Abstract
This paper critically examines sexual risk reduction interventions, more specifically how they are evaluated and the implications that this has for sexual health policy. The focus is on motivational interviewing (MI) interventions which aim to promote protective behaviors related to sexual risk on the part of young people. MI has become increasingly popular, largely due to it being a highly flexible counseling approach that may, with adequate staff training, and fidelity in implementation, be tailored to many different settings (e.g., health care, schools and in community work). Following a scoping review that comprised 34 papers, of which 29 were unique studies, the range and type of existing research were examined. The results show a wide range of study designs and evaluation procedures, MI conceptualizations, modes of MI delivery, and the particular sub-populations of youth and sexual risk behaviors targeted. While this makes it difficult to draw any generalized conclusions about “what works” in prevention, it provides important insights about the complexity of sexual risk behavior as well as complex behavioral treatment approaches like MI. We therefore problematize the political drive to implement evidence-based methods without adequate resource allocation and contextual adaptation.
Highlights
Evidence-informed decision-making has become institutionalized as a way for governments and authorities to define social problems and develop policies that answer to them
We report on a scoping review that investigated motivational interviewing (MI) interventions aiming to promote the choice of protective health behaviors and avoidance of sexual risk behaviors and related consequences on the part of young people (Folkhälsomyndigheten, 2018)
The most central information from the 34 papers were collated in a table detailing study design, intervention content, theoretical underpinnings, components, context, practitioner educational background and MI training, MI fidelity assessment procedures, intervention aim and target population, outcome measures, main results, and our comments
Summary
Evidence-informed decision-making has become institutionalized as a way for governments and authorities to define social problems and develop policies that answer to them. The background to the prevention strategies is a trend of increasing risky sexual behavior among youth (Folkhälsomyndigheten, 2017; Stenhammar, Ehrsson, Åkerud, Larsson, & Tyden, 2015). Our results show considerable variety in MI conceptualization and delivery. While this makes it difficult to draw any generalized conclusions about Bwhat works^ in prevention, it provides important insights about the complexity of sexual risk behaviors as well as about complex behavioral treatment approaches like MI. Our results problematize the political drive to implement evidence-based methods without adequate resource allocation and contextual adaptation
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