Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | | | - Esther Curtin
- Centre for Public Health, University of Bristol, Bristol, United Kingdom
| | | | - Mark Limmer
- Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Judi Kidger
- Centre for Public Health, University of Bristol, Bristol, United Kingdom
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Jämiä L, Piispanen N, Kylmä J, Haavisto E, Harju E. Contents, Methods, and Outcomes of Adolescent Sexual Health Promotion in School Environments: A Scoping Review . THE JOURNAL OF SCHOOL HEALTH 2024; 94:184-199. [PMID: 37723616 DOI: 10.1111/josh.13393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/28/2023] [Accepted: 08/29/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Schools play a significant role in adolescent sexual health (SH) promotion. Although adolescents' SH has improved, growing challenges still exist in some areas. Previous studies have noted a lack of knowledge about SH promotion implementation in school environments. The purpose of this review is to describe the contents, methods, and outcomes of adolescent SH promotion in school environments. METHODS Three databases (Cinahl, ERIC, Medline) were searched for peer-reviewed articles published in 2011 to 2022, to identify SH promotion in school environments for adolescents aged 12 to 19 years old. After critical appraisal, inductive content analysis was conducted. RESULTS After screening, 25 studies from 8 countries were included. Sexually transmitted diseases and contraception were emphasized in the contents of the methods. Five SH promotion methods were identified: traditional, virtual, interactive, practical skills supporting, and creative. The outcomes were advancement in SH abilities, changes in sexual behavior, and the strengthening of sexual identity. CONCLUSIONS The contents mostly considered negative consequences of sexual behavior, whereas positive aspects were less discussed. Traditional methods were emphasized, yet positive outcomes were identified regardless of the method. SH promotion should aim to better support adolescents' sexual identity reinforcement.
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Affiliation(s)
- Lotta Jämiä
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
| | - Niina Piispanen
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
| | - Jari Kylmä
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
| | - Elina Haavisto
- Faculty of Social Sciences, Health Sciences, Tampere University; Nurse Director (part-time), Tampere University Hospital, Tampere, Finland
| | - Eeva Harju
- Department of Surgery, Tampere University Hospital; Senior Research Fellow, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Zhang X, Wen YJ, Han N, Jiang Y. The Effect of a Video-Assisted Health Education Program Followed by Peer Education on the Health Literacy of COVID-19 and Other Infectious Diseases Among School Children: Quasi-Randomized Controlled Trial. JMIR Hum Factors 2024; 11:e43943. [PMID: 38285496 PMCID: PMC10862245 DOI: 10.2196/43943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 09/10/2023] [Accepted: 12/29/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND To improve the engagement and effectiveness of traditional health programs, it is necessary to explore alternative models of health education including video-assisted lectures and peer education. OBJECTIVE This study aimed to evaluate the effects of a combination of video-assisted lectures and peer education on health literacy related to infectious diseases among students. METHODS Third-grade classes from 11 pilot schools in Longgang District of Shenzhen, China, were randomized to the intervention and control groups. In the intervention group, a video-assisted interactive health education program was conducted twice over a time span of 5 months. Each of the 2 sessions included a 40-minute lecture on COVID-19 and other common infectious diseases in schools and a 5-minute science video. In addition, 5 "little health supervisors" at the end of the first session were elected in each class, who were responsible for helping class members to learn health knowledge and develop good hygiene habits. Students answered the same quiz before the first and after the second session. Models based on item response theory (IRT) were constructed to score the students' knowledge of infectious diseases based on the quiz. RESULTS In total, 52 classes and 2526 students (intervention group: n=1311; control group: n=1215) were enrolled. Responses of the baseline survey were available for 2177 (86.2%; intervention group: n=1306; control group: n=871) students and those of the postintervention survey were available for 1862 (73.7%; intervention group: n=1187; control group: n=675). There were significant cross-group differences in the rates of correctly answering questions about influenza symptoms, transmission, and preventive measures; chicken pox symptoms; norovirus diarrhea symptoms; mumps symptoms; and COVID-19 symptoms. Average IRT scores of questions related to infectious diseases in the intervention and control groups were, respectively, -0.0375 (SD 0.7784) and 0.0477 (SD 0.7481) before the intervention (P=.01), suggesting better baseline knowledge in the control group. After the intervention, the average scores of the intervention and control groups were 0.0543 (SD 0.7569) and -0.1115 (SD 0.7307), respectively (P<.001), suggesting not only significantly better scores but also greater improvement in the intervention group. CONCLUSIONS After the health education project, the correct answer rate of infectious disease questions in the intervention group was higher than that of the control group, which indicates significant effects of the combination of video-assisted lectures and peer education for the promotion of health literacy. In addition, the intervention effect of the first session persisted for at least 4 months up to the second session. As such, the proposed program was effective in improving the health literacy of school children in relation to infectious diseases and should be considered for massive health promotion campaigns during pandemics. TRIAL REGISTRATION ISRCTN ISRCTN49297995; https://www.isrctn.com/ISRCTN49297995.
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Affiliation(s)
- Xiaojuan Zhang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yingkun Justin Wen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, China
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Ning Han
- Institute of Public Health Supervision of Longgang District, Shenzhen, China
| | - Yawen Jiang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, China
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Leos C, Chen E, Jagannathan V. Using Human-Centered Design Strategies to Identify Unmet Adolescent Sexual Health Wants and Needs. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:174-184. [PMID: 37351667 PMCID: PMC10764404 DOI: 10.1007/s11121-023-01559-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 06/24/2023]
Abstract
This paper describes a human-centered design approach to investigate unmet adolescent sexual health wants and needs among youth of color in low-income and rural communities in Texas, North Carolina, and Connecticut (n = 149). The approach involved gathering qualitative data through in-depth interviews and other human-centered design activities between April 2016 and August 2016. Data were analyzed using thematic content analysis after each round of data collection. Themes were triangulated across multiple data sources to identify key insights. Results highlighted several important unmet wants and needs. Participants shared that schools were not the preferred place to learn about sexual health and healthy relationships, due to uncomfortable and sometimes even hostile environments. When discussing the potential to use internet- and technology-based sexual health resources, participants expressed concerns over privacy, safety, and credibility of information available. Similarly, participants preferred mobile apps over websites due to the privacy of the experience. Most importantly, key emotions impacting adolescents' access to and use of sexual health resources were identified. Results indicated a preference for consuming story-based information in a text message format that described diverse experiences related to sexual health topics. Together, these findings led to the development of an innovative, mobile health intervention for adolescents, the Real Talk mobile app. This human-centered approach can support researchers and practitioners in strengthening intervention development efforts to improve the reach, adoption, and implementation of sexual health interventions.
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Affiliation(s)
| | - Elizabeth Chen
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, USA
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Martin P, Alberti C, Gottot S, Bourmaud A, de La Rochebrochard E. Young people's proposals for a web-based intervention for sexual health promotion: a French qualitative study. BMC Public Health 2023; 23:1389. [PMID: 37468863 DOI: 10.1186/s12889-023-16257-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 07/06/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Promoting sexual health is key to improving the supportive behaviors and well-being of young people. With the advent of the Internet, web-based features for sexual health promotion may be attractive to a diverse range of young people. This study aims to assess young people's proposals regarding a web-based intervention for sexual health promotion. METHODS Nineteen French young people aged 15-24 years participated to the study. In a semi-structured interview, they presented their views on a web-based intervention for sexual promotion. Data were coded with N'Vivo and subjected to qualitative thematic analysis to explore their proposals. RESULTS The majority of participants (n = 18) thought that a web-based intervention for sexual health promotion would be attractive. Young people interviewed made 31 concrete proposals for sexual health promotion on the Internet. Participatory and interactive dimensions on the internet appeared essential, with the need for stimulating activities and interaction with peers, but also with competent professionals and moderation. Face to the risks of the internet, they expressed the need of a secure and confidential space, to generate trust and participation in intervention. For participants, sexual health should be addressed in all its dimensions, taking into account the relational, sexual, and gender dimensions, and by incrementing on the internet valid, credible and personalized content. CONCLUSIONS In sexual health promotion, young people are indispensable stakeholders who can make concrete proposals and can also participate in content creation and research. More broadly, in health promotion, involving target audiences in decisions represents a promising perspective.
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Affiliation(s)
- Philippe Martin
- Université Paris Cité, ECEVE, Inserm U1123 UFR de Médecine, 10 Avenue de Verdun, 75010, Paris, France.
- AP-HP, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, 1426, Inserm, CIC, France.
- GDID Santé, Paris, France.
- Institut National d'Etudes Démographiques (INED), UR14 - Sexual and Reproductive Health and Rights, Aubervilliers, F-93322, France.
| | - Corinne Alberti
- Université Paris Cité, ECEVE, Inserm U1123 UFR de Médecine, 10 Avenue de Verdun, 75010, Paris, France
- AP-HP, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, 1426, Inserm, CIC, France
| | | | - Aurélie Bourmaud
- Université Paris Cité, ECEVE, Inserm U1123 UFR de Médecine, 10 Avenue de Verdun, 75010, Paris, France
- AP-HP, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, 1426, Inserm, CIC, France
| | - Elise de La Rochebrochard
- Institut National d'Etudes Démographiques (INED), UR14 - Sexual and Reproductive Health and Rights, Aubervilliers, F-93322, France
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, F-94800, France
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Shorey S, Chua CMS. Perceptions, Experiences, and Needs of Adolescents About School-Based Sexual Health Education: Qualitative Systematic Review. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1665-1687. [PMID: 36581711 DOI: 10.1007/s10508-022-02504-3] [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: 07/19/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Adolescents are particularly vulnerable to poor sexual health outcomes such as sexually transmitted diseases, sexually transmitted infections, human immunodeficiency virus, and unintended pregnancy. While school-based sexual health education (SBSHE) can address adolescents' needs, they are often insufficient. Hence, their perception of SBSHE should be explored to improve current education. This review aims to consolidate the available evidence on perceptions, experiences, and needs of adolescents about SBSHE. Six electronic databases were searched from their inception date till June 2022. The included studies were assessed using the method of the Critical Appraisal Skills Program tool, and findings were meta-synthesized using Sandelowski and Barroso (2007). This review was registered via the International Prospective Register of Systematic Reviews. Overall, 51 studies were included, and three themes were identified: (1) teachings of SBSHE and its impact, (2) adolescents' preferred approach to SBSHE, and (3) importance of engaging and safe SBSHE. In conclusion, adolescents had mixed reactions toward SBSHE. They expressed the need for inclusivity (gender identity and racial, ethnic, and cultural groups). Having a "safe space," well-trained educators, and interactive approaches were important and hence should also be considered. More qualitative studies from different geographical regions are needed. Diverse topics (e.g., mutual consent, sexual abuse, and violence) should also be discussed. The use of multiple educators (e.g., schoolteachers, specialist teachers, and peers) should also be deliberated in future SBSHE research. Findings from this review should be triangulated by evaluating the perceptions of various stakeholders (e.g., educators, adolescents, and SBSHE administrators).
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore.
| | - Crystal Min Siu Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore
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Benton AD, Nason E, Lewis C, Vinklarek A, Santana A. Dose Matters in Evaluation of a School-Based Adolescent Sexual Health Education Program. THE JOURNAL OF SCHOOL HEALTH 2022; 92:815-821. [PMID: 35246980 PMCID: PMC9543517 DOI: 10.1111/josh.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Research on the effects of intervention dose on outcomes within adolescent sexual health education programming is lacking. Existing research on dose typically utilizes the number of sessions as a variable. In a school setting, there are scheduling limitations, student absences, and other logistical barriers that have the potential to affect the number of sessions for an intervention and, in turn, impact the efficacy of programming. METHODS This article evaluates the effectiveness of a school-based, peer-led adolescent comprehensive sexual health education program, with a focus on dose. A repeated measures MANOVA was used to evaluate the effects of individual difference variables and intervention variables on changes in participants' knowledge and attitudes across 2 time points. Additionally, paired t-tests were used to evaluate changes in specific behaviors. RESULTS Results indicated that knowledge improved following the intervention, and specifically larger doses, measured in minutes, of the intervention were associated with larger improvements in knowledge. There were no significant effects related to attitudes or behavioral outcomes. CONCLUSIONS This study adds to the knowledge base by including analysis of how the dose of intervention may impact youth outcomes. Implications for school health practices and research are discussed.
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Affiliation(s)
- Amy D. Benton
- School of Social Work, Texas State University, 601 University DriveSan MarcosTX78666USA
| | - Erica Nason
- School of Social Work, Texas State University, 601 University DriveSan MarcosTX78666USA
| | - Carol Lewis
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto BoulevardAustinTX78712USA
| | - Aubrey Vinklarek
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto BoulevardAustinTX78712USA
| | - Alda Santana
- ETR Associates, 333 University Avenue, Suite 130SacramentoCA95825USA
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Fields EL, Hussen SA, Malebranche DJ. Mind the Gap: HIV Prevention Among Young Black Men Who Have Sex with Men. Curr HIV/AIDS Rep 2021; 17:632-642. [PMID: 32914329 PMCID: PMC7483045 DOI: 10.1007/s11904-020-00532-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW Young Black men who have sex with men (YBMSM) suffer profound health inequities in new HIV diagnoses and clinical outcomes. While the evolution of HIV prevention options has become increasingly biomedical, inequities in access and uptake of these modalities persist. RECENT FINDINGS Studies suggest that while YBMSM display interest and acceptability of varied HIV prevention options, uptake lags due to the lingering effects of intersectional oppression from racism and sexual prejudice, HIV stigma, institutional and provider bias, and unresolved health policy barriers. Promising avenues to address these barriers have yet to be fully explored. We have the tools to effectively prevent HIV transmission and acquisition among YBMSM, but we have not yet effectively implemented these tools for this priority population. To end the epidemic, we must tailor and adapt HIV prevention strategies to meet the unique intersecting needs, identities, and social contexts of YBMSM.
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Affiliation(s)
- Errol L Fields
- Division of Adolescent/Young Adult Medicine, Johns Hopkins School of Medicine, 200 North Wolfe Street, Baltimore, MD, 21287, USA
| | - Sophia A Hussen
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - David J Malebranche
- Department of General Medicine, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA, 30310, USA.
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Voluntary Vs Nominated Peer Educators: a Randomized Trial within the NoTrap! Anti-Bullying Program. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:639-649. [PMID: 32221819 PMCID: PMC7305073 DOI: 10.1007/s11121-020-01108-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
There is a debate in scientific literature about the effectiveness of a peer-led approach to anti-bullying interventions. In order to understand which circumstances and for whom these approaches work best, the present study was carried out within the NoTrap! anti-bullying program. Using a cluster design, classes were randomly assigned into two different peer educator recruitment strategies: volunteering (N = 500; 48% females; mean age = 13.5 years, ds = 1.3) vs peer nominated (N = 466; 38% females; mean age = 13.9 years, ds = 1.3). Results showed that voluntary peer educators suffered a higher level of victimization, while the nominated ones tended to be more popular and likable. Furthermore, a set of linear mixed-effect models showed that the program was effective in reducing bullying and victimization, and in increasing defending behaviour only in the voluntary recruitment condition. On the contrary, in classrooms under the peer nominated recruitment condition, bullying and victimization remained stable, and defending behaviour increased only for peer educators, but not for their classmates. This implies that the step of peer selection and recruitment must be kept into consideration in developing and validating an intervention, because of its possible impact on the effectiveness of the whole intervention.
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Fields EL, Gayles TA. Considerations for Addressing Low HIV Testing Rates Among Adolescent Men Who Have Sex With Men. Pediatrics 2020; 145:peds.2019-3996. [PMID: 32047099 PMCID: PMC8188268 DOI: 10.1542/peds.2019-3996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2019] [Indexed: 01/18/2023] Open
Affiliation(s)
- Errol L. Fields
- Johns Hopkins School of Medicine, Department of Pediatrics,
Division of General Pediatrics and Adolescent Medicine, Baltimore, MD
| | - Travis A. Gayles
- Montgomery County Department of Health and Human Services,
Rockville, MD
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Crocker BCS, Pit SW, Hansen V, John-Leader F, Wright ML. A positive approach to adolescent sexual health promotion: a qualitative evaluation of key stakeholder perceptions of the Australian Positive Adolescent Sexual Health (PASH) Conference. BMC Public Health 2019; 19:681. [PMID: 31159767 PMCID: PMC6547521 DOI: 10.1186/s12889-019-6993-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 05/16/2019] [Indexed: 06/10/2024] Open
Abstract
Background Positive youth development (PYD) models are effective in improving adolescent sexual health. Adolescent programs including peer educators, parents and the wider community also demonstrate effectiveness in improving sexual health outcomes. An innovative Positive Adolescent Sexual Health (PASH) Conference model has been introduced in Northern NSW, Australia. It is run by the North Coast PASH Consortium, which is based on a health promotion framework. It takes a positive and holistic approach to sexual health education, and incorporates peer educators, parents, community workers and teachers. This study provides an introductory evaluation of the PASH Conference and identifies areas for increased effectiveness. It is intended as an early piece of research to inform future evaluations and to provide introductory information for public health educators. Methods Data collection included semi-structured interviews with 13 key stakeholders of the PASH Conference. Interviews were recorded, transcribed verbatim and analysed using deductive thematic analysis. Results Subjects included 2 teachers, 2 parents, 2 youth conference workers, 2 organisers, 2 presenters and 3 Peer Educators engaging Peers (PEEPs). Stakeholders perceived that young people were engaged to strengthen their sexual health and wellbeing due to many factors. These followed 3 themes: a safe and open learning environment, empowerment of young people and involvement of the support system and broader community. Multiple recommendations were identified across 2 themes: changes to conference format and planning, and enhancing stakeholder engagement. Discussion The PASH Conference is a promising new youth development design promoting positive adolescent sexual health, which may provide a feasible model for public health educators to trial. Elements of the conference identified as engaging to youth align well with those in PYD research literature. This study provides an early piece of research to inform the design of future research on the PASH Conference including evaluation of behavioural outcomes. It provides introductory information to inform PASH Conference development to further increase its effectiveness. Electronic supplementary material The online version of this article (10.1186/s12889-019-6993-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Sabrina W Pit
- University Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, POBox 3074, Lismore, NSW, 2480, Australia. .,Sydney School of Public Health, University Of Sydney, Sydney, Australia.
| | - Vibeke Hansen
- University Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, POBox 3074, Lismore, NSW, 2480, Australia
| | - Franklin John-Leader
- Harm Reduction and Health Promotion Programs, HIV and Related Programs (HARP), North Coast Public Health, Mid-North Coast Local Health District, Lismore, Australia
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Rotz D, Goesling B, Manlove J, Welti K, Trenholm C. Impacts of a School-Wide, Peer-Led Approach to Sexuality Education: A Matched Comparison Group Design. THE JOURNAL OF SCHOOL HEALTH 2018; 88:549-559. [PMID: 29992608 DOI: 10.1111/josh.12642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 08/15/2017] [Accepted: 04/04/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Teen Prevention Education Program (PEP) is a school-wide, peer-led comprehensive sexuality education program currently implemented in more than 50 schools across 2 states. Many teen pregnancy prevention researchers and practitioners view peer-led programs as a promising approach for reducing teen pregnancy and associated sexual risk behaviors. However, prior research on the effectiveness of these programs indicates mixed results. METHODS We randomly assigned schools to implement Teen PEP immediately (intervention group) or on a delayed schedule (comparison group) and used propensity score matching to improve the comparability of the study groups. We surveyed students at baseline and about 6 months after the program ended. RESULTS Teen PEP did not significantly impact rates of sexual activity or unprotected sex; however, the program led to improvements in exposure to information about sexual health topics and knowledge of preventing pregnancy and transmission of sexually transmitted infections. CONCLUSIONS Teen PEP succeeded in accomplishing some of its most proximal goals, increasing students' access to information and knowledge. However, we found little evidence that the program affects sexual risk-taking within 6 months of its conclusion. Future research will examine the program's longer-term impacts on sexual risk behaviors.
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Affiliation(s)
- Dana Rotz
- Mathematica Policy Research, 955 Massachusetts Avenue, Suite 801, Cambridge, MA 02139
| | - Brian Goesling
- Mathematica Policy Research, P.O. Box 2393, Princeton, NJ 08543
| | - Jennifer Manlove
- Child Trends, 7315 Wisconsin Avenue, Suite 1200W, Bethesda, MD 20814
| | - Kate Welti
- Child Trends, 7315 Wisconsin Avenue, Suite 1200W, Bethesda, MD 20814
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Vahedi Z, Sibalis A, Sutherland JE. Are media literacy interventions effective at changing attitudes and intentions towards risky health behaviors in adolescents? A meta-analytic review. J Adolesc 2018; 67:140-152. [PMID: 29957493 DOI: 10.1016/j.adolescence.2018.06.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/06/2018] [Accepted: 06/16/2018] [Indexed: 10/28/2022]
Abstract
Youth are inundated with media products promoting risky health behaviors (RHBs), including substance use and risky sexual activity. Media literacy interventions emphasize critical media consumption to decrease RHBs. However, it is unclear whether they positively influence attitudes and behavioral intentions towards RHBs. We conducted meta-analyses of 15 studies (N = 5000) testing intervention effectiveness on media literacy skills and 20 studies (N = 9177) testing effectiveness on attitudes and intentions towards RHBs. We found positive effects on media literacy skills (Hedge's g = .417, [95% CI, .29-.54]) and attitudes and intentions (Hedge's g = .100 [95% CI, .01-.19]). Intervention medium and target behavior moderated intervention success on attitudes and intentions, but no moderators emerged for media literacy skills. These interventions produce positive effects on media literacy skills and positive but smaller effects on attitudes and behavioral intentions, depending on medium and target behaviour. Implications for adolescent health initiatives are discussed.
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Affiliation(s)
- Zahra Vahedi
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario, Canada, M5B2K3.
| | - Annabel Sibalis
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario, Canada, M5B2K3.
| | - Jessica E Sutherland
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario, Canada, M5B2K3.
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