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Yarger J, Gutmann-Gonzalez A, Borgen N, Romero J, Decker MJ. In the Know: A Cluster Randomized Trial of an In-person Sexual Health Education Program Integrating Digital Technologies for Adolescents. J Adolesc Health 2024; 74:1019-1025. [PMID: 38323966 DOI: 10.1016/j.jadohealth.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 11/03/2023] [Accepted: 12/11/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE Integrating digital technologies into sexual health education can offer advantages for connecting with adolescents, particularly populations who may be underserved through common school-based approaches. This study assessed the effectiveness of In the Know, an in-person, group-based sexual health education program integrating digital technologies, codesigned with adolescents. METHODS The study design was a cluster randomized trial with 1,263 adolescents aged 13-19 in 95 cohorts, implemented in community-based organizations and schools throughout Fresno County, California. Participants completed a baseline survey and a follow-up survey 3 months later. Two-level mixed-effects regression models with random intercepts for cohort were used to estimate the intervention's impact on unprotected sex, use of clinical health services, knowledge of local sexual health services, technology use to find or schedule services, and sexual health knowledge at the 3-month follow-up. RESULTS The average age of participants was 15.7 years, and the majority identified as Hispanic (71%). In adjusted analyses, intervention group participants were more likely to use clinical services (42.7% vs. 33.2%, p = .009) and reported greater sexual health knowledge at 3 months (57.6% of items answered correctly vs. 50.7%, p = .001). No significant differences were observed in the other outcomes by study group. DISCUSSION In the Know participants demonstrated greater use of clinical health services and sexual health knowledge at 3 months. The study findings show the potential for incorporating user-centered design and technology into sexual health education to better support adolescents who may have limited access to this important information.
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Affiliation(s)
- Jennifer Yarger
- Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.
| | - Abigail Gutmann-Gonzalez
- Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California
| | - Natasha Borgen
- Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California
| | - Julio Romero
- Fresno Economic Opportunities Commission, Fresno, California
| | - Martha J Decker
- Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
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Phillips Z, Mitsumoto J, Fisher H, Wilhite J, Hardowar K, Robertson V, Paige J, Shahroudi J, Albert S, Li J, Hanley K, Gillespie C, Altshuler L, Zabar S. Using Unannounced Standardized Patients to Assess Clinician Telehealth and Communication Skills at an Urban Student Health Center. J Adolesc Health 2024; 74:1033-1038. [PMID: 38430075 DOI: 10.1016/j.jadohealth.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/16/2023] [Accepted: 01/04/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE As the COVID-19 pandemic forced most colleges and universities to go online, student health centers rapidly shifted to telehealth platforms without frameworks for virtual care provision. An urban student health center implemented a needs assessment involving unannounced standardized patients (USPs) to evaluate the integration of a new telehealth workflow and clinicians' virtual communication skills. METHODS From April to May 2021, USPs conducted two video visits with 12 primary care and four women's health clinicians (N = 16 clinicians; 32 visits). Cases included (1) a 21-year-old female presenting for birth control with a positive Patient Health Questionaire-9 and (2) a 21-year-old male, who vapes regularly, with questions regarding safe sex with men. Clinicians were evaluated using a checklist completed by the USP immediately following the visit and a systematic chart review of the electronic health record. RESULTS USP feedback indicates most clinicians received high ratings for general communication skills but may benefit from educational intervention in several key telemedicine skills. Clinicians struggled with using nonverbal signals to enrich communication (47% well done), acknowledging emotions (34% well done), and using video for information gathering (34% well done). Low rates of standard screenings (e.g., 63% administered the PHQ-2, <50% asked about alcohol use) suggested protocols for in-person care were not easily incorporated into telehealth practices, and clinicians may benefit from enhanced care team support. Performance reports were shared with clinicians and leadership postvisit. DISCUSSION Results suggest project design and implementation is scalable and feasible for use at other institutions, offering a structured methodology that can improve general student health care.
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Affiliation(s)
- Zoe Phillips
- Department of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, New York.
| | - Jun Mitsumoto
- New York University Student Health Center, New York, New York
| | - Harriet Fisher
- Department of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, New York
| | - Jeffrey Wilhite
- Department of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, New York
| | - Khemraj Hardowar
- Department of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, New York
| | | | - Joquetta Paige
- New York University Student Health Center, New York, New York
| | - Julie Shahroudi
- New York University Student Health Center, New York, New York
| | - Sharon Albert
- New York University Student Health Center, New York, New York
| | - Jacky Li
- New York University Student Health Center, New York, New York
| | - Kathleen Hanley
- Department of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, New York
| | - Colleen Gillespie
- Department of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, New York
| | - Lisa Altshuler
- Department of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, New York
| | - Sondra Zabar
- Department of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, New York
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Estruch-García V, Gil-Llario MD, Fernández-García O. Sexual experiences and knowledge of people with moderate intellectual disability. J Intellect Disabil Res 2024; 68:512-523. [PMID: 38304997 DOI: 10.1111/jir.13125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND This study addresses the sexuality of people with moderate intellectual disabilities (PMID), a topic that has been little studied. Understanding romantic and sexual experiences is highly relevant for reducing stigma and prejudice related to their sexuality. Additionally, comprehending the level of sexual knowledge of PMID contributes to the development of preventive and sexual health education programmes tailored for this group. Our aim is to explore the sexual history (relationships, sexual behaviour, condom use and sexual abuse), sex education received and the level of sexual knowledge of PMID. METHOD The total of 142 PMID completed questionnaires about sexual knowledge and experiences, and their support staff provided additional information. Data were analysed using chi-square test (χ2) and descriptive statistical analysis. RESULTS Masturbation was the most common sexual behaviour (75.7%), especially among men (χ2 = 5.81, P < 0.05). Sexual intercourse was rare, and only 30.5% reported using condoms. Women reported a higher prevalence of self-reported sexual abuse (27.3% vs. 6% in men). The study also highlighted misconceptions about sexual intercourse risks and contraceptive methods. CONCLUSION The results suggest that PMID need sexual education to ensure healthy sexual experiences and prevent risky behaviour.
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Affiliation(s)
- V Estruch-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - M D Gil-Llario
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - O Fernández-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
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Abstract
Lesbian, gay, and bisexual (LGB) adolescents are more likely to experience mental health problems than their heterosexual peers because they are victimized more often or fear discrimination. Governmental plans to improve this situation by addressing sexual diversity in German schools have been accompanied by public resistance and misinformation, e.g., that they aim to sexualize children. The present study assessed how widespread negative attitudes toward such plans really are and how they can be explained. A random sample of 2,013 German residents was surveyed by phone. Only 10% opposed promoting acceptance of LGB in school. Approval of such plans was predominantly predicted by respondents' beliefs about sexual orientation and the plans' aim, and only marginally by societal values. Respondents who knew that the plans' aim was to promote acceptance of LGB and not to sexualize children and that children with same-sex parents are just as well off as those with heterosexual parents showed higher approval, whereas respondents who believed that homosexuality is affected by socialization showed higher opposition.
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Affiliation(s)
- Ulrich Klocke
- Institut für Psychologie, Humboldt-Universität zu Berlin, Berlin
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Letessier M, Mignot D, Mejri I, Hitoto H. A rural interprofessional primary care team develops a school-based sex education program. Sante Publique 2024; 35:87-127. [PMID: 38388405 DOI: 10.3917/spub.236.0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Introduction In French rural areas, getting information about sexual health and identifying health actors on the topic is difficult for teenagers. Despite national and international guidelines, school-based sex education programs remain insufficient in France. The aim of this project was to develop a school-based psycho-affective and sexual health program (PASHP) for teenagers, led by an interprofessional primary care team (IPCT) in Montval-sur-Loir (Sarthe) and to coordinate local stakeholders. Method The IPCT developed the PASHP using a community-based participatory research method. The first step identified the target population and its needs for sex education. The second step was to create a steering group to tailor PASHP interventions in a participatory way and to define the PASHP’s aims and execution arrangements. The third step aimed at carrying out the PASHP and getting stakeholders’ and the target population’s feedback. Results The PASHP, carried out in the 2020–2021 and 2021–2022 school years, included an intervention about contraception and sexually transmitted infections, artistic workshops on consent or gender stereotypes, group discussions, and an intervention about pornography to assist parents. Conclusion The PASHP developed and coordinated by the Montval-sur-Loir IPCT is innovative because of its organization. It coordinates local stakeholders, teenagers, and their parents in a disadvantaged rural area, respecting national guidelines on sex education.
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Affiliation(s)
| | | | - Ilyess Mejri
- Maison de santé pluridisciplinaire de Montval-sur-Loir, France
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Velasco-Gijón IM, Polo-Oliver A, Gutiérrez-Ramírez L, Arias-Arias Á, Tejera-Muñoz A. [Survey to know the perception of sexual education in adolescents]. Rev Esp Salud Publica 2024; 98:e202402005. [PMID: 38333924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/29/2023] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVE Sex education is essential for an accurate approach of sexuality in adolescents, being more effective when it is carried out at early ages. This study aimed to estimate the sexual health knowledge and the information in this regard perceived by adolescents, as well as where it came from. METHODS A cross-sectional observational study was performed in students from two public high schools in Castilla-La Mancha who were surveyed about sexual knowledge. Comparisons were made by using the Student's t test or Mann Whitney U test, the Chi-square test (or Fisher's exact test) depending on the variables. RESULTS 248 students were included (68.1% from Madridejos and 31.9% from Herencia) with a mean age of 14.67±1.1 years. The 47.2% were women. Only 4.8% of the participants affirm to talk about sexuality with their parents. The 56% declared had consumed pornographic content, with a mean first access age of 12.8±1 years. Significant statistically differences were found between the information received in schools and in the familiar surroundings, being alcohol and drug intake, sexually transmitted infections (STI), and contraceptive methods more frequently treated at the educational centers. A 25% of the surveyed students who reported having performed sexual relations stated not having used condom. Approximately, half of the participants did not perceive a high risk of getting STIs (HIV, herpes and chlamydia) in the case of having sex without condom. CONCLUSIONS There is a lack of sexual knowledge in adolescents, perceiving a noteworthy heterogeneity in the offered information depending on it is received in high school or in familiar surroundings.
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Affiliation(s)
- Isabel M Velasco-Gijón
- Centro de Salud de Madridejos; GAI Alcázar de San Juan. Alcázar de San Juan (Ciudad Real). España
| | - Ana Polo-Oliver
- Centro de Salud Alcázar I; GAI Alcázar de San Juan. Alcázar de San Juan (Ciudad Real). España
| | - Lucía Gutiérrez-Ramírez
- Unidad de Apoyo a la Investigación; Hospital Mancha Centro. Alcázar de San Juan (Ciudad Real). España
- Instituto de Investigación de Castilla-La Mancha (IDISCAM). Toledo. España
- Fundación del Hospital Nacional de Parapléjicos para la Investigación y la Integración. Toledo. España
| | - Ángel Arias-Arias
- Unidad de Apoyo a la Investigación; Hospital Mancha Centro. Alcázar de San Juan (Ciudad Real). España
- Instituto de Investigación de Castilla-La Mancha (IDISCAM). Toledo. España
| | - Antonio Tejera-Muñoz
- Unidad de Apoyo a la Investigación; Hospital Mancha Centro. Alcázar de San Juan (Ciudad Real). España
- Instituto de Investigación de Castilla-La Mancha (IDISCAM). Toledo. España
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Wetzel GM, Sanchez DT. "What's Something You've Heard About Sex, But Are Unsure If It's True?": Assessing Middle and High School Students' Sex Education Questions. J Adolesc Health 2024; 74:327-339. [PMID: 37804300 DOI: 10.1016/j.jadohealth.2023.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/25/2023] [Accepted: 08/16/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE Comprehensive sex education (CSE) encourages safer sex behavior for teens and young adults. However, young people recognize a gap between sex education as taught in the classroom and the reality of their sexual experiences. Thus, CSE should take into account the perspectives of its target population. METHODS The current project assesses young people's sexual uncertainties by analyzing open-ended responses that were anonymously submitted during in-person sex education sessions. These education programs were administered in middle and high schools in New York State by facilitators from Planned Parenthood Hudson Peconic, Inc. The authors analyzed 1,335 responses from a racially diverse sample of students between the ages of 10 and 21, with 75% of participants between 15 and 17 years old. RESULTS Using content analysis, the authors identified 49 recurring content codes in participants' responses, which were organized into 16 categories. Most responses centered around pregnancy, sexually transmitted infections, and how to prevent these outcomes. However, responses also highlighted topics that are not always covered with nuance and transparency, if at all, in sex education (e.g., withdrawal, effectiveness of condoms and other contraception, anal and oral sex). Additionally, gender analyses indicated that girls made greater reference to pain, while boys made greater reference to pleasure, which has implications for girls' development of a positive sexuality. DISCUSSION These results should be interpreted with a social equity lens to inform the development of needs-driven, target-based CSE programming.
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Affiliation(s)
- Grace M Wetzel
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey.
| | - Diana T Sanchez
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey
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Boehnlein C, Boniface ER, Packham AJ, Baldwin MK. A Social Media Survey of US Adolescent Preferences for Menstrual Bleeding Patterns. J Pediatr Adolesc Gynecol 2024; 37:25-32. [PMID: 37935280 DOI: 10.1016/j.jpag.2023.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/09/2023]
Abstract
STUDY OBJECTIVE To assess preferences for menstrual pattern and acceptability and knowledge about the safety of induced amenorrhea among adolescents and young adults METHODS: We conducted a cross-sectional online survey of US residents aged 14-24 years at least 1 year post-menarche. Online recruitment was conducted via the social media platform TikTok on a teen reproductive health channel. Survey questions focused on menstrual history, menstrual pattern preferences, and demographic characteristics. The primary outcome was the proportion of postmenstrual individuals who would prefer amenorrhea vs scheduled bleeding. RESULTS From 5113 potential respondents who accessed the eligibility screening, 3001 completed surveys and met the inclusion criteria. Most were aged 14-18 (63.7%), distributed proportionally among all US Census regions. When asked if they could pick their period-bleeding style without any permanent impacts, almost three-quarters chose no bleeding at all (amenorrhea; 71.5%) compared with scheduled periods (28.5%). However, 63.7% agreed or were uncertain when faced with the statement "It might be unsafe if hormone medications stop your period bleeding." After adjusting for age, gender expression, race, religion, heavy bleeding, and frequent bleeding, factors associated with preference for amenorrhea vs regular bleeding were younger age, masculine gender expression, White race, and non-Christian religious background. Baseline bleeding amount and frequency were not associated with preference for amenorrhea. CONCLUSION More than two-thirds of US adolescents and young adults indicated a preference for medication-induced amenorrhea if the method was assured to not have any permanent effects on the body, despite highly prevalent misconceptions about health and safety.
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Thorne E, Babchishin KM, Fisico R, Healey L. Sexting in Young Adults: A Normative Sexual Behavior. Arch Sex Behav 2024; 53:593-609. [PMID: 38082175 DOI: 10.1007/s10508-023-02728-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/10/2023] [Accepted: 10/17/2023] [Indexed: 02/07/2024]
Abstract
With the advancement of technology, sexting has become more prominent in high school and university samples. The current study examined the rates and characteristics of sexting among an online sample of 2,828 young adults aged 18-30, primarily from the U.S. and Canada. We found that most participants sext (81%), sext often (most report ≥ 11 sexts), and start young (most by 16-17 years of age). Common reasons for sexting echoed reasons for participating in other normative sexual behaviors, including that it was sexually arousing, they were asked and wanted to reciprocate, or they wanted to flirt. Sexual coercion was a gendered phenomenon, with 1 in 10 cisgender women and 1 in 50 cisgender men reporting having sent a sext due to being threatened. The body parts captured in cisgender men's sexts were more diverse, whereas cisgender women focused on their chest, underwear/genitalia, and stomach. Sexual orientation was also found to be a relevant factor, with different patterns in sexting experiences emerging across identities. The current study adds to the mounting evidence that sexting is a normative sexual behavior. Sexual education programs should provide youth with information on consent and safe sexting practices rather than follow an abstinence approach.
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Affiliation(s)
- Evelyn Thorne
- John Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Kelly M Babchishin
- Department of Psychology, Carleton University, Ottawa, ON, K1S 5B6, Canada.
| | - Rebecca Fisico
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Lindsay Healey
- Department of Psychology, Carleton University, Ottawa, ON, K1S 5B6, Canada
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Castro CA, Monterrosa-Blanco A, Rodríguez LL, Castiblanco A, Bernal L, Ladino MJ, Pinilla D, Melo C, Baquero F. Knowledge and attitudes regarding contraceptive methods and sex education in students and parents of eight Colombian schools 2020-2021: a mixed methods study. Lancet Reg Health Am 2024; 30:100678. [PMID: 38322782 PMCID: PMC10844851 DOI: 10.1016/j.lana.2024.100678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 02/08/2024]
Abstract
Background In Colombia, the average age of first sexual intercourse is between 14 and 15, and it has one of the highest fertility rates among adolescents in Latin America, which reflects poor access to health services and a lack of knowledge about contraception. Some laws support comprehensive sex education as a learning process that families and schools should provide. The objective of this work was to assess the frequency of adequate knowledge and attitudes of acceptance towards contraception in students, their associated factors, sexual behaviours in sexually active students, and experiences with sex education. Methods Mixed methods study consisting of an analytical cross-sectional study and a qualitative hermeneutic phenomenological study. The former included students who completed a questionnaire with sociodemographic variables, surveys on knowledge and attitudes toward contraception, and questions about sexual behaviour. Focus groups were used in the qualitative study to evaluate students' and parents' sex education experiences. Findings 827 students were surveyed, of whom 52.3% had adequate knowledge about contraceptives and 80.1% had attitudes of acceptance. Talking with parents about sex education, receiving sex education, and being in the eleventh grade increased the likelihood of having adequate knowledge. Each year of age, being male, being a victim of forced displacement, and studying in a public school were associated with lower possibilities of attitudes of acceptance. Using condoms, compared to other contraceptives, was associated with less adequate knowledge and attitudes of acceptance (p < 0.05). Experiences with sex education, contraception, and sexual and reproductive rights were three emerging categories in the focus groups. Interpretation In a group of Colombian high school students, half of them had adequate knowledge, eight out of 10 had attitudes of acceptance about contraception, and both were associated with having received sex education. Nevertheless, different types of barriers to sexual education were identified at home and in schools. The results will allow the generation of educational policies that modify the educational model as well as new strategies by health professionals to raise awareness about responsible sexuality. Funding This project was financed by internal research of the Fundación Universitaria de Ciencias de la Salud-FUCS (DI-I-0392-20).
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Affiliation(s)
| | | | | | | | - Liliana Bernal
- Fundación Universitaria de Ciencias de la Salud - FUCS, Bogota, Colombia
| | - María José Ladino
- Nursing School, Fundación Universitaria de Ciencias de la Salud - FUCS, Bogota, Colombia
| | - Diana Pinilla
- School of Medicine, Fundación Universitaria de Ciencias de la Salud - FUCS, Bogota, Colombia
| | - Carlos Melo
- Fundación Universitaria de Ciencias de la Salud - FUCS, Bogota, Colombia
| | - Ferney Baquero
- Fundación Universitaria de Ciencias de la Salud - FUCS, Bogota, Colombia
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Döring N, Walter R, Scharmanski S. [Parental sex education and sexual risk behavior of daughters and sons: findings from the representative survey "Youth Sexuality"]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:14-22. [PMID: 37855911 PMCID: PMC10776709 DOI: 10.1007/s00103-023-03783-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/21/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND According to socialization theory, parental sex education should lead to increased sexual literacy in adolescents. However, current data for Germany is lacking. RESEARCH AIM Against this backdrop, the aim of the present study was to link for the first time the general conversations about sexuality in the family (research question 1, RQ1), and specifically parental contraception education (RQ2), with the sexual risk behavior of adolescents. MATERIALS AND METHODS The database is the ninth wave of the representative survey "Youth Sexuality" conducted by the Federal Centre for Health Education in Germany (BZgA). Data from all sexually active 14- to 17-year-old adolescents in the sample who provided information on their sexual behavior and whose parents reported on their sex education behavior were analyzed (N = 357). To answer the two research questions, logistic regression analyses were carried out with four central characteristics of adolescent sexual behavior. RESULTS The results showed that for both girls and boys conversations about sexuality in the family are positively correlated with (1) reached age of consent at first sexual intercourse, (2) a positive first sexual intercourse experience, (3) reliable contraception use, and (4) a low number of sexual partners (RQ1). The same pattern of results emerged for contraception education by parents (RQ2). DISCUSSION The positive correlations between parental sex education and less risky adolescent sexual behavior need to be further investigated with respect to the underlying causal mechanisms.
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Affiliation(s)
- Nicola Döring
- Technische Universität Ilmenau, Institut für Medien und Kommunikationswissenschaft (IfMK), Ilmenau, Deutschland.
- Institut für Medien und Kommunikationswissenschaft (IfMK), TU Ilmenau, Ehrenbergstraße 29, 98693, Ilmenau, Deutschland.
| | - Roberto Walter
- Technische Universität Ilmenau, Institut für Medien und Kommunikationswissenschaft (IfMK), Ilmenau, Deutschland
| | - Sara Scharmanski
- Bundeszentrale für gesundheitliche Aufklärung (BZgA), Köln, Deutschland
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Xiao H, Chang M, Torres A, Flores G, Lau M. Preventing Teen Pregnancy: A Qualitative Study of the Perspectives of Parenting and Expecting Latino Adolescents. J Pediatr Adolesc Gynecol 2023; 36:532-540. [PMID: 37468034 DOI: 10.1016/j.jpag.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/26/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
STUDY OBJECTIVE Latino youths in the United States experience disproportionately high rates of teen pregnancy. The aim of this study was to obtain expecting and parenting Latino adolescents' perspectives regarding factors contributing to teen pregnancy and pregnancy prevention. METHODS Expecting/parenting Latino adolescents were recruited from high schools with high proportions of Latino youths and teen pregnancy. Participants completed a questionnaire on sociodemographic and background characteristics. Focus groups were stratified by age and gender and audio recorded. Grounded theory was used to identify themes from the transcribed audio recordings. RESULTS Thirty-two expecting/parenting Latino adolescents (20 females, 12 males) 14-19 years old participated in four focus groups. Quantitative results revealed that two-thirds of participants at birth had adolescent mothers. Over three-quarters of participants reported that their pregnancies had occurred too soon. Qualitative themes for factors contributing to teen pregnancy included lack of contraceptive knowledge/access, belief of invincibility, influence within relationships, male decisions on contraceptive use, desire to belong among peers, lack of parental support for contraceptive use, lack of parental attention, rebellion, normalization of adolescent parenthood in Latino culture, and media. Themes for pregnancy prevention included time alone with physicians, parenting teens as mentors, reproductive health education, and community pregnancy-prevention programs. CONCLUSION Multiple factors contribute to teen pregnancy in Latino youth, including influences from Latino culture, family, peers, partners, and social determinants of health. Pregnancy prevention should incorporate interventions to address these aspects, including disseminating culturally sensitive education materials, providing parenting teens as peer mentors, encouraging time alone with health care providers, and addressing various social determinants of health.
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Affiliation(s)
- H Xiao
- University of Texas Southwestern Medical School, Dallas, Texas
| | - M Chang
- Los Angeles County & University of Southern California Medical Center, Los Angeles, California
| | - A Torres
- Universidad Autonoma de Guadalajara School of Medicine, Guadalajara, Mexico
| | - G Flores
- Department of Pediatrics, University of Miami Miller School of Medicine, and Holtz Children's Hospital, Jackson Health System, Miami, Florida
| | - M Lau
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Children's Health System of Texas, Dallas, Texas.
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Ademuyiwa I, Ayamolowo S, Oshinyemi T, Oyeku K. Knowledge and attitude of sex education among secondary school students in south-western Nigeria: A cross-sectional study. Dialogues Health 2023; 2:100085. [PMID: 38515483 PMCID: PMC10954024 DOI: 10.1016/j.dialog.2022.100085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 11/05/2022] [Accepted: 11/20/2022] [Indexed: 03/23/2024]
Abstract
Sex education helps in preparing adolescents to have responsible attitudes and behaviour towards sex for a harmonious sexual life. This study assessed the level of knowledge and attitude towards sex education among secondary school students in an urban south-western Nigeria. The study adopted a descriptive cross-sectional design. Multistage sampling technique was used to select a sample size of 378 students from a population of 3674 students in public secondary schools. A pre-tested self-administered questionnaire with Cronbach' Alpha value of 0.76 was used for data collection. The approval of the study was obtained from the Human Research Ethics Committee of Lagos University Teaching Hospital. Data were analyzed using SPSS version 20. Chi-square test and multiple logistic regression were used for test of association among the variables at p < 0.05. Majority of the respondents 338 (89.9%) were between age 14-17 with mean age of 16 ± 5.22 years. Majority of the respondents 309 (82.1%) had a good knowledge of sex education. More than half, 216 (57.5%) of the respondents had positive attitude towards sex education. There was a significant relationship between knowledge and attitude of the respondents towards sex education (p = 0.01). Knowledge of sex education increases as class of students increases to SS2 = (OR = 7.750; 95% CI [3.268-18.378] and SS3 = (OR = 2.219; 95% CI [1.067-4.613] respectively. The study concluded that the respondents had good knowledge of sex education and there was a significant relationship between students' knowledge and attitude towards sex education. There is need for awareness and effective sex education among secondary school students. Teachers and parents should create the view of improving the attitude of secondary school students towards sex education.
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Affiliation(s)
- I.Y. Ademuyiwa
- Department of Nursing Science, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi Araba, Lagos, Nigeria
| | - S.J. Ayamolowo
- Department of Nursing Science, Faculty of Basic Medical Sciences, Obafemi Awolowo University Ile-Ife, Nigeria
| | - T.E. Oshinyemi
- Department of Nursing Science, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi Araba, Lagos, Nigeria
| | - K.J. Oyeku
- Department of Nursing Science, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi Araba, Lagos, Nigeria
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Jones SC, Boniface ER, Boehnlein C, Jones Packham A, Baldwin MK. Menstrual Health Literacy among Adolescents and Young Adults Who Menstruate: Impact of Christian Family Background and United States Region. J Pediatr Adolesc Gynecol 2023; 36:518-524. [PMID: 37482080 DOI: 10.1016/j.jpag.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
STUDY OBJECTIVE To compare menstrual health literacy among adolescents and young adults on the basis of family religious background and United States region METHODS: We conducted a cross-sectional online survey of post-menarcheal US adolescents and young adults aged 14-24 years who identified their family religious background, including Christian or non-religious, with recruitment via the social media platform TikTok. We asked participants several questions to assess their health literacy regarding common myths about the use of gonadal steroid hormones for menstrual suppression. RESULTS From 3250 online survey respondents, 2997 met the criteria for analysis, with 1989 identifying their family as Christian (66.4%) and 1008 identifying their family as non-religious (33.6%), with equal representation by US region. Health literacy was lower among those with a Christian family background, with concerns that menstrual suppression is unhealthy (16.4% vs 10.5% with non-religious background, P < .01), is unsafe (31.4% vs 24.2%, P < .01), and could lead to infertility (32.6% vs 20.0%, P < .01). Similarly, adolescents and young adults from the US South were worried that menstrual suppression is unhealthy (31.5%; P < .01) and would lead to infertility (33.8%; P < .01). CONCLUSION Health literacy is lower among adolescents and young adults with a Christian family background and those who live in the South. These results demonstrate a need for an evidence-based national curriculum that addresses the safe and effective use of hormonal medications for menstrual suppression.
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Kohn BH, Vidal P, Chiao R, Pantalone DW, Faja S. Sexual Knowledge, Experiences, and Pragmatic Language in Adults With and Without Autism: Implications for Sex Education. J Autism Dev Disord 2023; 53:3770-3786. [PMID: 35922688 PMCID: PMC9362056 DOI: 10.1007/s10803-022-05659-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/18/2022]
Abstract
Autistic adults have similar levels of desire for sexual and romantic relationships as their non-autistic peers. However, autistic adults are less likely to be in relationships and have less dating experience. We compared sexual knowledge, experiences, and pragmatic language ability in a community sample of young adults with (n = 27, mean age = 22.11) and without autism (n = 122, mean age = 19.47). Receipt of sex education and sexual knowledge did not differ between groups. However, autistic adults had significantly fewer partnered experiences and impaired pragmatic language. Within both groups, pragmatic skill predicted accurate sexual knowledge above and beyond general communication abilities. Findings suggest that sex education for autistic adults must address the social communication component of healthy romantic and sexual relationships.
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Affiliation(s)
- Brooke H Kohn
- Boston Children's Hospital, Boston, MA, USA
- New York University Langone Health, New York, NY, USA
| | - Paige Vidal
- Boston Children's Hospital, Boston, MA, USA
- Boston College, Boston, MA, USA
| | - Rachael Chiao
- Boston Children's Hospital, Boston, MA, USA
- Boston University, Boston, MA, USA
| | - David W Pantalone
- University of Massachusetts, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Susan Faja
- Boston Children's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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16
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Nesfechi EF, Pouralizadeh M, Khalesi ZB, Maroufizadeh S. Approaches and styles of mothers in sex education process of children and the related factors. BMC Nurs 2023; 22:253. [PMID: 37528437 PMCID: PMC10394873 DOI: 10.1186/s12912-023-01410-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 07/20/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION Sex education supports the development of suitable sexual behaviors in children. However, due to the limitations of sexual issues in Iran, parents may have different sex education styles. This study aimed to assess the styles of mothers in the sex education process of children and the related factors. METHODS In a cross-sectional study, from March to May 2021, 306 mothers with a 4-12-year-old child who were referred to the comprehensive health service centers in Rasht city were entered into the study by a convenience sampling method. The tool was a questionnaire of parents' sex education styles. Data analysis was performed with independent t-tests, one-way ANOVA, Pearson's correlation coefficient, and the multiple linear regression model using SPSS software version 16. RESULTS The majority of the mothers had a mean age of 36.2 ± 6.4 years. The score of the authoritarian sex education style was significantly higher than the other styles (P < 0.001). According to the multivariate analysis, 40.6% of the changes in the strict style (R2 = 0.406), 32.7% of the changes in the permissive style (R2 = 0.327), and 36.1% of the changes in the authoritative style (R2 = 0.361) were explained by the personal characteristics of the participants. CONCLUSION The authoritative style was a dominant sex education style. Identifying the factors associated with types of child sex education styles has an important role in promoting the health of children and the community. It is recommended that nursing policymakers identify related factors of sex education styles in mothers of different cultures, and therefore, implement training programs for empowering mothers.
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Affiliation(s)
- Elnaz Faraji Nesfechi
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Moluk Pouralizadeh
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
- Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Hamidyan Ave, Rasht, Iran.
| | - Zahra Bostani Khalesi
- Department of Midwifery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Saman Maroufizadeh
- Department of Biostatistics and Epidemiology, School of Health, Guilan University of Medical Sciences, Rasht, Iran
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Kantor LZ, Tordoff DM, Haley SG, Crouch JM, Ahrens KR. Gender and Sexual Health-Related Knowledge Gaps and Educational Needs of Parents of Transgender and Non-Binary Youth. Arch Sex Behav 2023:10.1007/s10508-023-02611-9. [PMID: 37233838 DOI: 10.1007/s10508-023-02611-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 03/26/2023] [Accepted: 04/19/2023] [Indexed: 05/27/2023]
Abstract
Parents can have a substantial impact on adolescent sexual decision-making, but few studies have explored the role of parents in providing sexual health information to transgender and non-binary (TNB) youth, a population that experiences significant sexual and mental health disparities and lower levels of perceived family support compared with other youth. This study aimed to elucidate existing knowledge gaps and content deemed important for a sexual health curriculum and educational materials for parents of TNB youth. We conducted 21 qualitative interviews with five parents of TNB youth, 11 TNB youth aged 18+, and five healthcare affiliates to identify parents' educational needs. We analyzed the data using theoretical thematic analysis and consensus coding. Parents self-reported multiple knowledge deficits regarding gender/sexual health for TNB individuals and were primarily concerned with long-term impacts of medical interventions. Youth goals for parents included greater understanding of gender/sexuality and sufficient knowledge to support youth through social transition to their affirmed gender identity. Content areas suggested for a future curriculum for parents of TNB youth included: basics of gender/sexuality, diverse narratives of TNB experiences/identities, gender dysphoria, non-medical gender-affirming interventions, medical gender-affirming interventions, and resources for peer support. Parents desired access to accurate information and wanted to feel equipped to facilitate affirming conversations with their child, something that could combat health disparities among TNB youth. An educational curriculum for parents has the potential to provide a trusted information source, expose parents to positive representations of TNB individuals, and help parents support their TNB child through decisions about potential gender-affirming interventions.
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Affiliation(s)
- Lane Z Kantor
- David Geffen School of Medicine at the University of California Los Angeles, 10833 Le Conte Ave., Los Angeles, CA, 90095, USA.
| | - Diana M Tordoff
- Department of Epidemiology, Stanford University School of Medicine Palo Alto, Stanford, CA, USA
| | | | - Julia M Crouch
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Kym R Ahrens
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
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Rousseau M, Asselin I, Morello R, Lecoutour X, Brouard J, Fauvet R, Pizzoferrato AC. Prevalence and factors associated with active cybersexuality among teenagers between 15 and 17 years old: a cross sectional study in Normandy, France. Arch Pediatr 2023:S0929-693X(23)00030-1. [PMID: 37147154 DOI: 10.1016/j.arcped.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/13/2022] [Accepted: 01/29/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Teenagers use the Internet to obtain and exchange information in multiple fields, including about taboo subjects such as sexuality. Our objectives were to determine the prevalence and vulnerability factors related to active cybersexuality among teenagers aged between 15 and 17 years in western Normandy. MATERIAL AND METHODS This was an observational, cross-sectional, multicenter study integrated into sexual education classes for teenagers between 15 and 17 years old. An anonymous questionnaire, designed for the study, was given at the beginning of each session. RESULTS The study had a 4-month duration and involved 1,208 teenagers. The results revealed that 66% of them engaged in cybersex, with sexting being the most widespread practice: 21% sent such sexts, 60% received such sexts, and 12% of boys shared such texts with others. Other practices, such as dedipix, dating websites, and skin parties, were more marginal, but 12% of teenagers had met someone in real life after meeting them first online. A history of experiencing violence, a lack of parental control, female gender, poor self-esteem, and consuming toxic drugs were associated with a higher risk of cybersexuality with an odds ratio (OR) of 1.63, 1.95, 2.07, 2.27, and 2.66, respectively. Number of friends on social networks >300 and daily viewing of pornography were also strongly associated with cybersexuality with an OR of 2.83 and 6.18, respectively. CONCLUSIONS This study shows that cybersex is practiced by two thirds of teens. Vulnerability factors most strongly associated with cybersexuality were female gender, poor self-esteem, consuming toxic drugs, number of friends on social networks >300, and daily viewing of pornography. Cybersexuality involves risks (social exclusion, bullying, dropout, poor self-esteem, breakdown) that are possible to prevent by highlighting this theme during sexual education classes.
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Affiliation(s)
- M Rousseau
- Department of Gynaecology, Obstetrics, and Reproductive Medicine, Caen University Hospital, Caen, France
| | - I Asselin
- Department of Gynaecology, Obstetrics, and Reproductive Medicine, Caen University Hospital, Caen, France
| | - R Morello
- Unit of Biostatistics and Clinical Research, Caen University Hospital, Caen, France; Caen Normandie University, Caen, France
| | - X Lecoutour
- Caen Normandie University, Caen, France; Unit of Epidemiology, Health Economics and Prevention, Caen University Hospital, Caen, France
| | - J Brouard
- Caen Normandie University, Caen, France; Department of Paediatrics, Caen University Hospital, Caen, France
| | - R Fauvet
- Department of Gynaecology, Obstetrics, and Reproductive Medicine, Caen University Hospital, Caen, France; Caen Normandie University, Caen, France; Inserm U1086 ANTICIPE, Unité de Recherche Interdisciplinaire pour la Prévention et le Traitement des Cancers, Axe 2: Biologie et Thérapies Innovantes des Cancers Localement Agressifs (BioTICLA), France
| | - A-C Pizzoferrato
- Department of Gynaecology, Obstetrics, and Reproductive Medicine, Caen University Hospital, Caen, France.
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Flores D, Kornides M, Meanley S. Inclusive and Age-Appropriate Timing of Sexual Health Discussions at Home According to Gay, Bisexual, and Queer Adolescent Males. J Adolesc Health 2023; 72:754-762. [PMID: 37062572 PMCID: PMC10111203 DOI: 10.1016/j.jadohealth.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE The exclusion of gay, bisexual, and queer (GBQ) adolescent males' specific sexuality concerns in standard classroom education heightens the need for parents to be primary sources of trusted sexual health information. The aim of this study was to collect GBQ adolescent males' suggestions for a comprehensive list and age-appropriateness of topics that parents may use for inclusive discussions at home throughout the elementary, middle school, and high school years. METHODS Semistructured interviews and card sorts of 48 topics were conducted with a sample of 30 racial and ethnic diverse GBQ adolescents in central North Carolina. Thematic analysis of the interview transcripts and a calculation of card sort responses followed. RESULTS Topics chosen for elementary-age GBQ youth were focused on core issues about human anatomy, safety, and the continuum of sexual orientations and gender identities. Participants designated the majority of topics for home-based discussions in middle school and emphasized considerations for engaging in sex, relating with others socially, options for HIV/STI risk reduction, issues around interpersonal safety, and pleasure. They reserved topics for high school focused on complex sociorelational issues and technology-based concerns. DISCUSSION Participants' varied rationale for timing of topics centered on the age-appropriateness and level of details that they deemed acceptable for discussions with parents. To address disproportionate negative sexual and mental health outcomes noted in this youth subgroup, parents should focus on being supportive by providing factual and sequential information crucial for their GBQ childrens' anticipated developmental needs and sexual identity milestones.
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Affiliation(s)
- Dalmacio Flores
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Melanie Kornides
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Steven Meanley
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
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Lo Moro G, Bert F, Cappelletti T, Elhadidy HSMA, Scaioli G, Siliquini R. Sex Education in Italy: An Overview of 15 Years of Projects in Primary and Secondary Schools. Arch Sex Behav 2023; 52:1653-1663. [PMID: 36749406 PMCID: PMC10125923 DOI: 10.1007/s10508-023-02541-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
School-based sex education is essential to improve the knowledge and behavior of young people. Unlike most European countries, sex education in Italy is not compulsory in the school curriculum. Therefore, to assess potential gaps, the main aim of this study was to explore Italian regional initiatives about sex education. A review of gray literature from 2006 to 2021 was conducted in December 2021 on national databases and institutional websites of each Italian region, during which official documents on regional sex education programs were selected. Moreover, a rapid systematic review was carried out in scientific databases to find more information. For both reviews, the sex education topics recommended by UNESCO were used for extracting and analyzing data. A total of 12 Italian regions out of 20 had at least one sex education program, for a total of 39 projects. Overall, all the topics identified by UNESCO have been covered, with considerable differences between northern, central, and southern Italy. Contraception, love, marriage, partnerships, and family were the main topics discussed (hosted in 92% of the regions). Only 25% of the regions discussed pregnancy and birth. Disability was the least debated topic (17%). The rapid systematic review showed that relevant improvements were achieved after sex education interventions. In conclusion, this study underlined important limitations to the implementation of school-based sex education in Italy. Hence, it is necessary to increase sex education interventions to reach adequate standards and flatten the differences not only between Italian regions but also between Italy and other European countries.
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Affiliation(s)
- Giuseppina Lo Moro
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
| | - Fabrizio Bert
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
| | - Toni Cappelletti
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
| | | | - Giacomo Scaioli
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy.
| | - Roberta Siliquini
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
- A.O.U. City of Health and Science of Turin, Turin, Italy
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Crehan ET, Yang X, Dufresne S, Barstein J, Stephens L, Dekker L, Greaves-Lord K. Adapting the Tackling Teenage Training Sex Education Program for Autistic Adults in the US: A Pilot Study. J Autism Dev Disord 2023:10.1007/s10803-023-05962-3. [PMID: 37046158 DOI: 10.1007/s10803-023-05962-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 04/14/2023]
Abstract
Despite the established need for sexuality and relationship programming for autistic adults, there are extremely limited curricula for this population. This pilot study used an evidence-based sexuality and relationship education program for autistic adolescents (Tackling Teenage Training) as the basis for an adult-focused virtual psychoeducational group. Qualitative feedback, quantitative ratings of the programming, and behavioral surveys from participants were collected. Nine participants completed the program, and corresponding pre and post measures. Highly rated topics, for example gender identity and online dating, were consistent with previous research on what autistic adults want from a sexuality and relationship education program. Future programming should incorporate increased attention to themes and topics highlighted by participants, and should utilize the teaching tools (e.g., role play, peer discussions) identified as useful by the participants.
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Affiliation(s)
| | - Xihan Yang
- Tufts University, 105 College Ave, Medford, MA, 02155, USA
| | | | | | | | - Linda Dekker
- Department of Psychology, Education and Child Studies, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
| | - Kirstin Greaves-Lord
- Department of Psychology, Clinical Psychology and Experimental Psychopathology Unit, University of Groningen, Groningen, The Netherlands
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute Groningen, Groningen, The Netherlands
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Gholizadegan Rayat S, Nasseri N, Fariborzi E, Saffariantoosi M. Effectiveness of Psycho-Religious Sexuality Education upon Anger and Depression of Iranian Female Adolescents: The Relationship of Quality Family Relationships and Birth Order. J Relig Health 2023; 62:1070-1089. [PMID: 36538141 PMCID: PMC9765359 DOI: 10.1007/s10943-022-01716-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Sexually active adolescents tend to have a wider range of psychosocial problems, including depression, anger, poor academic achievement, low self-esteem, and substance use. Developing a high-quality and curriculum-based comprehensive sexuality education (CSE) program is of great importance for adolescents following Iranian culture. Due to the lack of such an educational program, the purpose of this study was to investigate the effectiveness of psycho-religious CSE upon anger and depression of Iranian female adolescents, as well as the relationship of quality family relationships and birth order. The research design is quasi-experimental with pre-test and post-test with experimental and control groups. The statistical population of this study comprised all Iranian female adolescents aged 15 to 18 years in Mashhad who participated in this workshop voluntarily. For data collection, the Child and Adolescent Depression Inventory and Spielberger's State-Trait Anger Expression Inventory (STAXI) were used. SPSS 21 software and analysis of variance (ANOVA) and covariance (ANCOVA) were used for data analysis. The results showed that there was a significant difference in the mean difference between depression and anger in the control and experimental groups (p-Value < 0.05). The results also showed a significant relationship between birth order and the quality of family relationships on depression and anger. Psycho-religious-based SE can reduce depression and anger in female students. These findings can be used in planning educational interventions with a psycho-religious-based approach to reducing anger, depressive symptoms and dangerous sexual behaviors among adolescents.
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Affiliation(s)
| | - Naziasadat Nasseri
- Department of Educational Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Elham Fariborzi
- Department of Educational Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
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Jangi S, Nourizadeh R, Sattarzadeh-Jahdi N, Farvareshi M, Mehrabi E. The effect of cognitive-behavioral therapy and sexual health education on sexual assertiveness of newly married women. BMC Psychiatry 2023; 23:201. [PMID: 36978034 PMCID: PMC10045628 DOI: 10.1186/s12888-023-04708-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The present study aimed at investigating the effect of sexual health education and cognitive-behavioral therapy (CBT) on sexual assertiveness (primary outcome) and sexual satisfaction (secondary outcome) of newly married women. METHOD This RCT was conducted on 66 newly married women with cases in pre-marriage counseling centers in Tabriz, Iran. Participants were assigned into three groups using block randomization. Eight group sessions of CBT were held for one of the intervention groups (n = 22) and 5-7 sessions of sexual health education for other intervention group (n = 22). The control group (n = 22) received neither education nor counseling during the research. The data were collected using the demographic and obstetric characteristics, Hulbert sexual assertiveness index, and Larson sexual satisfaction questionnaires, and analyzed using ANOVA and ANCOVA tests. RESULTS The mean (standard deviation: SD) score of the sexual assertiveness and sexual satisfaction in the CBT group enhanced from 48.77 (13.94) and 73.13 (13.53) before the intervention to 69.37 (7.28) and 86.57 (7.5) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the sexual health education group increased from 48.9(11.39) and 74.95 (8.30) before the intervention to 66. 94 (7.42) and 84.93 (6.34) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the control group changed from 45.04 (15.87) and 69.04 (10.75) before the intervention to 42.74 (14.11) and 66.44 (10.11) after the intervention, respectively. Eight weeks after the intervention, the mean scores of sexual assertiveness and sexual satisfaction in two intervention groups were more than that in the control group (P < 0.001), However, there was no significant difference between the two intervention groups (P > 0.05). CONCLUSION The results of this research indicated that CBT and sexual health education are effective in improving women's sexual assertiveness and sexual satisfaction. Considering that sexual health education, does not require complex counseling skills compared to CBT, it can be used as a preferred intervention in promoting sexual assertiveness and satisfaction of newly married women. TRIAL REGISTRATION Iranian Registry of Clinical Trials: IRCT20170506033834N8. Date of registration: 11.09.2021. URL: http://en.irct.ir .
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Affiliation(s)
- Sanaz Jangi
- Student Research Committee, Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghaiyeh Nourizadeh
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Niloufar Sattarzadeh-Jahdi
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmoud Farvareshi
- Razi Psychiatric Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Esmat Mehrabi
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Srivastava S, Chauhan S, Patel R, Marbaniang SP, Kumar P, Dhillon P, Pandey N. Exposure to Pornographic Content Among Indian Adolescents and Young Adults and Its Associated Risks: Evidence from UDAYA Survey in Bihar and Uttar Pradesh. Arch Sex Behav 2023; 52:361-372. [PMID: 36109450 DOI: 10.1007/s10508-022-02411-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 06/24/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Adolescence is period characterized by sexual development, increasing romantic relationships, and the initiation of sexual activity. To enhance the exploration of their sexuality, adolescents may look into sexual resources such as pornography. There has been little research in India to understand how much adolescents are exposed to Internet pornography and what are the associated risk factors. This study examined the level of exposure to pornography among adolescents and the associated factors which determine the exposure to pornography in Uttar Pradesh and Bihar. Understanding the Lives of Adolescents and Young Adults (UDAYA) survey data collected in 2015-2016 was used for this study. The study was based on 3885 adolescent boys and 7766 adolescent girls aged 15-19 years. The mean age for adolescent boys was 16.66 years (SD: 1.3), and for girls it was 16.67 years (SD: 1.3). About 47% of adolescent boys but only 6% of girls were exposed to pornography. The likelihood of exposure to pornography was 1.69 times and 2.27 times more likely among adolescents and girls who had their own personal mobile phones, respectively, compared to those who did not have their own personal mobile phones. The odds of exposure to pornography were significantly higher among adolescent boys who had frequent media exposure than those who had no/rare exposure. Programs on life skills and comprehensive sexuality education need to be prioritize.
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Affiliation(s)
- Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Shekhar Chauhan
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | | | - Pradeep Kumar
- Research & Data Analyst, Population Council, New Delhi, India.
| | - Preeti Dhillon
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
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Decker MJ, Zárate CG, Atyam TV, Saphir M. Improving Adolescent Perceptions of Barriers and Facilitators to Sexual and Reproductive Health Services Through Sexual Health Education. J Adolesc Health 2023; 72:138-46. [PMID: 36289042 DOI: 10.1016/j.jadohealth.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/21/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE This study examines whether comprehensive sexual health education that provides information on clinical services can change adolescents' perceptions of barriers, facilitators, and intention to use services and whether changes in perceptions differ by participant characteristics. METHODS Adolescent participants in a statewide sexual health education program in California were surveyed at baseline and at exit about their perceptions of barriers, facilitators, and intention to use clinical services. Linked baseline and exit surveys (n = 7,460) assessed change in perceptions after program completion. Logistic regression analyses that accounted for the clustered data structure assessed associations between participant characteristics and improvement in perceptions. RESULTS After the program, there were significant reductions in two perceived barriers (worry about cost and judgment by staff), but there were also small but significant increases in perceptions of two barriers (worry about confidentiality of services and test results). There were significant increases in all three perceived facilitators and intention to use sexual and reproductive health services, which rose from 90.6% at baseline to 96.2% at exit. Younger youth were more likely than older youth to show improvement in all perceived facilitators and intentions. Girls and Black youth were more likely than boys and Hispanic youth to show improvement in two facilitators (knowing what to expect and access). No sociodemographic characteristics were consistently associated with reductions in perceived barriers. DISCUSSION Comprehensive sexual health education that addresses adolescents' questions and concerns regarding clinical services can help to reduce perceived barriers, increase facilitators, and increase intention to use services if needed.
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Setty E, Dobson E. Department for Education Statutory Guidance for Relationships and Sex Education in England: A Rights-Based Approach? Arch Sex Behav 2023; 52:79-93. [PMID: 36171488 PMCID: PMC9859846 DOI: 10.1007/s10508-022-02340-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 02/03/2022] [Accepted: 04/13/2022] [Indexed: 06/16/2023]
Abstract
In England, the Children and Social Work Act (HMSO, 2017) bestowed compulsory status on relationships and sex education (RSE), which means that young people's right to receive RSE has been codified in law. This paper analyzes how this right is upheld and enacted within the Department for Education (DfE) (2019) statutory guidance on RSE for schools in England. The analysis suggests that the guidance features contradictory discourses in which young people's rights are ostensibly advanced, but remain structured by adult-centric, heteronormative understandings of sex and relationships. It upholds a decontextualized and legalistic approach to rights, responsibilities, informed choice, and decision making. A narrow conception of rights is particularly evident regarding young people's digital sexual cultures, which are predominantly framed in terms of risk and harm. We argue that scholars should investigate how educators are designing and delivering RSE in light of the guidance, and the opportunities for and obstacles to a genuinely "rights-based" approach to RSE. While the policy discussed in this article is specific to England, the discussion has wider relevance for practitioners and policymakers across cultural and geographic contexts as it draws upon a model for analyzing how young people's sexuality is presented and addressed in legislative and curricular documentation.
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Affiliation(s)
- Emily Setty
- Department of Sociology, University of Surrey, 11 AD 03, Guildford, GU2 7XH, Surrey, UK.
| | - Emma Dobson
- School of Education, University of Durham, Durham, UK
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Apaydin Cirik V, Aksoy B, Bulut E. Attitudes of parents in the role of a father in Turkey toward child sex education and their sexual communication with their children. J Pediatr Nurs 2022:S0882-5963(22)00329-3. [PMID: 36585347 DOI: 10.1016/j.pedn.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE The study aimed to evaluate the attitudes of parents in the role of a father in Turkey toward child sex education and their sexual communication with their children. METHODS This descriptive and cross-sectional study was conducted with the fathers of children in the pediatric outpatient clinic at a state hospital between December 30, 2021, and April 15, 2022. The study was reported based on STROBE. The data were collected from 297 fathers using the Descriptive Information Form, the Attitudes Scale Toward Sex education (ASTSE), and the Sexual Communication Scale for Parents(SCSP). RESULTS Sample statistics demonstrate that 67.7% of the participants did not receive sex education in their childhood, and 57.4% stated that their children received sex education only from their mothers. Higher attitudes toward sexual education were found in the fathers with a university or higher education degree (χ2 = 15.396; p < 0.01), and those giving sex education to their children (χ2 = 18.388;p < 0.001). Higher total scores were obtained on the sexual communication scale by fathers with university and higher education degrees (χ2 = 12.898;p < 0.01) and those who received sex education in their childhood (t = 2.330;p = 0.021). There is a highly significant positive correlation between the mean scores of the role of a parent subscale of the ASTSE and the mean total score of the SCSP (r = 0.81;p < 0.001). CONCLUSIONS There is a positive correlation between fathers' parental role attitudes toward sex education and their sexual communication with their children. PRACTICE IMPLICATIONS Supporting fathers' sexual communication with their children can positively affect fathers' attitudes and communication toward sex education.
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Yahyavi S, Raisi F, Firoozikhojastefar R, Shahvari Z, Mirsepassi Z. Sex education for patients with severe mental illness in Iran: A qualitative study. PEC Innov 2022; 1:100016. [PMID: 37213718 PMCID: PMC10194151 DOI: 10.1016/j.pecinn.2022.100016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 12/18/2021] [Accepted: 01/03/2022] [Indexed: 05/23/2023]
Abstract
Objective Patients with severe mental illness may experience cognitive deficits, impaired judgment or loss of skills. Therefore, they are prone to sexual health complications. Sex education can promote sexual health, and in many countries, it is integrated into other domains of education. The educational contents taught in western countries are not necessarily appropriate for developing countries.This study aims to address sex educational content for these patients in Iran. Methods We have conducted twenty-three face-to-face, deep and semi-structured interviews with patients, family members, psychiatrists, general practitioners, nurses and psychologists. We used the strategy of maximum diversity in selecting the participants. Results "Improving basic knowledge," "decreasing the risk of unsafe sex", "empowerment" and "persuading to ask for help" should be covered in the education. Conclusions Sexuality is not considered a priority for these patients. It is necessary to develop a training program with simple educational content for this high-risk group. Innovation Raising awareness and knowledge about the possible risks of social media on high-risk behaviours, developing social and behavioural skills, and encouraging patients to talk about their new challenges in sexual life is recommended. Cultural, spiritual and personal beliefs should be considered in designing the educational program.
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Affiliation(s)
- SeyyedTaha Yahyavi
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Firoozeh Raisi
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Shahvari
- Department of Nursing and Midwifery, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran
| | - Zahra Mirsepassi
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author at: Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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ROSSI VALENTINA, NAPOLITANO FRANCESCA, HAYTER MARK, WATSON ROGER, CALZOLARI MICHELA, ALEO GIUSEPPE, ZANINI MILKO, CATANIA GIANLUCA, SASSO LOREDANA, BAGNASCO ANNAMARIA. Validation of the Italian version of the SexContraKnow instrument. J Prev Med Hyg 2022; 63:E611-E617. [PMID: 36890991 PMCID: PMC9986989 DOI: 10.15167/2421-4248/jpmh2022.63.4.2676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/16/2023] [Indexed: 03/10/2023]
Abstract
Introduction A large proportion of all pregnancies worldwide occur in young adolescent women, and almost all these pregnancies are unintentional. To address effective educational interventions, it is necessary to assess adolescents' literacy on this topic. The aim of this study was to translate and validate the Italian version of the SexContraKnow instrument. Methods This was a methodological study. The validation of the instrument was performed following the EORTC Quality of Life Group translation procedure. The process consisted of four phases: translation, content validation, face validation, and pilot test. Data were collected between May and September 2021. The STROBE guidelines were followed for this study. Results After performing forward and backward translations, we evaluated content validity (Scale-Content Validity Index = 0.91) and face validity. We then conducted a pilot test, test re-test, with 10 students (Cronbach α = 0.928; Pearson's R = 0.991). Conclusion The Italian Version of the SexContraKnow instrument has a good level of validation and reliability and can be effectively used by nurses to assess adolescents' literacy about the use of contraceptives and to develop targeted educational interventions. This instrument will help to evaluate the effectiveness of education programmes about health literacy about safe sex and contraception. The attention of nurses should be actively directed towards the process of health literacy among adolescents, in the perspective of a society focused on the empowerment of the population.
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Affiliation(s)
| | | | - MARK HAYTER
- Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
| | - ROGER WATSON
- Academic Dean. Institution, Southwest Medical University, Luzhou, China
| | | | - GIUSEPPE ALEO
- Department of Health Sciences, University of Genoa, Italy
- Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - MILKO ZANINI
- Department of Health Sciences, University of Genoa, Italy
- Correspondence: Milko Zanini, Department of Health Sciences, University of Genoa, via Pastore 1, 16132 Genoa, Italy - Tel.: 0039 010 3538590 - E-mail:
| | | | - LOREDANA SASSO
- Department of Health Sciences, University of Genoa, Italy
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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: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Bloor D, Ballantyne C, Gillespie-Smith K, Wilson C, Hendry G. Investigating the challenges of teaching sex education to autistic learners: A qualitative exploration of teachers' experiences. Res Dev Disabil 2022; 131:104344. [PMID: 36182810 DOI: 10.1016/j.ridd.2022.104344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 08/11/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sex education is essential as it equips individuals with the knowledge to live independent and safe sex lives. However, in the United Kingdom, sex education is not particularly accessible for autistic learners which may lead to a lack of knowledge around appropriate sexual behaviours. AIMS The current study focusses on the challenges of teaching sex education to autistic learners. METHODS AND PROCEDURES The data was produced through one-to-one interviews with thirteen educational practitioners that have experienced delivering sex education to autistic learners. OUTCOMES AND RESULTS Reflexive thematic analysis (Braun & Clarke, 2006) was used to interpret the data, producing themes of (1) Pedagogical Restrictions, and (2) Sexual Impulses. CONCLUSIONS AND IMPLICATIONS These findings demonstrated that the main challenges of teaching sex education to autistic learners pertained to Pedagogical Restrictions in the classroom, and learners' own sexual impulses. These findings are a positive step towards understanding how to adapt sex education lessons to make them more inclusive and accessible for learners with autism. This study contributes to developing understanding around how to support autistic learners, highlighting gaps in the current sex education curriculum for policy makers, and enabling those surrounding autistic individuals to best support them with body transformations.
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Affiliation(s)
- Daisy Bloor
- School of Education, University of Glasgow, UK
| | - Carrie Ballantyne
- School of Education and Social Sciences, University of the West of Scotland, UK
| | | | | | - Gillian Hendry
- School of Education and Social Sciences, University of the West of Scotland, UK.
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Decker MJ, Price M, Unti L, Firpo-Triplett R, Atyam T, Spitzer J, Coyle K. Monitoring unplanned sexual health curricula adaptations: Using results to improve fidelity and support implementation. Eval Program Plann 2022; 94:102126. [PMID: 35820289 DOI: 10.1016/j.evalprogplan.2022.102126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 06/20/2022] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
Maintaining fidelity to an evidence-based curriculum is important, yet educators may need to adapt to unexpected situations or particular contexts. The purpose of this study is to identify the reasons for unplanned adaptations during implementation of an evidence-based sexual health education program in California. Evaluators reviewed fidelity checklists from the implementation of 571 cohorts for activities with reported unplanned adaptations. Reasons were qualitatively coded and compared across two phases of implementation and by setting. Educators reported 319 unplanned adaptations, affecting 21.5% of the 571 cohorts and 2.9% of 13,782 activities. The most common reasons for unplanned adaptations were due to time management issues, site logistic issues, and to increase participant engagement. Over time, health educators reported fewer unplanned adaptations, particularly those due to time management, resulting in a decrease in the cohorts and activities affected. Adaptations to evidence-based curricula are necessary and often occur during implementation to fit local conditions and populations. Ongoing review of adaptation data provides an opportunity to refine training and technical assistance efforts. Guidance about the types of permitted adaptations and how to anticipate and plan for adaptations for future implementation can ensure fidelity to the core curriculum components and responsiveness to youth participants.
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Affiliation(s)
- Martha J Decker
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois St, Floor 7, San Francisco, CA 94158, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, Floor 2, San Francisco, CA 94158, USA.
| | - Melisa Price
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois St, Floor 7, San Francisco, CA 94158, USA.
| | - Lisa Unti
- ETR, 5619 Scotts Valley Dr, Suite 140, Scotts Valley, CA 95066, USA.
| | | | - Tara Atyam
- California Department of Public Health, Maternal, Child, and Adolescent Health Division, PO Box 997377, MS 0500, Sacramento, CA 95899-7377, USA.
| | - Jason Spitzer
- California Department of Public Health, Maternal, Child, and Adolescent Health Division, PO Box 997377, MS 0500, Sacramento, CA 95899-7377, USA.
| | - Karin Coyle
- ETR, 5619 Scotts Valley Dr, Suite 140, Scotts Valley, CA 95066, USA.
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Gómez-Lugo M, Morales A, Saavedra-Roa A, Niebles-Charris J, Abello-Luque D, Marchal-Bertrand L, García-Roncallo P, García-Montaño E, Pérez-Pedraza D, Espada JP, Vallejo-Medina P. Effects of a Sexual Risk-Reduction Intervention for Teenagers: A Cluster-Randomized Control Trial. AIDS Behav 2022; 26:2446-2458. [PMID: 35084613 PMCID: PMC9162964 DOI: 10.1007/s10461-022-03574-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2021] [Indexed: 12/03/2022]
Abstract
This study evaluated the efficacy of the COMPAS program in the short term and 6 months after its application. For the initial sample, 2047 teenagers aged 14–19 years from 14 schools in 11 Colombian cities participated; eight schools were randomly assigned to the experimental condition and six to the control group. The participants completed self-report assessments that evaluated several variables theoretically associated with protective sexual behaviors. In the short term, the experimental group showed increased knowledge about HIV and other STIs, sexual assertiveness, self-efficacy, greater behavioral intention toward condom use, and more favorable attitudes toward HIV and condom use than the control group. After 6 months, most psychological and health variables also showed a significant positive change. In conclusion, the COMPAS program is the first school-based sexuality education program that has been shown to be effective in reducing mediating and behavioral variables associated with sexual risk reduction in Colombia.
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Affiliation(s)
| | - Alexandra Morales
- AITANA Research Group, Department of Health Psychology, Universidad Miguel Hernández, Avda. de la Universidad, s/n., 03202, Elche, Alicante, Spain.
| | | | | | | | | | | | | | | | - Jose P Espada
- AITANA Research Group, Department of Health Psychology, Universidad Miguel Hernández, Avda. de la Universidad, s/n., 03202, Elche, Alicante, Spain
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Dolev-Cohen M, Ricon T. Dysfunctional Parent-Child Communication About Sexting During Adolescence. Arch Sex Behav 2022; 51:1689-1702. [PMID: 35112270 DOI: 10.1007/s10508-022-02286-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
Sexting (sending, receiving, and forwarding nude, semi-nude, or sexually explicit content) entails risks for adolescents; therefore, it is important for parents to be able to communicate with their children about its implications. The goal of the present study was to identify parental characteristics that lead to dysfunctional communication (lower quality of communication) about sexting, on a sample of 427 parents (336 mothers and 91 fathers) of Israeli adolescents aged 10-18 years and to determine whether parents' perceived severity of sexting and the degree to which they perceive their adolescent to be susceptible to sexting function as mediating factors. Parents completed a set of questionnaires online. Findings indicated that authoritarian and permissive parenting styles were positively associated with dysfunctional parent-child communication about sexting. Authoritative style was inversely related to dysfunctional communication and was mediated by positive attitudes toward sex education. Additionally, authoritative parents were capable of assessing the severity of their children's sexting activities, and the degree to which their children were susceptible to engage in sexting. The quality of the discussion initiated by authoritative parents appears to have enabled them to be aware of adolescent behaviors and to adjust their communication about the inherent risks. Findings suggest that the perception of sexting as too risky diminishes parents' ability to conduct a high-quality discussion about it. In conclusion, research findings emphasize parents' role in mediation of the online experiences of their children and conducting a constructive discussions with them about sexting.
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Affiliation(s)
- Michal Dolev-Cohen
- Educational Counseling Program, Faculty of Graduate Studies, Oranim Academic College of Education, 36006, Tivon, Israel.
| | - Tsameret Ricon
- Educational Counseling Program, Faculty of Graduate Studies, Oranim Academic College of Education, 36006, Tivon, Israel
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Szucs LE, Harper CR, Andrzejewski J, Barrios LC, Robin L, Hunt P. Overwhelming Support for Sexual Health Education in U.S. Schools: A Meta-Analysis of 23 Surveys Conducted Between 2000 and 2016. J Adolesc Health 2022; 70:598-606. [PMID: 35305795 PMCID: PMC10904928 DOI: 10.1016/j.jadohealth.2021.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/19/2020] [Accepted: 05/04/2021] [Indexed: 10/18/2022]
Abstract
PURPOSE Surveys suggest that the general public (i.e., adults or parents) supports sexual health education in schools. However, the number of schools providing sex education continues to decline in the United States. The purpose of this study is to conduct a meta-analysis of U.S.-based representative surveys to provide a pooled estimate of public support for sexual health education delivered in schools. METHODS A systematic search of three databases (Medline, PsycInfo, and ERIC) was conducted to identify survey measuring adult and parent attitudes toward sexual health education in school between 2000 and 2016. Meta-analyses were conducted in OpenMetaAnalyst via the metaphor package in R using a DerSimonian-Laird random effect models to account for heterogeneity between surveys. RESULTS A total of 23 citations met study inclusion and exclusion criteria, representing 15 unique probability surveys conducted with the public. Among the included surveys, 14 were nationwide and 11 included parents or an overrepresentation of parents. Across all survey findings, 88.7% (95% confidence interval = 86.2-91.2) of respondents supported sexual health education. Among surveys that only included parents or oversampled for parents, 90.0% (95% confidence interval = 86.5-93.4) supported sexual health education, and among nationally representative surveys, 87.7% (95% confidence interval = 85.1-90.6) of respondents supported sexual health education. CONCLUSION These findings demonstrate overwhelming support for sexual health education delivered in schools. Additional research is needed to determine individual differences in support for specific sexual health education topics and skills delivered through classroom-based instruction.
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Affiliation(s)
- Leigh E Szucs
- The Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia.
| | - Christopher R Harper
- The Centers for Disease Control and Prevention, Division of Violence Prevention, Atlanta, Georgia
| | - Jack Andrzejewski
- San Diego State University-University of California, San Diego Joint Doctoral Program in Public Health, Health Behavior Track, La Jolla, California
| | - Lisa C Barrios
- The Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia
| | - Leah Robin
- The Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia
| | - Pete Hunt
- The Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia
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Mirsepassi Z, Raisi F, Shahvari Z, FirooziKhojastefar R, Yahyavi ST. Evaluating family knowledge about sexual health in patients with severe mental illness: a qualitative study in Iran. BMC Psychiatry 2022; 22:174. [PMID: 35272647 PMCID: PMC8908587 DOI: 10.1186/s12888-022-03788-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 02/16/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Although paying more attention to sex education in patients with severe mental illness is recommended in the literature, the role of families has not been specifically clarified. AIM: This study aims to explore family knowledge about sexual health in patients with severe mental illness in Iran. METHODS We conducted a total number of 21 interviews with 4 patients, 5 families, 7 psychiatrists, 1 general practitioner, 2 nurses, and 2 psychologists through purposive sampling. The text was analyzed using conventional qualitative content analysis. RESULTS The family knowledge about patients' sexual health is described in three subcategories: 'informal sources for knowledge acquisition', 'common myths, and 'inappropriate reaction to the patients' needs". CONCLUSIONS Family sex education should be integrated into a comprehensive rehabilitation program to promote sexual health in patients with severe mental illness. Family members should be aware of the necessity of accurate information about patients' sexual concerns.
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Affiliation(s)
- Zahra Mirsepassi
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Firoozeh Raisi
- Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zahra Shahvari
- grid.510409.90000 0004 6092 1266Department of Nursing and Midwifery, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran
| | - Reihaneh FirooziKhojastefar
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed Taha Yahyavi
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Ponsford R, Bragg S, Meiksin R, Tilouche N, Van Dyck L, Sturgess J, Allen E, Elbourne D, Hadley A, Lohan M, Mercer CH, Melendez Torres GJ, Morris S, Young H, Campbell R, Bonell C. Feasibility and acceptability of a whole-school social-marketing intervention to prevent unintended teenage pregnancies and promote sexual health: evidence for progression from a pilot to a phase III randomised trial in English secondary schools. Pilot Feasibility Stud 2022; 8:52. [PMID: 35246272 PMCID: PMC8895534 DOI: 10.1186/s40814-022-00971-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 01/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background Reducing unintended teenage pregnancy and promoting adolescent sexual health remains a priority in England. Both whole-school and social-marketing interventions are promising approaches to addressing these aims. However, such interventions have not been rigorously trialled in the UK and it is unclear if they are appropriate for delivery in English secondary schools. We developed and pilot trialled Positive Choices, a new whole-school social marketing intervention to address unintended teenage pregnancy and promote sexual health. Our aim was to assess the feasibility and acceptability of the intervention and trial methods in English secondary schools against pre-defined progression criteria (relating to randomisation, survey follow-up, intervention fidelity and acceptability and linkage to birth/abortion records) prior to carrying out a phase III trial of effectiveness and cost-effectiveness. Methods Pilot RCT with integral process evaluation involving four intervention and two control schools in south-east England. The intervention comprised a student needs survey; a student/staff-led school health promotion council; a classroom curriculum for year-9 students (aged 13–14); whole-school student-led social-marketing activities; parent information; and a review of local and school-based sexual health services. Baseline surveys were conducted with year 8 (aged 12–13) in June 2018. Follow-up surveys were completed 12 months later. Process evaluation data included audio recording of staff training, surveys of trained staff, staff log books and researcher observations of intervention activities. Survey data from female students were linked to records of births and abortions to assess the feasibility of these constituting a phase III primary outcome. Results All six schools were successfully randomised and retained in the trial. Response rates to the survey were above 80% in both arms at both baseline and follow-up. With the exception of the parent materials, the fidelity target for implementation of essential elements in three out of four schools was achieved. Student surveys indicated 80% acceptability among those who reported awareness of the programme and interviews with staff suggested strong acceptability. Linkage to birth/abortion records was feasible although none occurred among participants. Conclusions The criteria for progression to a phase III trial were met. Our data suggest that a whole-school social-marketing approach may be appropriate for topics that are clearly prioritised by schools. A phase III trial of this intervention is now warranted to establish effectiveness and cost-effectiveness. Births and terminations are not an appropriate primary outcome measure for such a trial. Trial registration ISRCTN65324176.
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Affiliation(s)
- R Ponsford
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - S Bragg
- Department of Education, Practice and Society, University College London, 20 Bedford Way, WC1H 0AL, London, UK
| | - R Meiksin
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - N Tilouche
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - L Van Dyck
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - J Sturgess
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - E Allen
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - D Elbourne
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - A Hadley
- Teenage Pregnancy Knowledge Exchange, University of Bedfordshire, University Square, Luton, LU1 3JU, UK
| | - M Lohan
- School of Nursing and Midwifery, Queens University Belfast, University Road, Belfast, BT7 1NN, UK
| | - C H Mercer
- University College London, Gower Street, London, WC1E 6BT, UK
| | | | - S Morris
- Department of Health and Primary Care, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - H Young
- School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - R Campbell
- School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - C Bonell
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Rassem M, Siddiqui M, Wunder S, Ganshorn K, Kraushaar J. Sexual health counselling in patients with spinal cord injury: Health care professionals' perspectives. J Spinal Cord Med 2022; 45:280-286. [PMID: 32644037 PMCID: PMC8986290 DOI: 10.1080/10790268.2020.1786322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Objectives: We aimed to explore barriers to discussing sexual health with spinal cord injured (SCI) patients as perceived by health care professionals, to determine interest and preferences regarding further education in sexual health, and to assess the perceived need for an inpatient Sexual Health Team.Design: Pre and post surveys were completed by attendees following a 1-2 hour educational session on sexual health and SCI, assessing core elements including participant characteristics, confidence levels, and perceptions towards sexual health counselling and education.Setting: Wascana Rehabilitation Centre, a facility in Regina, SK offering inpatient and outpatient rehabilitation services in Saskatchewan.Participants: Eighty-six participants with a mean age of 39 years took part in this study. Among them, nearly half were nurses.Interventions: Educational sessions on SCI patients' sexual health.Outcome Measures: Self-administered surveys.Results: Significant differences were observed between pre- and post-session participant responses regarding their confidence levels (P < 0.001). Most participants (82.1%) had never provided sexual health counselling to SCI patients. The main perceived barrier to lack of sexual health counselling was insufficient training; the preferred learning method was via in-person workshops. The majority (80%) of participants indicated a Sexual Health Team should be created and 39.4% of participants expressed interest in becoming a member of this team.Conclusion: These results support that an educational session may help improve the confidence, knowledge, and perceptions around delivery of sexual health education of SCI patients. Study results suggest a perceived need for a Sexual Health Team and interest from health care professionals to become more involved in sexual health counselling.
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Affiliation(s)
- Mariam Rassem
- Division of Physical Medicine and Rehabilitation, Glenrose Rehabilitation Hospital, Edmonton, Canada,College of Medicine, University of Saskatchewan, Saskatoon, Canada,Correspondence to: Mariam Rassem, Physical Medicine and Rehabilitation, #301-6040 Andrews Way, Edmonton, AB T6W 3S9, Canada.
| | - Muhammad Siddiqui
- Department of Research, Saskatchewan Health Authority, Regina, Canada
| | - Shane Wunder
- College of Medicine, University of Saskatchewan, Saskatoon, Canada,Department of Physical Medicine & Rehabilitation, Saskatchewan Health Authority, Regina, Canada
| | - Keren Ganshorn
- College of Medicine, University of Saskatchewan, Saskatoon, Canada,Department of Family Medicine, Saskatchewan Health Authority, Regina, Canada
| | - Jacqueline Kraushaar
- College of Medicine, University of Saskatchewan, Saskatoon, Canada,Department of Physical Medicine & Rehabilitation, Saskatchewan Health Authority, Regina, Canada
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Zhang Y, Wang C, Liang M. A Latent Class Analysis of Sexual Behavior and Associations with Sex Education, Smoking, Drinking, and Pornography Use Among Chinese Youth. Arch Sex Behav 2022; 51:1351-1361. [PMID: 34750778 DOI: 10.1007/s10508-021-02091-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 02/20/2021] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
The incidence of sexually transmitted diseases has alarmingly increased among Chinese youth in the past decade, and newly diagnosed cases of AIDS have almost doubled between 2010 and 2015. However, little is known about classes of sexual behavior among Chinese youth and associations with their other health behavior or experience of sex education. This study aimed to first identify classes of sexual behavior using latent class analysis and then to examine their associations with sex education, smoking, alcohol drinking, and pornography use. Data were from 13,865 unmarried youth aged 18-24 from the 2009 National Youth Reproductive Health Survey. Six indicators were used: timing of the first sexual intercourse, the number of past-year sexual partners, sex outside of a relationship, incidence of pregnancy, and contraceptive use at the latest and the first sexual intercourse. Four classes were identified: no sex (Class 1, 69%), safer sex (Class 2, 13%), early risk (Class 3, 13%), and multiple risk (Class 4, 5%). Smoking, drinking, and regular pornography use were associated with increased odds of being in the multiple risk class relative to the safer sex class. Sex education, smoking, and pornography use were associated with decreased odds of being in the no sex class relative to the safer sex class. The findings revealed qualitatively different classes of sexual behavior among Chinese youth and important roles of sex education, substance use, and pornography use. Reproductive health service providers can offer individually tailored services to serve youth with different profiles and needs.
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Affiliation(s)
- Yudong Zhang
- Institute of Human Development and Social Change, New York University, 627 Broadway Street, New York, NY, 10012, USA.
| | - Cuntong Wang
- School of Social Development, Central University of Finance and Economics, No. 39, College South Road, Haidian District, 100081, Beijing, People's Republic of China
| | - Mengyuan Liang
- Department of Comparative Human Development, University of Chicago, 1101 E 58th St, Chicago, IL, 60637, USA
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Lindberg LD, Kantor LM. Adolescents' Receipt of Sex Education in a Nationally Representative Sample, 2011-2019. J Adolesc Health 2022; 70:290-297. [PMID: 34743916 DOI: 10.1016/j.jadohealth.2021.08.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Updated estimates of adolescents' receipt of sex education are needed to monitor trends and potential inequities. METHODS Using nationally representative data from the 2011-2015 and 2015-2019 National Survey of Family Growth, we use logistic regression to examine changes in the receipt of formal sex education by gender. For 2015-2019, we estimate patterns by gender and race/ethnicity for content, timing, and location of instruction. RESULTS Between 2011-2015 and 2015-2019, there were few significant changes in adolescents' receipt of formal sex education. Between these periods, instruction on waiting until marriage to have sex declined (73%-67% female [F.], p = .005; 70%-58% males [M.], p < .001). In both the periods, about half of the adolescents received sex education that meets the minimum standard articulated in national goals. In 2015-2019, there were significant gender differences in the instruction about waiting until marriage to have sex (67% F., 58% M., p < 001) and condom skills (55% F., 60% M., p = .003). Non-Hispanic Black and Hispanic males were less likely than non-Hispanic White males to receive formal instruction before the first sex on sexually transmitted infection/HIV, birth control, or where to get birth control. Many adolescents reported religious settings as the sources of instruction about waiting until marriage to have sex (56% F. and 49% M.), but almost none received instruction about birth control from those settings. CONCLUSIONS Differences in the receipt of sex education, by gender, race/ethnicity, and the location of instruction, leave many adolescents without critical information. Gaps in meeting national objectives indicate the need to expand the provision of sex education.
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Affiliation(s)
| | - Leslie M Kantor
- Department of Urban-Global Public Health, Rutgers University, Rutgers School of Public Health, New York, New Jersey
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Dawson K, Nic Gabhainn S, Willis M, MacNeela P. Development of a Measure to Assess What Young Heterosexual Adults Say They Learn About Sex from Pornography. Arch Sex Behav 2022; 51:1257-1269. [PMID: 34761345 PMCID: PMC8888499 DOI: 10.1007/s10508-021-02059-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 04/21/2021] [Accepted: 05/21/2021] [Indexed: 06/13/2023]
Abstract
This study involved the development of two new measures to assess what some young heterosexual-identifying adults report learning about sex from pornography. Inventory items were generated from an extensive literature review and six qualitative focus group sessions with young adults (N = 54) aged 18-29 which explored how pornography could be used as a source of sexual information. A total of 135 items pertaining to sexual learning from pornography were produced, reviewed and categorized by a sample of young adults (n = 9), and finally reviewed for item and construct relevance by a panel of pornography, sex education and scale development experts (n = 6). Inventory items were administered to a sample of young adult university students (n = 1306). Two separate exploratory factor analyses were conducted for the female and male datasets. The final factors were reviewed by a panel of young adults = 8) to identify the theme of each factor. Both the SIPI-F and SIPI-M yielded three factors: (1) How to be a good sexual partner, (2) Body aesthetic, and (3) Sexual exploration. Results show that pornography provides information about a range of sex-related topics. Findings also show that more frequent female pornography users reported learning more about how to be a good sexual partner and body aesthetic than less frequent pornography users. The SIPI-F and SIPI-M can be useful for examining a variety of questions regarding the use of pornography as an informal source of sexual information and its correlates.
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Affiliation(s)
- Kate Dawson
- School of Psychology, National University of Ireland, Galway, Ireland.
| | | | - Malachi Willis
- Social and Public Health Sciences Unit Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Pádraig MacNeela
- School of Psychology, National University of Ireland, Galway, Ireland
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Seidu AA, Ameyaw EK, Ahinkorah BO, Baatiema L, Dery S, Ankomah A, Ganle JK. Sexual and reproductive health education and its association with ever use of contraception: a cross-sectional study among women in urban slums, Accra. Reprod Health 2022; 19:7. [PMID: 35033115 PMCID: PMC8760577 DOI: 10.1186/s12978-021-01322-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Sexual and reproductive health education among girls and women has several reproductive health benefits, including improved contraceptive knowledge, contraception use at first intercourse, increased chance of contraceptive use in a lifetime, and effective usage of contraceptives. It is however not clear whether women/girls in urban slums who have had sexual and reproductive health education would likely utilize contraception. This study sets out to test the hypothesis that Accra slum women who have had sex education have higher chances of ever using contraception. Methods A cross-sectional survey was conducted among reproductive aged women in two slums (i.e. Agbogbloshie and Old Fadama) in Accra, Ghana. A sample size of 691, made up of respondents who provided responses to the question on ever used contraception, sex education as well as those with complete information on all the other variables of interest was considered in this study. Binary logistic regression models were fitted to examine association between sexual and reproductive health education and ever use of contraception. Crude odds ratios (cOR) and adjusted odds ratios (aOR) at p-value less than 0.05 were used to assess the strength of the association between the outcome and independent variables. Results More than half (56.73%) of the women have never received sexual and reproductive health education. Most of the respondents (77.28%) had ever used contraceptives. Women who had no form of sexual and reproductive health education had lower odds of ever using contraception (OR = 0.641, 95% CI 0.443, 0.928) and this persisted after controlling for the effect of demographic factors (AOR = 0.652, 95% CI 0.436, 0.975] compared to those who have ever received any form of sex education. Non-married women as well as women who were exposed to media (newspapers/radio/television) were also more likely to use contraceptives in slums in Accra, Ghana. Conclusion The study revealed a relatively low prevalence of sex education among women in urban slums in Accra. However, sex education was found to increase the odds of ever use of contraception. These findings call for intensified sexual and reproductive health education among reproductive aged girls and women in urban slums in Accra using existing informal social networks and local media platforms. Sexual and reproductive health education among girls and women has several reproductive health benefits, including improved contraceptive knowledge, contraception use at first intercourse, increased chance of contraceptive use in a lifetime, and effective usage of contraceptives. It is however not clear whether women/girls in urban slums who have had some form of sex education would likely utilize contraception more than those who have not. This study sets out to test the hypothesis that Accra slum women who have had sex education have higher chances of ever using contraception. A cross-sectional survey was conducted among reproductive aged women in two slums (i.e. Agbogbloshie and Old Fadama) in Accra, Ghana. A sample size of 691 girls/women aged 15–49 was considered. More than half (56.73%) of the women had never received some form of sex education. Most of the respondents (77.28%) had ever used contraceptives. Women who had no form of sex education had lower odds of ever using contraception and this persisted after controlling for the effect of demographic factors compared to those who have ever received any form of sex education. Non-married women as well as women who were exposed to media (newspapers/radio/television) were also more likely to use contraceptives in slums in Accra, Ghana. In sum, the study revealed that while prevalence of sex education was relatively low among urban slum women, sex education generally increased the chances of ever use of contraception. These findings call for more and targeted sexual and reproductive health education among reproductive aged girls and women in urban slums in Accra using existing informal social networks and local media platforms.
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Affiliation(s)
- Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Leonard Baatiema
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Accra, Ghana
| | - Samuel Dery
- Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
| | | | - John Kuumuori Ganle
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, P. O. Box LG 13, Accra, Ghana.
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Crowley G, Bandara P, Senarathna L, Malalagama A, Gunasekera S, Rajapakse T, Knipe D. Sex education and self-poisoning in Sri Lanka: an explorative analysis. BMC Public Health 2022; 22:26. [PMID: 34991547 DOI: 10.1186/s12889-021-12374-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 11/30/2021] [Indexed: 11/25/2022] Open
Abstract
Background Self-harm and suicide are important causes of morbidity and mortality in Sri Lanka, but our understanding of these behaviours is limited. Qualitative studies have implicated familial and societal expectations around sex and relationships. We conducted an explorative analysis using case-control data to investigate the association between sex education and self-poisoning in Sri Lanka. Methods Cases (N=298) were self-poisoning inpatients on a toxicology ward, Teaching Hospital Peradeniya. Controls (N=500) were sex and age frequency matched to cases and were outpatients/visitors to the same hospital. Participants were asked whether they had received sex education, and to rate the quality and usefulness of any sex education received. Logistic regression models adjusted for age, sex, and religion quantified the association between receipt, quality and usefulness of sex education and self-poisoning. We tested whether the associations differed by sex. Results Roughly 1-in-3 cases and 1-in-5 controls reported having not received sex education. Individuals who did not receive sex education were nearly twice as likely to have self-poisoned than those who did (OR 1.68 (95% CI 1.11-2.55)). Those who reported the sex education they received as not useful were more likely to have self-poisoned compared to those who reported it useful (OR 1.95 (95% CI 1.04-3.65)). We found no evidence of an association between self-poisoning and the self-rated quality of sex education, or that associations differed by participant sex. Conclusion As sex education is potentially modifiable at the population-level, further research should aim to explore this association in more depth, using qualitative methods and validated measurement tools. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12374-4.
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Nguyen BT, Violette C. Condom Use at Coitarche Among Men in Non-Steady Relationships in the United States, 2006-2013. J Adolesc Health 2022; 70:127-132. [PMID: 34362645 DOI: 10.1016/j.jadohealth.2021.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE Using U.S. National Survey of Family Growth (NSFG) data from 2006 to 2013, we characterized men aged 15-44 years who reported not using a condom at their first vaginal intercourse (coitarche), while in a non-steady relationship with a female partner. METHODS Men who reported ever having intercourse were asked about male and female contraceptives used at coitarche. Analysis was restricted to respondents whose first sexual relationship was reported as non-steady, thereby comprising a population for whom condoms are recommended for preventing both pregnancy and sexually transmitted infections. Demographic and behavioral factors were examined against condom use, with significant associations included in multivariable logistic regression. We additionally describe young men's receipt of various components of sex education prior to coitarche. RESULTS Nearly half (43%) of men aged 15-44 in the U.S. reported not using a condom at coitarche during a non-steady relationship. Among these men, coitarche was reported on average at 16 years old; more than one third (37%) endorsed mixed feelings or not wanting to have sex at the time. Older men (adjusted odds ratio [adjOR] 1.07, 95% confidence interval [CI] 1.06-1.08), as with men from earlier National Survey of Family Growth cycles, were increasingly likely to have reported unprotected coitarche. Similarly, men reporting coitarche before the age of 15 (adjOR 2.39, 95% CI 1.99-2.87) or having a younger sex partner at coitarche (adjOR 1.73, 95% CI 1.11-2.69) were more likely to have not used condoms. About three quarters of men received at least some form of sex education prior to coitarche. CONCLUSIONS Condomless coitarche is commonly reported among men in non-steady adolescent relationships and with mixed feelings about having sex. Condomless coitarche among these men is independently associated with initiating sex before the age of 15 and having sex with a younger female partner. These findings may guide how to structure young men's sexual education programing.
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Affiliation(s)
- Brian T Nguyen
- Section of Family Planning, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, California.
| | - Caroline Violette
- Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, California
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Decker MJ, Atyam TV, Zárate CG, Bayer AM, Bautista C, Saphir M. Adolescents' perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey. BMC Health Serv Res 2021; 21:1263. [PMID: 34809640 PMCID: PMC8609799 DOI: 10.1186/s12913-021-07278-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Adolescents may forego needed sexual and reproductive health (SRH) services due to a variety of concerns and barriers. The purpose of this study is to compare adolescents’ perceptions of these barriers by participant characteristics including race/ethnicity, gender, sexual orientation, housing situation, and sexual experience. Methods Adolescents in a California-wide sexual health education program completed an anonymous survey at baseline (N = 10,015) about perceived barriers to using SRH services. Logistic regression analyses that accounted for the clustered data structure assessed differences by gender, age, sexual orientation, race/ethnicity, living situation, and sexual experience. Results The majority of participants were Hispanic/Latino (76.4%) with an average age of 14.9 years, and 28.8% had sexual experience. Half of the youth reported concerns about test results (52.7%), cost of services (52.0%), and confidentiality of services (49.8%). When controlling for other characteristics, youth identifying as transgender/non-binary/multiple genders had the highest odds of perceiving cost (odds ratio (OR) 1.89) and confidentiality (OR 1.51) as barriers. Increasing age was associated with decreasing odds of all barriers. Sexual orientation was a consistent predictor, with LGBQ+ youth having higher odds of perceiving test results (OR 1.21), cost (OR 1.36), and confidentiality (OR 1.24) as barriers. Asian or Pacific Islander/Native Hawaiian youth had higher odds of perceiving test results (OR 1.68) and cost (OR 1.37) as barriers. In contrast, Black youth had lower odds of reporting cost (OR 0.65) and confidentiality (OR 0.77) as barriers. Younger respondents and youth who identified as female, transgender/non-binary/multiple genders, LGBQ+, and Asian or Pacific Islander/Native Hawaiian had higher odds of reporting five or more barriers compared to reference groups. Conclusions The majority of adolescents face barriers to accessing appropriate SRH services, with females, gender-minority youth, younger adolescents, LGBQ+ youth, and Asian and Pacific Islander/Native Hawaiian youth more likely than others to report barriers. Access to SRH services can be improved through strengthening linkages between clinics and SRH education programs, providing youth-friendly clinical services, and ensuring youth have sufficient information, skills, and support to access care. Trial registration Approved by California Health and Human Services Agency’s Committee for the Protection of Human Subjects [12-08-0658, 11/30/2017]. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07278-3.
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Affiliation(s)
- Martha J Decker
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA. .,Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois St, San Francisco, CA, 94107, USA. .,Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, USA.
| | - Tara V Atyam
- California Department of Public Health, Maternal, Child and Adolescent Health Division, 1615 Capitol Ave, MS 8300, P.O. Box 997420, Sacramento, CA, 95899-7420, USA
| | - Catherine Gilmore Zárate
- California Department of Public Health, Maternal, Child and Adolescent Health Division, 1615 Capitol Ave, MS 8300, P.O. Box 997420, Sacramento, CA, 95899-7420, USA
| | - Angela M Bayer
- California Department of Public Health, Maternal, Child and Adolescent Health Division, 1615 Capitol Ave, MS 8300, P.O. Box 997420, Sacramento, CA, 95899-7420, USA
| | - Consuelo Bautista
- California Department of Public Health, Maternal, Child and Adolescent Health Division, 1615 Capitol Ave, MS 8300, P.O. Box 997420, Sacramento, CA, 95899-7420, USA
| | - Melissa Saphir
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois St, San Francisco, CA, 94107, USA
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Matin BK, Ballan M, Darabi F, Karyani AK, Soofi M, Soltani S. Sexual health concerns in women with intellectual disabilities: a systematic review in qualitative studies. BMC Public Health 2021; 21:1965. [PMID: 34717594 PMCID: PMC8556840 DOI: 10.1186/s12889-021-12027-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies indicate that women with intellectual disabilities (ID) face various personal and socio-environmental barriers in their sexual lives. This study aimed to identify the concerns and sexual health needs experienced by women with ID. METHOD A systematic review of relevant qualitative articles was conducted in PubMed, Web of Science Scopus and PsycINFO databases from June 2018 to August 2018. We designed our search strategy according to two main foci: (1) sexuality; and (2) women with ID. In the study, searches were limited to articles published from January 2000 to December 2017. In this review, studies on women ages 16 and over were included. RESULTS Within the four databases, the search found 274 unique articles. After three steps of screening (title, abstract and full text), 22 studies were included in the final review. The articles mentioned difficulties with lack of sexual experience, negative experiences with sexuality, negative attitudes towards sexuality by nondisabled individuals, limited cognitive capacities to understand sexual identity, difficulty with finding the right partner, lack of access to sexual health information, lack of school-based sexuality education, violence and sexual abuse, lack of support from families and caregivers about sexuality, fear of sexual acts and unwanted pregnancy, shyness in expressing sexual desires, and limited knowledge of sexual behaviors. CONCLUSION Our findings indicate that women with ID need to be provided with school-based sexuality education tailored to the level of understanding needed to attain the requisite knowledge to form relationships, understand sexual and romantic relationships, and practice safe sex when they choose this option. Families along with education and healthcare systems should provide opportunities for women with ID to talk about their sexual needs and make their own choices.
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Affiliation(s)
- Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Michelle Ballan
- School of Social Welfare, Stony Brook University, New York, USA
| | - Fatemeh Darabi
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Ali Kazemi Karyani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moslem Soofi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahin Soltani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Usonwu I, Ahmad R, Curtis-Tyler K. Parent-adolescent communication on adolescent sexual and reproductive health in sub-Saharan Africa: a qualitative review and thematic synthesis. Reprod Health 2021; 18:202. [PMID: 34629082 PMCID: PMC8504018 DOI: 10.1186/s12978-021-01246-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Improving adolescent sexual and reproductive health continues to be a global public health need. Effective parent–adolescent communication on sexual health issues has been cited as a factor that could influence adolescents towards adopting safer sexual behaviour. The current review synthesises qualitative literature to understand the nature and relevance of parent–adolescent sexual and reproductive health communication and the barriers to effective communication in sub-Saharan Africa. Methods We systematically searched and synthesised qualitative literature published between 1st January 1990 to December 2019 and searched from CINAHL, PsycINFO, MEDLINE, Global Health, EMBASE, PubMed, and Google Scholar. We assessed the methodological quality of included studies using the Critical Appraisal Skills Programme (CASP) checklist. We thematically analysed qualitative data from the included primary studies. Results Fifteen studies were included. Social and physiological events act as triggers for initiating discussions. Fear of personal, social, and economic consequences of high-risk sexual behaviours act as drivers for communication but also carry a negative framing which hinders open discussion. Lack of parental self-efficacy and cultural and religious norms create an uncomfortable environment leaving peers, media, teachers, and siblings as important and sometimes preferred sources of sexual health information. Conclusions While mothers recognise their own role in adolescent sexual and reproductive health and school-based interventions can act as useful prompts for initiating discussion, fathers are mainly absent from home-based dialogue. Fear dominates the narrative, and the needs of adolescents remain unarticulated. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01246-0. Improving adolescent sexual and reproductive health remains an important public health need globally. Effective communication on sexual health issues between adolescents and their parents has been recognised to influence safer sexual behaviour among adolescents. This review combined qualitative evidence to understand the nature of, and barriers to communication about sex between parents and adolescents in sub-Saharan Africa. We searched academic databases for relevant articles published between January 1990 and December 2019 and found 15 studies of appropriate quality. Data on parents and adolescents’ experiences of sex communication in these studies was synthesised. Drivers for sex communication including fear of personal and economic consequences were highlighted. Results also identified barriers to communication such as cultural and religious norms and lack of parental knowledge and skills. Findings showed that adolescents sometimes prefer other sources of sexual health information like peers, media, and siblings. Mothers are recognised to be more involved with home-based interactions on sexual health with adolescents compared to fathers. The results of this review point to the necessity for adolescents’ needs to be understood and articulated towards influencing policy and programmes. Adolescents in sub-Saharan Africa remain at high risk for sexually transmitted infections, female genital mutilation, and early pregnancy. Adolescents mostly view sex-related discussions with parents as uncomfortable, and interactions are driven by fear of personal, social, and economic consequences of sexual risk-taking behaviour. Parents recognise their lack of capacity to engage with adolescents and are influenced by cultural norms and religious beliefs. Future research needs to address the current imbalance of adult versus adolescent voices in published work and also ensure a creation of space for conversations about sexuality with sexual and gender minority youth in the Lesbian, Gay, Bi-sexual, Transgender, Queer, Intersex, and Asexual communities.
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Affiliation(s)
- Ijeoma Usonwu
- Nursing, City University of London School of Health Sciences, London, UK.
| | - Raheelah Ahmad
- Division of Health Services Research and Management, City University of London School of Health Sciences, London, UK
| | - Katherine Curtis-Tyler
- Division of Health Services Research and Management, City University of London School of Health Sciences, London, UK
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Baker AM, Jahn JL, Tan AS, Katz-Wise SL, Viswanath K, Bishop RA, Agénor M. Sexual Health Information Sources, Needs, and Preferences of Young Adult Sexual Minority Cisgender Women and Non-Binary Individuals Assigned Female at Birth. Sex Res Social Policy 2021; 18:775-787. [PMID: 34484461 PMCID: PMC8414874 DOI: 10.1007/s13178-020-00501-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/04/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND Young adult sexual minority women (SMW) have unique sexual health needs and higher rates of some poor sexual health outcomes compared to their heterosexual peers. Unequal access to relevant sexual health information may contribute to sexual orientation disparities in sexual health among women, but research on sexual health communication among SMW is sparse. METHODS In-depth interviews conducted in 2016-2017 investigated sexual health communication in a sample of 29 racially/ethnically diverse cisgender women and non-binary individuals assigned female at birth who were between 19 and 36 years of age and identified as a sexual minority. Data were analyzed using a thematic analysis approach that involved inductive and deductive coding to identify themes. RESULTS Three broad themes were identified: 1) sources of sexual health information; 2) sexual health information needs; and 3) preferences for sexual health information delivery. Participants discussed and critiqued the Internet, other mass media, health care providers, school-based sex education, family, and peers/partners as sources of sexual health information. Participants expressed a need for customized, non-heteronormative information pertaining to sexually transmitted infection risk and prevention. They preferred receiving information from health care providers, the Internet, and other mass media, and some also suggested school-based sex education and peer education as methods for delivering information. CONCLUSIONS Participants expressed clear desires for relevant, high-quality sexual health information delivered through a variety of channels, especially the Internet, other mass media, and health care providers. POLICY IMPLICATIONS Findings call for policies that improve provision of sexual health information through health care providers, online resources, and school-based sex education.
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Affiliation(s)
- Allison M. Baker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jaquelyn L. Jahn
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andy S.L. Tan
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Sabra L. Katz-Wise
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kasisomayajula Viswanath
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rachel A. Bishop
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Executive Office of Health & Human Services, Commonwealth of Massachusetts, Boston, MA, USA
| | - Madina Agénor
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Community Health, Tufts University, Medford, MA, USA
- Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
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Tabaac AR, Haneuse S, Johns M, Tan AS, Austin SB, Potter J, Lindberg L, Charlton BM. Sexual and reproductive health information: Disparities across sexual orientation groups in two cohorts of U.S. women. Sex Res Social Policy 2021; 18:612-620. [PMID: 34484460 PMCID: PMC8414943 DOI: 10.1007/s13178-020-00485-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Limited research exists about how receiving/seeking sexual and reproductive health (SRH) information differs by sexual orientation. Our goal was to identify how sources and topics of SRH information differed by sexual orientation during adolescence in a sample of U.S. women. METHODS A sample of 8,541 U.S. women ages 22-35 years from two cohorts of the Growing Up Today Study completed a 2016 questionnaire measure about receiving/seeking SRH information before age 18 years. Adjusted log-linear models assessed differences in SRH information topics and sources by reported sexual orientation (completely heterosexual with no same-sex partners [reference]; completely heterosexual with same-sex partners; mostly heterosexual; bisexual; lesbian). RESULTS Compared to the referent, most sexual minority subgroups were more likely to receive/seek information from peers, media, and other sources (e.g., community centers). With the exception of lesbians, sexual minority subgroups were more likely to receive/seek information about contraception, and mostly heterosexual and bisexual women were more likely to receive information about sexually transmitted infections. Conclusions: Findings indicate women of diverse sexual orientations need access to SRH information from sources like schools, peers, and media. Sexual minority women receive/seek information about many SRH topics, which indicates that opportunities to tailor educational resources within and outside of schools are needed so SRH benefits to these populations are maximized. POLICY IMPLICATIONS Specifying sexual minority-sensitive educational materials in sex education policy can meet information needs and aid sexual minority women in making informed sexual health decisions.
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Affiliation(s)
- Ariella R. Tabaac
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA
- Center for Gender Surgery, Boston Children’s Hospital, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Michelle Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Andy S.L. Tan
- Dana-Farber Cancer Institute, Population Sciences Division, Center for Community Based Research, Boston, MA
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA
| | - S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Jennifer Potter
- Beth Israel Deaconess Medical Center, Boston, MA
- Harvard Medical School, Boston, MA
- Fenway Institute, Boston, MA
| | | | - Brittany M. Charlton
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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50
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Atkins DN, Bradford WD. The Effect of State-Level Sex Education Policies on Youth Sexual Behaviors. Arch Sex Behav 2021; 50:2321-2333. [PMID: 33537882 DOI: 10.1007/s10508-020-01867-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 06/12/2023]
Abstract
Two types of sex education are generally offered in the U.S. abstinence-only and comprehensive sex education. There is no clear scientific consensus over which approach minimizes the risk of unintended pregnancy and sexually transmitted diseases for youth. While there have been many studies of specific programs in clinical or quasi-experimental settings, there are very few evaluations of how state-level sex education policies affect the youth population. We estimate the impact of various state-level sex education policies on youth sexual activity and contraceptive use using data from four waves of the Youth Risk Behavior Surveillance System from 39 states. We found that states that require sexuality (sex and/or HIV/STD) education and contraceptive content or states that mandate education but leave the actual content up to local districts have lower rates of sexually active youth and higher rates of contraception use when youth are sexually active. States that require sexuality education and require abstinence content increase the rate at which youth are sexually active, and youth in those states are less likely to use hormonal birth control if they are sexually active. In conclusion, we found that state policies regarding sex and HIV/STD education had statistically significant effects that are meaningful in magnitude from a public health perspective.
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Affiliation(s)
- Danielle N Atkins
- Department of Health Management and Informatics, University of Central Florida, Orlando, FL, 32816, USA.
| | - W David Bradford
- Department of Public Administration and Policy, University of Georgia, Athens, GA, USA
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