Abstract
In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs) have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance) of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular), a systematic design framework that uses theory, empirical evidence, and input from the community to develop CHoosing And Maintaining Effective Programs for Sex Education in Schools (iCHAMPSS), an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings.
Highlights
In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues
The Internet has been widely used to disseminate information about sexual health evidence-based programs (EBPs) [13, 14], this information predominantly focuses on describing EBPs, providing program materials, and linking users to training resources
We identified a program theme for the online decision support system, which was to be a sexual health advocate, or champion, for the dissemination of sexual health EBPs by school districts
Summary
In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues. National agencies, including the U.S Department of Health and Human Services’ Office of Adolescent Health [13] and National Campaign to Prevent Teen and Unplanned Pregnancy [14], have developed online repositories (or lists) of evidence-based HIV, STI, and teen pregnancy prevention programs [hereafter referred to as sexual health evidence-based programs (EBPs)] These programs are designated as evidence-based because they have been rigorously evaluated (usually in an experimental or quasi-experimental design) and shown to reduce sexual risk behaviors (e.g., sexual initiation, contraceptive use, frequency of sexual activity, and number of sexual partners) and/or prevent teen pregnancies or STIs [13]. Over 35 sexual health EBPs are designed for multiple settings (e.g., school, after school, clinic, and home), but more than half are school based [13]
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