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Yang B, Li Y, Yan K, Choi Y, Bennett-Jones B. Analyzing U.S. State Governments' COVID-19 Homepages during the Initial Lockdown in March and April 2020: Information Content and Interactivity. HEALTH COMMUNICATION 2023; 38:1327-1337. [PMID: 34852700 DOI: 10.1080/10410236.2021.2007574] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
During times of a pandemic, government emergency response webpages are an important communication channel and if properly managed, will mitigate pandemic impacts. Guided by the Crisis and Emergency Risk Communication (CERC) framework and web interactivity literature, this study examined the information content and interactivity of U.S. state governments' COVID-19 homepages when many states declared stay-at-home orders in March or April of 2020. Using a web archive service, we retrieved 48 state governments' COVID-19 homepages. Three coders coded these pages for the presence or absence of information content on five dimensions (timely updates, sensemaking information, efficacy information, targeted guidance, and anti-stigma communication) and interactivity on four dimensions (accessibility, navigability, media richness, and engagement). Results revealed that a large proportion of state governments' COVID-19 homepages provided timely information facilitating people's understanding of the pandemic. Yet, there were some information gaps regarding how to cope with the pandemic or its related problems, such as mental stress and social discrimination. While many COVID-19 homepages allowed easy navigation, page engagement and accessibility seemed inadequate. U.S. state governments' COVID-19 homepages could be a good source for sensemaking. Practitioners and researchers should explore how to better harness interactive Internet technologies and present information that fosters people's efficacy to manage through the pandemic.
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Affiliation(s)
- Bo Yang
- Department of Communication, University of Arizona
| | - Yachao Li
- Department of Communication Studies, The College of New Jersey
- Department of Public Health, The College of New Jersey
| | - Kun Yan
- Department of Communication, University of Arizona
| | - Yunjin Choi
- Department of Communication, University of Arizona
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Bailey J, Mann S, Wayal S, Hunter R, Free C, Abraham C, Murray E. Sexual health promotion for young people delivered via digital media: a scoping review. PUBLIC HEALTH RESEARCH 2015. [DOI: 10.3310/phr03130] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundYoung people are at risk of poor sexual health and are, therefore, in need of comprehensive, effective sexual health education. Young people are confident and constant users of digital technology, such as the internet and mobile phones, and there are many innovative possibilities for sexual health education involving these technologies.ObjectivesTo summarise evidence on effectiveness, cost-effectiveness and mechanism of action of interactive digital interventions (IDIs) for sexual health; optimal practice for intervention development; contexts for successful implementation; research methods for digital intervention evaluation; and the future potential of sexual health promotion via digital media.DesignLiterature review of evidence on digital interventions for sexual health for young people, integrating the findings with the views of young people, parents and experts in digital media/sexual health. IDIs are defined as digital media programmes that provide health information and tailored decision support, behaviour-change support and/or emotional support. We focus on sexual well-being for young people aged 13–24 years in the UK.ResultsThere are many imaginative IDIs for sexual health promotion, but few interventions address issues that are important to young people, such as sexual pleasure and relationships. It is vital to collaborate with young people and to use Behaviour-Change Theory in designing interventions. We located 19 randomised controlled trials of IDIs for sexual health promotion for young people, finding a moderate effect on sexual health knowledge [standardised mean difference (SMD) 0.54, 95% confidence interval (CI) 0.17 to 0.92], a small effect on confidence (self-efficacy) (SMD 0.11, 95% CI 0.02 to 0.20) and a positive effect on sexual behaviour (odds ratio 1.28, 95% CI 1.01 to 1.61), but no significant effects on safer sex intention or biological outcomes. One study suggests that IDIs may be as good as face-to-face interventions for sexual health knowledge and safer sex intention. There are no existing data on the cost-effectiveness of IDIs for sexual health promotion. The impact of an IDI will be determined by the proportion of the target population reached, intervention efficacy, adoption in a setting, how well it is delivered and maintenance/sustainability. All of these elements must be addressed for IDIs to be successful. More collaboration is needed to capitalise on the knowledge of users and stakeholders, the design and software skills of the commercial sector and the theoretical expertise and evaluation skills of academia.ConclusionsIDIs are effective for knowledge acquisition and sexual behaviour, and could usefully contribute to sexual health education in schools, in clinic settings and online; however, there are obstacles to overcome, such as access to information technology and ensuring the quality and safety of interventions.Future workMore evidence is needed on the best designs for interventions (e.g. choice of behaviour-change mechanisms and interactive features) and the best models of delivery (e.g. setting, modes of delivery, methods of facilitation and support for engagement) to improve sexual behaviour, biological outcomes and sexual well-being in a cost-effective way.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Julia Bailey
- e-Health unit, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Sue Mann
- Camberwell Sexual Health Centre, King’s College Hospital, London, UK
| | - Sonali Wayal
- e-Health unit, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Rachael Hunter
- PRIMENT Clinical Trials Unit, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Caroline Free
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Elizabeth Murray
- e-Health unit, Research Department of Primary Care and Population Health, University College London, London, UK
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Marques SS, Lin JS, Starling MS, Daquiz AG, Goldfarb ES, Garcia KCR, Constantine NA. Sexuality Education Websites for Adolescents: A Framework-Based Content Analysis. JOURNAL OF HEALTH COMMUNICATION 2015; 20:1310-1319. [PMID: 26147453 DOI: 10.1080/10810730.2015.1018621] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The web has unique potential for adolescents seeking comprehensive sexual health information. As such, it is important to understand the nature, scope, and readability of the content and messaging provided by sexuality educational websites. We conducted a content analysis of 14 sexuality education websites for adolescents, based on the 7 essential components (sexual and reproductive health and HIV, relationships, sexual rights and sexual citizenship, pleasure, violence, diversity, and gender) of the International Planned Parenthood Framework for Comprehensive Sexuality Education. A majority of content across all sites focused on sexual and reproductive health and HIV, particularly pregnancy and STI prevention, and other information about STIs and HIV. No other topic comprised more than 10% of content coverage across a majority of sites. The authors found little discussion of gender issues, sexual rights, sexual diversity, or sexual violence. Most sites provided brief references to sexual pleasure, generally moderated with cautionary words. Language used implied a heterosexual female audience. Reading levels for most sites were above the 9th-grade level, with several at the college level. These findings have implications for enhancing online sexuality education and broadening the coverage of essential topics.
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Affiliation(s)
- Sara S Marques
- a Center for Research on Adolescent Health and Development , Public Health Institute , Oakland , California , USA
| | - Jessica S Lin
- a Center for Research on Adolescent Health and Development , Public Health Institute , Oakland , California , USA
| | - M Summer Starling
- a Center for Research on Adolescent Health and Development , Public Health Institute , Oakland , California , USA
| | - Aubrey G Daquiz
- a Center for Research on Adolescent Health and Development , Public Health Institute , Oakland , California , USA
| | - Eva S Goldfarb
- b Department of Health and Nutrition Sciences , Montclair State University , Montclair , New Jersey , USA
| | - Kimberly C R Garcia
- a Center for Research on Adolescent Health and Development , Public Health Institute , Oakland , California , USA
| | - Norman A Constantine
- a Center for Research on Adolescent Health and Development , Public Health Institute , Oakland , California , USA
- c School of Public Health , University of California, Berkeley , Berkeley , California , USA
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Xiao Z, Li X, Lin D, Tam CC. Mass Media and HIV/AIDS Prevention Among Female Sex Workers in Beijing, China. JOURNAL OF HEALTH COMMUNICATION 2015; 20:1095-1106. [PMID: 25950448 PMCID: PMC6277979 DOI: 10.1080/10810730.2015.1018575] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The current study aimed to identify the sources of HIV prevention information for female sex workers in Beijing and assess the associations between levels of mass media exposure of HIV/AIDS prevention information and HIV/AIDS knowledge as well as condom use-related attitudes, beliefs, and behaviors. Cross-sectional data were collected from 359 female sex workers in Beijing, China. Chi-square tests and one-way ANOVA tests were employed. Female sex workers sampled in Beijing were more likely to obtain HIV/AIDS prevention information from television and street posters than radio and the Internet. However, a higher level of exposure to and a lasting impression on online information were significantly associated with a higher level of condom use self-efficacy and more consistent condom use among the participants. Exposure to HIV/AIDS prevention information delivered by radio, street posters, and the Internet was found to be associated with sexual communication about HIV or condom use with sexual partners. Overall, this study provides preliminary evidence of the utility of various mass media outlets in delivering HIV/AIDS prevention information among female sex workers in China. Future studies are needed to systematically examine the effectiveness of mass media-based prevention education on HIV/AIDS related attitudes and behaviors among female sex workers and other populations in China.
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Affiliation(s)
- Zhiwen Xiao
- a Valenti School of Communication , University of Houston , Houston , Texas , USA
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Pedrana A, Hellard M, Gold J, Ata N, Chang S, Howard S, Asselin J, Ilic O, Batrouney C, Stoove M. Queer as F**k: reaching and engaging gay men in sexual health promotion through social networking sites. J Med Internet Res 2013; 15:e25. [PMID: 23391459 PMCID: PMC3636214 DOI: 10.2196/jmir.2334] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 11/08/2012] [Accepted: 11/08/2012] [Indexed: 01/15/2023] Open
Abstract
Background A growing number of health promotion interventions are taking advantage of the popularity and interactivity of new social media platforms to foster and engage communities for health promotion. However, few health promotion interventions using social networking sites (SNS) have been rigorously evaluated. "Queer as F**k"(QAF) began as pilot project in 2010 to deliver sexual health promotion via short "webisodes" on SNS to gay men. Now in its fifth season, QAF is among the few published examples internationally to demonstrate the sexual health promotion potential of SNS. Objective The objective of this evaluation is to assess reach, interactivity, and engagement generated by QAF to inform future health interventions and evaluations using SNS. Methods We undertook a mixed method process evaluation using an uncontrolled longitudinal study design that compared multiple measurements over time to assess changes in reach and engagement. We adapted evaluation methods from the health promotion, information systems, and creative spheres. We incorporated online usage statistics, interviews informed by user diary-scrapbooks, and user focus groups to assess intervention reach and engagement. Results During Series 1-3 (April 2010 to April 2011), 32 webisodes were posted on the QAF Facebook and YouTube pages. These webisodes attracted over 30,000 views; ranging from 124-3092 views per individual episode. By April 2011, the QAF Facebook page had 2929 predominantly male fans. Interview and focus group participants supported the balance of education and entertainment. They endorsed the narrative "soap opera" format as an effective way to deliver sexual health messages in an engaging, informative, and accessible manner that encouraged online peer discussion of sexual health and promoted community engagement. Conclusions QAF offers a successful example of exploiting the reach, interactivity, and engagement potential of SNS; findings from this process evaluation provide a model to inform the delivery and evaluation of future health promotion interventions on SNS.
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Affiliation(s)
- Alisa Pedrana
- Burnet Institute, Centre for Population Health, Melbourne, Australia.
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Frith H. ‘CONGRATS!! You had an orgasm’: Constructing orgasm on an internet discussion board. FEMINISM & PSYCHOLOGY 2012. [DOI: 10.1177/0959353512463558] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Drawing on insights from conversation analysis, this article explores a discussion about orgasm on an internet forum. Critical of sex education for failing to address young women as sexual subjects with embodied desires, some feminists believe the internet offers alternative spaces for young women to discuss pleasure. I argue that the micro-political work done by offering ‘congratulations’ on one such site serves to mark young women’s orgasms as both ‘newsworthy’ and ‘good news’ in ways which simultaneously disrupt the idea that sexuality is inappropriate for young women while paradoxically reaffirming conventional ideas about the centrality of orgasm to sexuality.
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Murray E. Web-based interventions for behavior change and self-management: potential, pitfalls, and progress. MEDICINE 2.0 2012; 1:e3. [PMID: 25075231 PMCID: PMC4084772 DOI: 10.2196/med20.1741] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 01/05/2012] [Accepted: 07/27/2012] [Indexed: 11/16/2022]
Abstract
The potential advantages of using the Internet to deliver self-care and behavior-change programs are well recognized. An aging population combined with the increasing prevalence of long-term conditions and more effective medical interventions place financial strain on all health care systems. Web-based interventions have the potential to combine the tailored approach of face-to-face interventions with the scalability of public health interventions that have low marginal costs per additional user. From a patient perspective, Web-based interventions can be highly attractive because they are convenient, easily accessible, and can maintain anonymity/privacy. Recognition of this potential has led to research in developing and evaluating Web-based interventions for self-management of long-term conditions and behavior change. Numerous systematic reviews have confirmed the effectiveness of some Web-based interventions, but a number of unanswered questions still remain.
This paper reviews the progress made in developing and evaluating Web-based interventions and considers three challenging areas: equity, effectiveness, and implementation. The impact of Web-based interventions on health inequalities remains unclear. Although some have argued that such interventions can increase access to underserved communities, there is evidence to suggest that reliance on Web-based interventions may exacerbate health inequalities by excluding those on the “wrong” side of the digital divide. Although most systematic reviews have found a positive effect on outcomes of interest, effect sizes tend to be small and not all interventions are successful. Further work is needed to determine why some interventions work and others do not. This includes considering the “active ingredients” or mechanism of action of these complex interventions and the context in which they are used. Are there certain demographic, psychological, or clinical factors that promote or inhibit success? Are some behaviors or some clinical problems more amenable to change by computer-based interventions? Equally problematic is the issue of implementation and integration of such programs into routine clinical practice. Many eHealth projects end when the research is concluded and fail to become part of mainstream clinical care.
One way of addressing these challenges is to apply the Medical Research Council framework for developing, evaluating, and implementing complex interventions. This includes having a strong theoretical foundation, developing a proposed mechanism or pathway of action, ensuring that the evaluation adequately reflects this proposed pathway, and considering implementation from the beginning of the development process.
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Affiliation(s)
- Elizabeth Murray
- e-Health Unit Research Department of Primary Care and Population Health University College London London United Kingdom
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Online sex-seeking behaviors among men who have sex with men: implications for investigation and intervention. AIDS Behav 2012; 16:1690-8. [PMID: 21785872 DOI: 10.1007/s10461-011-0005-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To investigate factors associated with online sex-seeking behaviors among men who have sex with men (MSM) in Beijing, China. MSM participants were recruited from two cohort studies with multiple enrollment methods from November 2006 to February 2007 and from March to June 2008, respectively. Data collected included demographics and sexual behaviors. Of the 901 participants, 68.1% were single; 69.3% were non-Beijing residents; 94.4% considered themselves to be homosexual; 65.2% received college or higher levels of education; the median age was 26 years; 73.0% sought male sex partners via the Internet in the past 3 months; 66.2% had ≥2 sex partners. Younger age, higher levels of education and having had ≥2 male sex partners in the past 3 months were independently associated with seeking sex partners on the Internet. These findings indicate that Internet-based intervention programs could encourage younger high-risk MSM to use condoms and reduce their numbers of sexual partners.
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Cortese J, Lustria MLA. Can tailoring increase elaboration of health messages delivered via an adaptive educational site on adolescent sexual health and decision making? ACTA ACUST UNITED AC 2012. [DOI: 10.1002/asi.22700] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Juliann Cortese
- School of Communication, College of Communication and Information; Florida State University; Room C3100 UCC, 296 Champions Way, P.O. Box 3062664; Tallahassee; FL; 32306-2664
| | - Mia Liza A. Lustria
- School of Library and Information Studies, College of Communication and Information; Florida State University; Room C3100 UCC, 296 Champions Way, P.O. Box 3062664; Tallahassee; FL; 32306-2664
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Horvath KJ, Wilkerson JM, McFarlane M, Courtenay-Quirk C. Developing and maintaining HIV-related websites: a view from the other side. SEXUAL AND RELATIONSHIP THERAPY 2012. [DOI: 10.1080/14681994.2012.686662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
The rapidly changing media landscape and proliferation of new technologies creates vast new opportunities for HIV prevention. The fast growth of the relatively new eHealth field is a testament to the excitement and promise of these new technologies. eHealth interventions in HIV prevention tested to date include computer- and Internet-based interventions; chat room interventions; text messaging interventions; and social media. The current article provides a brief review of these types of interventions in HIV prevention, including their unique advantages and evidence of efficacy. Implications for future research in the eHealth HIV prevention field are discussed.
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Affiliation(s)
- Seth M Noar
- School of Journalism and Mass Communication, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Schneider F, van Osch L, Schulz DN, Kremers SP, de Vries H. The influence of user characteristics and a periodic email prompt on exposure to an internet-delivered computer-tailored lifestyle program. J Med Internet Res 2012; 14:e40. [PMID: 22382037 PMCID: PMC3376522 DOI: 10.2196/jmir.1939] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 12/14/2011] [Accepted: 01/09/2012] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Internet is a promising medium in the field of health promotion for offering tailored and targeted lifestyle interventions applying computer-tailored (CT) techniques to the general public. Actual exposure to CT interventions is not living up to its high expectations, as only a (limited) proportion of the target group is actually using these programs. OBJECTIVE To investigate exposure to an Internet-delivered, CT lifestyle intervention, targeting physical activity, fruit and vegetable intake, smoking behavior, and alcohol intake, we focused on three processes: first use, prolonged use, and sustained use. The first objectives were to identify user characteristics that predict initiation of an online CT lifestyle program (first use) and completion of this program (prolonged use). Furthermore, we studied the effect of using a proactive strategy, consisting of periodic email prompts, on program revisits (sustained use). METHODS The research population for this study consisted of Dutch adults participating in the Adult Health Monitor, offered by the regional public health services. We used a randomized controlled trial design to assess predictors of first use, prolonged use, and sustained use. Demographics and behavioral characteristics, as well as the strategy used for revisiting, were included as predictors in the model. RESULTS A total of 9169 participants indicated their interest in the new program and 5168 actually logged in to the program. Participants significantly more likely to initiate one of the CT modules were male, older, and employed, and had a lower income, higher body mass index, and relatively unhealthy lifestyle. Participants significantly more likely to complete one of the CT modules were older and had a higher income and a relatively healthier lifestyle. Finally, using a proactive strategy influenced sustained use, with people from the prompting condition being more likely to revisit the program (odds ratio 28.92, 95% confidence interval 10.65-78.52; P < .001). CONCLUSIONS Older, male, and employed participants, and those with a lower income, higher body mass index, and a relatively unhealthy lifestyle were more likely to initiate a CT module. Module completers predominantly had a higher income and age. The current program therefore succeeded in reaching those people who benefit most from online lifestyle interventions. However, these people tended to disengage from the program. This underlines the importance of additional research into program adjustments and strategies that can be used to stimulate prolonged program use. Furthermore, sending periodic email prompts significantly increased revisits to the program. Though promising, this effect was modest and needs to be further examined, in order to maximize the potential of periodic email prompting. TRIAL REGISTRATION Nederlands Trial Register (NTR: 1786) and Medical Ethics Committee of Maastricht University and the University Hospital Maastricht (NL2723506809/MEC0903016); http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1786 (Archived by WebCite at http://www.webcitation.org/65hBXA6V7).
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Affiliation(s)
- Francine Schneider
- CAPHRI, Department of Health Promotion, Maastricht University, Maastricht, Netherlands.
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Abstract
BACKGROUND The popularity of the Internet for health information and the growing availability of online access make the Internet a compelling medium for health promotion and HIV/STI prevention efforts for adolescents. Many private and federally funded programs have incorporated Web-based approaches and online technologies into their sexual education and HIV/STI prevention efforts for adolescents. These efforts have resulted in numerous Web sites and varied online content. This content is currently understudied and underevaluated. In this study, current sexual health Web sites targeted at adolescents were catalogued and coded. METHODS Web sites targeted at adolescents were coded for educational content, credibility, usability, as well as interactivity. RESULTS A significant amount of sexual health information geared toward teens is available online. All the Web sites reviewed showed deficiencies in educational content, as well as deficiencies in usability, authority, and interactivity. Planned Parenthood's Web site was the most well rounded of the sites assessed.
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Affiliation(s)
- Laura B Whiteley
- Bradley Hasbro Research Center, Brown University, 1 Hoppin Street, Providence, RI 02860, USA.
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Kocić B, Petrović B. THE INTERNET-BASED HEALTH INFORMATION AND ADOLESCENTS. ACTA MEDICA MEDIANAE 2011. [DOI: 10.5633/amm.2011.0412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abstract
OBJECTIVES To describe the technologic advances in the digital media, including computers, mobile phones, and the Internet, that have greatly expanded opportunities to deliver evidence-based HIV education, prevention, and treatment programs. METHODS This article examines the use of digital media in the United States and its potential role in HIV prevention and care. RESULTS Although the "digital divide" is shrinking, access varies by age, race/ethnicity, and education. The Internet is an important medium for delivering universal and targeted HIV education and prevention, especially for men who have sex with men, who report going online to seek health information online and for social and sexual networking. Online and off-line behavioral interventions using digital media range from computerized multimedia interventions that take into account individual behaviors to brief untailored video interventions. Numerous Web sites facilitate access to care by providing a variety of services, including location of and linkage to HIV testing and treatment sites. HIV treatment and adherence programs that use online medical records text messaging, paging, and tablet computer-based counseling tools are also being developed. CONCLUSIONS HIV prevention and care programs using digital media have great potential to cost-effectively meet the complex needs of diverse and often underserved populations living with or at high risk of HIV.
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Mustanski B, Lyons T, Garcia SC. Internet use and sexual health of young men who have sex with men: a mixed-methods study. ARCHIVES OF SEXUAL BEHAVIOR 2011; 40:289-300. [PMID: 20182787 PMCID: PMC2914836 DOI: 10.1007/s10508-009-9596-1] [Citation(s) in RCA: 164] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 12/07/2009] [Accepted: 12/07/2009] [Indexed: 05/09/2023]
Abstract
Young gay, bisexual, and other men who have sex with men (MSM) experience sexual health disparities due to a lack of support in settings that traditionally promote positive youth development. The Internet may help to fill this void, but little is known about how it is used for sexual health purposes among young MSM. This mixed-methods study reports quantitative results of a large survey of 18- to 24-year-old MSM in an HIV testing clinic (N = 329) as well as qualitative results from interviews. Level of Internet use was high in this sample and the majority of participants reported using the Internet to find HIV/AIDS information. Black and Latino youth used the Internet less frequently than White youth, and after controlling for age, education, and frequency of Internet use, Black youth were 70% less likely to use the Internet to find HIV/AIDS information. Qualitative analyses identified themes related to the role of the Internet in finding sexual health information, sexual minority identity development, and sexual risk taking behaviors. Participants reported that the Internet filled an important and unmet need for sexual health education. It allowed for connections to the gay community and support during the coming out process, but also exposure to homophobic messages. There was no evidence of increased risk behaviors with partners met online, but at the same time the potential for the use of the Internet to facilitate safer sex communication was largely untapped. Our findings generally present an optimistic picture about the role of the Internet in the development of sexual health among young MSM.
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Affiliation(s)
- Brian Mustanski
- Department of Psychiatry, Institute for Juvenile Research,University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA.
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Jenness SM, Neaigus A, Hagan H, Wendel T, Gelpi-Acosta C, Murrill CS. Reconsidering the internet as an HIV/STD risk for men who have sex with men. AIDS Behav 2010; 14:1353-61. [PMID: 20665100 DOI: 10.1007/s10461-010-9769-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Previous studies linking online sexual partnerships to behavioral risks among men who have sex with men (MSM) may be subject to confounding and imprecise measurement of partnership-specific risks. We examined behavioral risks associated with having only online, only offline, or both online and offline partners in the past year, the confounding effects of multiple partnerships, and partnership-specific risks among a sample of MSM from New York City recruited offline in 2008. Overall, 28% of 479 participants had an online partner in the past year, but most of those (82%) also had an offline partner. Having an online partner was associated with past-year unprotected anal intercourse (UAI) and other risks, but not after controlling for multiple partnerships. There were slightly higher levels of risk within offline partnerships, but differences were largely attributable to MSM who had both offline and online partners. Last sex partners met offline were more likely to be HIV-serodiscordant and engage in concurrent substance use with the participant. This suggests that online partnerships may not be an independent cause of behavioral risks, but a marker for risks occurring independent of Internet use.
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Horvath KJ, Harwood EM, Courtenay-Quirk C, McFarlane M, Fisher H, Dickenson T, Kachur R, Rosser BRS, O'Leary A. Online resources for persons recently diagnosed with HIV/AIDS: an analysis of HIV-related webpages. JOURNAL OF HEALTH COMMUNICATION 2010; 15:516-31. [PMID: 20677056 DOI: 10.1080/10810730.2010.492562] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The Internet is a major source of HIV-related information and resources for persons recently diagnosed with HIV/AIDS (PRDHA). This study examined the types of HIV-related websites that appear as a result of HIV-related keyword searches and the extent to which website information targets PRDHA. The first page of HIV-related webpages from 18 keyword searches was coded. Among 137 webpages meeting inclusion criteria, 63% represented HIV-informational websites, 31% targeted HIV-positive individuals, and over half contained or provided access to HIV prevention, treatment, and transmission information. Thirty-three percent of webpages contained or provided access to PRDHA-targeted information, with a greater percentage of those webpages having mobile, non-English, and "Ask the Expert" features compared with non-PRDHA targeted webpages. Implications for PRDHA include the following: (1) they should explore HIV-related websites to gain insight into the credibility of the information contained on those sites; (2) PRDHA must be aware that HIV-related websites have the potential to elicit dated, emotionally distressing, or irrelevant information; and (3) to obtain information that relates to their demographic and situational profile, they may wish to use specific key terms (e.g., "HIV women") rather than attempting to navigate webpages that arise from general search terms (e.g., "HIV"). Recommendations for future development of online resources for PRDHA include providing HIV-relevant information in a stepwise fashion, providing demographically targeted HIV information, and greater utilization of mobile technology.
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Affiliation(s)
- Keith J Horvath
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota 55454, USA.
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Courtenay-Quirk C, Horvath KJ, Ding H, Fisher H, McFarlane M, Kachur R, O'Leary A, Rosser BS, Harwood E. Perceptions of HIV-related websites among persons recently diagnosed with HIV. AIDS Patient Care STDS 2010; 24:105-15. [PMID: 20064028 DOI: 10.1089/apc.2009.0228] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Many HIV-positive persons use the Internet to address at least some of their needs for HIV-specific information and support. The aim of this multimethod study was to understand how a diverse sample of persons who were recently diagnosed with HIV (PRDH) used the Internet after an HIV diagnosis and their perceptions of online HIV-related information and resources. HIV-positive persons (N = 63) who had been diagnosed since the year 2000 were recruited primarily through HIV-related websites and HIV medical clinics. One third of participants (33%, n = 21) were gay or bisexual men, 25% (n = 16) were heterosexual men, 32% (n = 20) were heterosexual women, and 10% (n = 6) were transgender women (male to female). Semistructured interviews and brief postinterview surveys were used to collect qualitative and quantitative data. Qualitative findings suggested that the most appealing websites to PRDH included those that: (1) provided usable information on topics of immediate concern; (2) used accessible formats that were easy to navigate; (3) were perceived as trustworthy, and (4) provided access to diverse perspectives of persons living with HIV/AIDS. Topics that PRDH found most useful included various medical treatment-related issues, tools for coping with depression and fear, and learning how others cope with HIV. Incorporating the perspectives of HIV-positive persons into the design and content of HIV-related websites is important to enhance their appeal for this diverse and growing population.
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Affiliation(s)
- Cari Courtenay-Quirk
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Keith J. Horvath
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Helen Ding
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Holly Fisher
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary McFarlane
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rachel Kachur
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ann O'Leary
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - B.R. Simon Rosser
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Eileen Harwood
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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Resnicow K, Strecher V, Couper M, Chua H, Little R, Nair V, Polk TA, Atienza AA. Methodologic and design issues in patient-centered e-health research. Am J Prev Med 2010; 38:98-102. [PMID: 20117564 PMCID: PMC5413301 DOI: 10.1016/j.amepre.2009.09.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Revised: 08/07/2009] [Accepted: 09/25/2009] [Indexed: 11/26/2022]
Affiliation(s)
- Ken Resnicow
- University of Michigan, Ann Arbor, 48109-2029, USA.
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21
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Noar SM, Palmgreen P, Chabot M, Dobransky N, Zimmerman RS. A 10-year systematic review of HIV/AIDS mass communication campaigns: Have we made progress? JOURNAL OF HEALTH COMMUNICATION 2009; 14:15-42. [PMID: 19180369 DOI: 10.1080/10810730802592239] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The purpose of the current study was to conduct a 10-year systematic review of HIV/AIDS mass communication campaigns focused on sexual behavior, HIV testing, or both (1998-2007) and to compare the results with the last comprehensive review of such campaigns, conducted by Myhre and Flora (2000). A comprehensive search strategy yielded 38 HIV/AIDS campaign evaluation articles published in peer-reviewed journals, representing 34 distinct campaign efforts conducted in 23 countries. The articles were coded on a variety of campaign design and evaluation dimensions by two independent coders. Results indicated that compared with the previous systematic review (1986-1998 period), campaigns increasingly have employed the following strategies: (1) targeted defined audiences developed through audience segmentation procedures; (2) designed campaign themes around behavior change (rather than knowledge change); (3) used behavioral theories; (4) achieved high message exposure; (5) used stronger research designs for outcome evaluation; and (6) included measures of behavior (or behavioral intentions) in outcome assessments. In addition, an examination of 10 campaign efforts that used more rigorous quasi-experimental designs revealed that the majority (8 of 10) demonstrated effects on behavior change or behavioral intentions. Despite these positive developments, most HIV/AIDS campaigns continue to use weak (i.e., preexperimental) outcome evaluation designs. Implications of these results for improved design, implementation, and evaluation of HIV/AIDS campaign efforts are discussed.
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Affiliation(s)
- Seth M Noar
- Department of Communication, University of Kentucky, Lexington, Kentucky 40506-0042, USA.
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Horvath KJ, Rosser BRS, Remafedi G. Sexual risk taking among young internet-using men who have sex with men. Am J Public Health 2008; 98:1059-67. [PMID: 18445804 DOI: 10.2105/ajph.2007.111070] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the characteristics of young Internet-using men who have sex with men (MSM) and risks associated with seeking sex online, offline, or through both strategies. METHODS Data were obtained from MSM aged 18 to 24 years who completed a 45-minute online survey regarding sex and Internet use in the preceding 3 months. RESULTS Significantly more Internet-using MSM who had met sexual partners both online and offline (43%) reported unprotected anal intercourse than did those who had met sexual partners exclusively online (29%) or offline (34%). MSM who met sexual partners exclusively offline reported the fewest partners but the greatest proportion of partnerships involving unprotected anal intercourse (49%). Meeting sexual partners both online and offline (odds ratio [OR]=3.38-58.42) and being drunk (OR=1.57) or high (OR=2.24) increased the odds of having more sexual partners. The same factors increased the odds of having unprotected anal intercourse (online and offline sexual partners, OR=1.60; being drunk, OR=1.43; being high, OR=1.61). CONCLUSIONS Risky sexual behavior was prevalent among all of the study subgroups. Our findings suggest that online sex seeking is associated with greater numbers of sexual partners but neither promotes nor discourages unprotected anal intercourse. Regardless of where sexual partners met, being drunk and high were significant risks for unprotected anal intercourse.
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Affiliation(s)
- Keith J Horvath
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA.
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23
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Ybarra ML, Bull SS. Current trends in Internet- and cell phone-based HIV prevention and intervention programs. Curr HIV/AIDS Rep 2008; 4:201-7. [PMID: 18366952 DOI: 10.1007/s11904-007-0029-2] [Citation(s) in RCA: 135] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
As the reach of the Internet and cell phones increases, their use as health intervention and prevention tools has been increasingly researched. To identify recent advances in technology-based HIV prevention and intervention research, we conducted a literature search in the Spring of 2007. Only a handful of articles have been published in the last year describing evaluations of technology-based HIV programs. Nonetheless, many programs have recently been funded and are being developed or imminently evaluated. Results to date suggest the Internet and cell phones are feasible technologies to deliver HIV prevention and intervention programs for some target populations. Opportunities for future research are identified, including the development of programs for populations other than men who have sex with men who also are at risk for HIV (eg, adolescents, elderly), the integration of advances from other fields, examination of the potential for using text messaging to affect HIV behavior change, and applications of Internet-based programs in developing countries.
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Affiliation(s)
- Michele L Ybarra
- Internet Solutions for Kids, Inc., 1820 East Garry Avenue #105, Santa Ana, CA 92705, USA.
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