Sex Education Research Articles

Correlation between Geography of Residence, Socio-Culture and Family Structure with Early Marriage In South Bangka

Background: One of four women in the world who had married before 18 years old. Bangka Belitung Islands Province was in the third highest rate of early marriage in Indonesia. This province was mostly a coastal area that had a variety of social cultures. The purpose of the study was to analyze the correlation between the geography of residence, socio-culture, and family structure with early marriage and explore these three factors. Methods: This study used a qualitative study method with 13 informants for qualitative research (5 young women and their parents, village head, Head of Religious Affairs Office, Head of Islamic Community Development Division, Ministry of Religion). Qualitative research was conducted by conducting in-depth interviews with purposive sampling and explained through transcription, coding and categorization processes. Results: Qualitative research found that the geographical factors of residence, socio-culture and family structure influence early marriage. Conclusion: The geography of residence, socio-culture and family structure influenced early marriage. Suggestion: A synergistic effort by providing reproductive health education and sexuality education to children and adolescents. Keywords: Early marriage, geography of residence, socio-cultural, family structure, South Bangka

The effectiveness of Reprofitstacko as an educational game innovation related to sexuality education for urban adolescent females

The effectiveness of Reprofitstacko as an educational game innovation related to sexuality education for urban adolescent females

Application of ultrasonic imaging technology in beef cattle breeding management

ObjectiveThe aim of this study was to explore in depth the application of ultrasonic imaging technology in beef cattle reproduction management in order to improve the efficiency and management of beef cattle reproduction. MethodsIn this study, ultrasonographic diagnostic techniques were used to follow up the follicles and corpus luteum in the uterus and ovaries of dairy cows at different stages of development as well as at different periods of gestation of dairy cows, and to detect the effects of different fattening conditions of the cows and the number of litters on the sitting rate. ResultsThe diameter of mature follicles was generally around 16 mm, and the majority of them were 11–20 mm in diameter. Ultrasonography was used to detect early pregnancy in cows at 33–55 d. Ultrasound was used to identify the sex of the foetus most easily at 70–80 d. The results of this study showed that the sex of the foetus was most easily identified in cows at 70–80 d. The fat of the cow and the number of births also had a significant impact on pregnancy rates. ConclusionUltrasound imaging technology has an important application value in the management of beef cattle reproduction, and in pregnancy detection, it can achieve early and accurate diagnosis, improve the accuracy of detection, and differentiate between heifers in estrus and pregnant heifers. In addition, it can also be used for foetal sex identification at a specific period of time, providing a basis for breeding programmes.

An Analysis of the Development of Sex Education in China

In contemporary China, despite growing awareness and attention to sexual education issues, the promotion and popularization of comprehensive sexual education remain hindered by deeply ingrained conservative attitudes that have persisted for millennia. These attitudes have led to sub-optimal outcomes, including limited access to accurate information and resources, which can negatively impact public health and social development. This study examines the historical development and current state of sexual education in China, as well as the various challenges that hinder its advancement, through an analysis of regionally gathered data. The study highlights the regional disparities in sexual education across China. Urban areas tend to have more progressive attitudes and better access to resources than rural regions, where conservative views and limited infrastructure can further restrict the dissemination of vital information. These disparities underscore the need for tailored approaches that address the specific needs of different communities. To overcome these challenges and optimize promotional efforts, the study suggests several key strategies, including formulating relevant policies by the government, managing relevant courses in schools, and parents’ understanding of related knowledge. By implementing these strategies, it is hoped that promoting and popularizing sexual education in China will lead to improved health outcomes, greater gender equality, and a more informed society overall.

The Effect of Flashcard Education on Premarital Sexual Behavior in Adolescent

Background: Adolescent who experience puberty in their bodies appear sex hormones that begin to work, resulting in a sense of attraction to the opposite sex. Premarital sex is a behavior that is carried out based on sexual desire in adolescents. Adolescent knowledge and sources of information received by adolescents are important points in efforts to prevent premarital sexual behavior. The preventive efforts can be done by providing education about the right information through various methods and media. One of them is education using flashcard media. Purpose: The purpose of this study was to analyze the effect of education on premarital sexual behavior using flashcard media. Methods: This study design was a quasi-experimental pre-test-post test design with control group. The number of samples were 60 which were divided into two groups and the inclusion criteria being adolescents aged 15-17 years and were or had been dating. The intervention group received treatment in the form of pre-marital sexual behavior education with flashcard media. The control group received pre-marital sexual behavior education using the lecture method. Before and after the intervention, researchers conducted a pretest and posttest using a pre-marital sexual behavior questionnaire and data were analyzed using the Wilcoxon test. Results: There was a difference in the average score of premarital sexual behavior in the intervention group after receiving flashcard education intervention with p value = 0.010 (p <0.05). Conclusion: Education using flashcard affects premarital sexual behavior in adolescents. Preventive and promotive efforts of premarital sexual behavior in adolescents using flashcard media are an alternative for nurses in providing counseling.

A REALIZAÇÃO DO PROGRAMA SAÚDE NA ESCOLA COMO FERRAMENTA PARA PROMOÇÃO DE EDUCAÇÃO EM SAÚDE DURANTE A FORMAÇÃO EM MEDICINA DE FAMÍLIA E COMUNIDADE: UM RELATO DE EXPERIÊNCIA

Introduction: The School Health Program (PSE), announced by the Ministry of Health in 2007, aims to promote health in partnership with educational institutions to improve the quality of life of the population, specifically school-aged children. This involves collaboration between health and education professionals, providing appropriate knowledge to reduce vulnerabilities that may compromise the development and the future of children and adolescents. Objective: To report the experience of a family medicine resident, part of a family health team (eSF) in the Federal District (DF), primarily promoting sexual education for children and adolescents in two public schools within the team's area of coverage. Methodology: This is a descriptive and qualitative study, of the experience report type, conducted during the two years of residency in Family and Community Medicine, from 2023 to 2024, in the satellite city of Sobradinho, Federal District. Results: The students involved, aged between 9 and 12 years, showed great interest in the topics addressed regarding sexuality and hygiene habits, adopting a participatory attitude, engaging in the exchange of experiences, raising questions, and discussing the subjects covered in the meeting and topics detailed in the adolescent health booklet. Conclusion: The necessity of partnership between health teams and education professionals was evident to provide health promotion, especially focused on sexual education, aiming to reduce negative outcomes and minimize future social and health damages in the vulnerable population of the DF.

The Concept of Homosexuality and Homosexuals among Late Adolescents

In India, generally studies on dimensions of alternate sexualities, are rare. The social stigma surrounding sexual minorities often acts as a hindrance in the production of research focusing on alternative sexualities. Kerala is the state with the highest literacy rate in India. But, the people of Kerala are still prejudiced towards homosexuality. Recent incidents, such as the legal fight for freedom by lesbian couples when they were separated by family and tortured (Onmanorama, 2022); the queer person's family's refusal to receive his body (The News Minute, 2022), reflects the highly homophobic attitude of the people. The presented study is qualitative and explores the conceptualization of homosexuality among late adolescents in Kerala. The study utilized semi-structured interviews. Using reflexive thematic analysis, four major themes were extracted: (1) Knowledge about homosexuality and homosexuals, (2) Factors determining the attitude toward homosexuality and homosexuals, (3) Behavior toward homosexuality and homosexuals, and (4) Perceived causes of homosexuality. The non-visibility of the LGBTQIA+ community and lack of authentic sources of knowledge were found to be significant barriers to their understanding of homosexuality. Positive portrayal of the LGBTQIA+ community in media and implementation of comprehensive sex education in institutions are recommended to foster a better understanding of homosexuality.

Teachers perspectives on positive and inclusive sex education in Dutch secondary schools

Abstract Sex education in schools can play an important role in improving young people’s sexual health. Dutch youth are often dissatisfied with the sex education they receive at school; they want more attention to discussing pleasure, consent and diversity. While there have been various calls for positive and inclusive sex education over the past decade, still very few schools provide it. This study examined teachers’ perspectives on positive and inclusive sex education and documents the barriers teachers are confronted with in providing this type of sex education. Based on an online questionnaire survey of 508 sex education teachers, we examined the extent to which teachers possess the knowledge, attitudes and skills that facilitate the delivery of positive and inclusive sex education. We also held focus groups with 25 teachers from 10 schools and explored what they consider to be key barriers and best practices in teaching positive and inclusive sex education. Teachers overall have the knowledge, attitudes and skills that are needed to provide positive and inclusive sex education, but there is room for improvement, for example regarding knowledge on intersex individuals and the clitoris. Teachers experienced barriers at three levels: the personal level (e.g. personal discomfort), the classroom level (e.g., safety in the classroom) and the structural level (e.g. sex education not being part of the national curriculum; lack of time). Structural barriers seem to be at the basis of the barriers at the personal and classroom level. It is advised that positive and inclusive sex education gets a permanent place in the national curriculum. By developing concrete core objectives in the area of relationships, sexuality and diversity, for all grades, and by providing more extensive teacher training, teachers and schools will be facilitated to organize sex education in a more sustainable way. Key messages • Sex education teachers in the Netherlands desire better training to provide positive and inclusive sex education in the classroom. • Integrating sex education in the national curriculum would help teachers to address sexuality in a more sustainable way in the classroom.

Equipping prospective teachers for culturally and religiously sensitive sexuality education: curriculum reviews at Islamic universities in Indonesia

ABSTRACT Sexuality education is essential for equipping children to prevent sexual abuse and fostering understanding of their bodies, relationships, and boundaries. Early childhood education programs in Indonesia were recommended to integrate sexuality education courses tailored to child development and sensitive to religious and cultural contexts. This research employed qualitative methods to investigate the integration of sexuality education courses at eight Islamic universities in Indonesia. Data were collected through interviews with eight course instructors and documentation of their Semester Learning Plans, using content and thematic analysis. Findings revealed that while two universities offered dedicated sexuality education courses, six integrated them into child development and parenting psychology courses. Dedicated sexuality education courses had more comprehensive learning objectives compared to integrated approaches. Teaching methods predominantly included lectures, paper presentations, with some incorporating field studies and project-based learning. Challenges included credit allocation impacting study durations, which hindered the integration of specialized courses like sexuality education. Enhancing pedagogy and ensuring effective delivery of sexuality education were identified as crucial tasks requiring the refinement of curricula in early childhood education. This approach would enable prospective educators to impart knowledge sensitively, taking into account children’s developmental stages and cultural-religious norms.

Pleasure-inclusive sex education, sexual agency and sexual wellbeing in youth: A scoping review

Abstract Background A recent review study showed that pleasure-inclusive sex education can contribute to reducing sexual health risks such as unwanted pregnancy and STIs (Zaneva et al., 2022). Pleasure-inclusive sex education could also contribute to other measures of sexual wellbeing. In this study, we review the literature on associations between pleasure-incorporating sex education and sexual agency (including related concepts such as autonomy) and sexual wellbeing (part 1), and between sexual agency and sexual wellbeing (part 2). Methods We searched in 5 scientific databases using a wide scope of variables related to pleasure inclusive sex education, sexual agency, and various outcomes of sexual wellbeing, focusing on the last 2 decades. Forty-six articles were selected. Results In part 1 of the review we found that all studies reported associations between pleasure-based sex education and sexual agency or sexual wellbeing, but the literature is characterized by limitations and did not permit conclusions about the role of an added benefit of the pleasure component. In part 2 of the review study, we found positive associations between sexual agency (and related variables) and sexual wellbeing (including decreased levels of (re-)victimization). Conclusions Sexual agency may be related to increased sexual wellbeing, but it is still largely unclear whether pleasure-inclusive sex education can significantly contribute to this. There is a great need for high quality research, using innovative evaluation designs, taking into account the role of other important sources of sex education and other contextual factors. Key messages • A lot of work has been done, but the evidence that pleasure in sex ed ‘works’ for sexual wellbeing, is limited and indirect. • Great need for high quality research using novel and more realistic evaluation approaches.

Skills and competences of sexuality educators. Evidences from a qualitative research in Italy

Abstract Background The scientific literature recognizes the strategic role of educators in sexuality education projects in schools. If, however, there is often a discussion about the most effective professional figure (teachers, school experts or external experts), there is a little attention to the skills and competences that an educator should possess and to which he or she must be trained. Adopting a Comprehensive Sexuality Education (CSE) approach, which is evaluated as the most effective, it is necessary to consider a skill set for educators that should not be limited to the knowledge in the area of sexual health promotion and risk prevention. Methods In order to build evidence-based competencies and skills, a qualitative study was conducted. A total of 72 educators involved in school-based CSE interventions in 4 Italian Regions, in 24 middle and secondary schools (68 classes), during 2 consecutive school years were enrolled. Before, during, and after the activities in the classrooms, qualitative feedback was collected, through reflective journals written by educators themselves. These data were analyzed through a qualitative approach, according to the principles of empirical phenomenology. Results The phenomenological evidences confirm the need to overcome the conception of educator as instructor equipped only with knowledge in the field of sexual health. It is considered fundamental to possess and develop pedagogical competences and skills, such as: caring attitude, teaching skills, theoretical awareness, capacity to manage the unexpected. Moreover, educators reported the necessity of an initial and continuous training on these dimensions considered as the most challenging. Conclusions The research confirms the complexity of the competency profile of CSE educators. Therefore, their professional development should include tailored designed multi-disciplinary training programs, with particular attention to the pedagogical dimension. Key messages • Comprehensive sexuality education requires an adequate professional figure intended not as an instructor aimed only at risk prevention and health promotion, but as a real caring educator. • Pedagogical skills and competences should be included in the training processes for sex educator, through adequate activities.

The effects of hypothetical psychological interventions on alcohol use in European young adults

Abstract Background Low psychosocial well-being (PWB) and high emotion-driven impulsiveness (EDI) are associated with alcohol. Yet, it is unclear whether a hypothetical intervention targeting one or the other in adolescence might be more effective in reducing alcohol consumption (AC) in young adulthood. Therefore, we aimed to compare the separate causal effects of PWB and EDI in adolescence on AC in young adulthood. Methods We included 505 European young adults from the IDEFICS/I.Family cohort (mean age: 20.2 years; age range: 18.2-23.5 years) who did not drink alcohol at study entry. AC was operationalized as the amount of weekly consumed alcoholic beverages (mean: 4.2 drinks per week; range: 0.3-70 drinks per week). EDI was assessed using the negative urgency subscale from the UPPS-P Impulsive Behaviour Scale. PWB was assessed using the KINDLR Health-Related Quality of Life Questionnaire. Following the principles of target trial emulation, we estimated, separately, the average causal effects of PWB and EDI on AC accounting for relevant confounders and applying a semi-parametric doubly robust method (targeted maximum likelihood estimation). We stratified the results by sex and parental education. Results If all adolescents, hypothetically, had high levels of PWB, compared to low levels, we estimated a decrease in the average amount of alcoholic beverages in young adulthood by 0.1 drinks per week [95%-confidence interval: -2.3; 2.1]. Furthermore, if all adolescents had low levels of EDI, compared to high levels, we estimated an increase in alcoholic beverages in young adulthood by 1.5 drinks per week [0.1; 2.9]. Different effects for sex and parental education groups were found. Conclusions Hypothetical interventions targeting PWB in adolescents were not found to have effects on reducing AC in young adulthood. Interventions targeting EDI, however, would lead to an increase in AC. This may be due to unmeasured confounding and the missing distinction between drinking motives. Key messages • We demonstrate that causal inference methods, compared to traditional ones, improve the robustness of estimated effect measures and address important sources of bias in European cohort data. • To inform public health interventions on reducing alcohol consumption, future research should investigate different drinking motives, e.g. alleviating negative emotions or enhancing positive emotions.

Effectiveness of Cartoons, Comics, and Animation-Based Sexual Health Promotion and Education Interventions: A Scoping Review

Objective Sexual health education is crucial for promoting healthy sexual behaviors among people of all ages. Interventions involving cartoons, comics, and animations have emerged as effective tools due to their engaging and accessible nature. This scoping review explores the effectiveness of these interventions across different time frames and age groups. Methods Using the PICOS framework and PRISMA guidelines for scoping reviews, a review was conducted across 14 databases to include relevant studies published between 2000 and 31 May 2024. Results Analyzing 51 intervention studies meeting the inclusion/exclusion criteria revealed varied outcomes in interventions that highlight a significant shift in focus from developing educational tools and empowering youth in the earlier period (2000–2010) to implementing advanced technology-based cartoons, comics, and animations interventions and addressing diverse populations in the later period (2011–2024). The results of these studies were predominantly positive, with many reporting significant improvements in knowledge, behaviors, and engagement. Conclusion While many studies report positive outcomes, further investigation is needed into the long-term impact of digital-based cartoons, comics, and animation interventions on behavior change and health outcomes. Research should also explore the effectiveness of these tools in different cultural and socioeconomic contexts to ensure their broad applicability. Ongoing research and iterative development are warranted to ensure that these interventions continue to evolve and meet the changing needs of users in an increasingly digital world across diverse populations

Analysis of parents’ needs regarding sexual and reproductive health issues of their children

Abstract Background Promoting sexual and reproductive health is a key intervention for young people’s health and well-being. Studies have shown that young people have a need to be supported by a strong network and that parents are considered an important source of information. The aim of our work was to understand the needs and critical issues parents face when raising the topic of sexual and reproductive health with their children in order to strengthen their skills and provide the best tools to support young people. Methods A qualitative focus group research methodology was used; a sexual psychologist facilitated the meetings. Parents of children attending secondary schools in Udine (Italy) in the 2022/2023 school year were invited to participate in the project. The meetings were recorded and transcribed verbatim by two independent researchers. Following an inductive method, recurring themes were extrapolated to represent the main categories and more specific subcategories. Results 46 parents participated in the focus group; 76% of them had no experience with sexual and affective education. Parents felt that sex education was useful in providing accurate information, preventing risks and promoting respect and relationships with others; however, there were concerns that the values taught were not consistent with those of the family. The topic was found to be difficult to discuss with children, both in terms of technical/scientific aspects and addressing issues such as gender identity and sexual orientation. Parents would like to understand what the right communication key is to discuss with their children in an atmosphere of trust. Conclusions Parents recognized the importance of the topic and saw the need to deepen some aspects, especially in terms of relationship and communication. The results of this work will be a useful starting point for the creation of ad hoc pathways aimed at parents to strengthen the relationship with their children. Key messages • Parents want to overcome difficulties by finding the right key to communicate with their children. • Supporting young people and their network to promote sexual and reproductive health is essential.

Addressing the complexities of evaluating comprehensive sexuality education: an Italian case study

Abstract Background Existing evaluation methods for assessing sexuality education programs may not be suitable for Comprehensive Sexuality Education (CSE) interventions, which are globally indicated as the most effective approach for promoting sexual health and preventing STIs. This holds particular significance in countries, such as Italy, where CSE is not integrated into school curricula. In a pilot project funded by the Italian Ministry of Health since 2019 (EduForIST), we aimed to develop a composite evaluation framework to test the CSE intervention we implemented in lower and upper secondary schools over the past 4 years. Methods Based on the latest available evidence, evaluating a CSE intervention requires addressing various dimensions. These include assessing the quality of programs and their implementation, as well as measuring outcomes and impact. Through iterative consultations with experts and providers, methods, criteria, and metrics were chosen and tested for each dimension. Results Program quality was evaluated by an expert advisory board. Instruments for implementation quality assessment included: satisfaction survey among students; reflective journals and SWOT analysis drawn up by educators delivering intervention, exploring their perceptions, practices, and attitudes; surveys among teachers and parents, measuring knowledge, attitude, and practice on CSE, and observed changes among adolescents. A four-arm, Solomon, cluster design study was designed to evaluate outcomes in terms of changes in students’ knowledge. Clinical and behavioral indicators in the short, medium and long term were selected as measures of the impact of the intervention. Conclusions In the field of CSE implementation research, a multi-component approach to evaluation is needed to provide a solid basis for informing policymakers. The involvement of providers, recipients and contextual adults is essential in evaluating CSE interventions. However, assessing long-term impact requires long time frame. Key messages • Assessing CSE interventions requires a multi-component evaluation approach, considering the impact on the personal and emotional development of individuals in order to sustain behavior changes. • The proposed evaluation framework may inform scientific community, professionals, and decision-makers on effectiveness of interventions in settings where CSE is not yet included in school curricula.

Documenting the availability and accessibility of reproductive health services for youth in Albania

Abstract Youth in Albania are initiating sexual activity at an earlier age. However, use of all forms of contraception has declined in the last decade and uptake now stands at 4%. The self-reported prevalence of sexually transmitted infections (STIs) and STI symptoms has risen dramatically, as has reliance on abortion as a predominant method of family planning. In 2020-2022, we conducted a multi-method qualitative study in Albania to document the availability and accessibility of sexual and reproductive health (SRH) services and examine challenges that youth face when seeking SRH care. This study comprised a document review, a curriculum review, a community-based survey with 273 youth, semi-structured interviews with 15 youth, semi-structured interviews with 15 key informants, and a service mapping exercise in Tirana. Lack of adequate infrastructure and bureaucratic hurdles make it difficult for youth to navigate and access SRH services in Albania. A third of survey participants (n = 90, 33%) expressed discomfort inquiring about SRH matters, while nearly two-thirds rarely or never sought SRH services from a doctor or clinic. Furthermore, Albania’s school-based sexuality education curriculum lacks in topics, content, and responsiveness, resulting in inconsistent learning experiences and limited knowledge of SRH. Sexuality education is primarily focused on the anatomy and physiology of reproduction, leading to significant knowledge gaps in other aspects of SRH. Only half of survey participants (n = 150, 55%) had received any education on birth control, contraception, or family planning; and only few had knowledge about gender identity (n = 103, 38%), or consent (n = 77; 28%). Widespread lack of awareness and fear of judgment contribute to the underutilization of SRH services among youth in Albania. Improving knowledge and awareness, alongside investing in infrastructure and capacities, are essential to enhancing accessibility and quality of SRH services for Albanian youth. Key messages • Lack of knowledge and awareness prevent youth from accessing SRH services. • Establishing youth-friendly services and training health providers and educators are crucial to delivering confidential and non-judgmental youth-friendly SRH care.

Sexual health education in Italian schools: preliminary results of EduForIST3 national project

Abstract Background School-based comprehensive sexuality education (CSE) is the best approach to disseminate scientific evidence and promote healthier sexual behaviours among young people. However, in Italy, CSE is not included in schools curricula. This study, funded by the Ministry of Health, seeks to investigate information uptake and attitudes towards sexuality among adolescents included in a pilot CSE intervention in 6 Italian regions, from December 2023 to June 2024. Methods A 10-hours education intervention was implemented in a convenient sample of 26 upper and lower secondary schools (U/LSS), covering topics such as changes in adolescence, relationships and consent, sexual identity, sexually transmitted infections (STIs), contraception and sexual health services. Students’ evaluation comprised pre/post tests assessing knowledge, attitudes towards sexuality and satisfaction. A Solomon 4-group design study was used to compare intervention and control classes. A follow-up test will be conducted 4-6 months post-intervention. Results Preliminary analysis of available data as of 30 April, 510 pre-tests and 266 post-tests, showed incremented correct answers in all items. A significant increase (p<.05) was found in 12/21 items for USS and in 9/19 items for LSS, especially in the domain STIs symptoms and prevention, among those mostly appreciated. Over 90% of students considered schools as suitable setting to receive CSE, preferably by external experts. Ongoing qualitative and long-term analysis will provide further insights of the overall impact of the activity. Conclusions The pilot CSE intervention increased the knowledge and attitudes of the students involved. Additional insights will be available after study completion. Findings from this study will contribute to evaluate the effects of CSE initiatives on sexual health knowledge and attitudes among Italian secondary schools students, as well as the effectiveness of such programs in fostering healthier behaviours. Key messages • Providing evidence-based, relevant information and education on sexual health to young people in secondary schools increases their knowledge and improves attitudes towards sexuality. • CSE should be included in Italian school curricula in order to promote an incremental uptake of information and to improve young people’s sexual health.

Predictive machine learning algorithms for metabolic syndrome among Tunisian adults

Abstract Background Metabolic syndrome (MS), a cluster of interconnected risk factors for cardiovascular disease and type 2 diabetes, poses a significant health burden globally. In Tunisia, amidst an ongoing epidemiological transition, the prevalence of MS presents a growing concern. Our study aimed to identify the potential risk factors of MS and propose better machine learning (ML) based models for predicting MS among Tunisian adults. Methods Data was sourced from the Tunisian Health Examination Survey THES-2016, encompassing individuals aged 20 years and older. MS was defined based on the criteria set by the International Diabetes Federation. Logistic regression (LR) was employed to determine risk factors for MS. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated. Five ML algorithms (Naïve Bayes, Support Vector Machine (SVM), Artificial Neural Network (ANN), AdaBoost, and Random Forest (RF)) were utilized to predict MS. Performance evaluation was conducted using accuracy, precision, recall, and area under the curve (AUC) metrics. Results Among the 8908 participants, the prevalence of MS was 32.8% (95% CI: 31.4% - 34.6%). LR identified age group 60-69 years (aOR: 18.5, 95% CI: 16.9-19.9, p < 0.001), female sex (aOR: 1.7, 95% CI: 1.2-1.9), sedentariness (aOR: 1.6, 95% CI: 1.5-1.8) and low education level (aOR: 1.2, 95% CI: 1.1-1.4) as significant factors associated with MS. Among ML models tested, AdaBoost had the highest accuracy (89.8%), followed by SVM (89.6%). Naïve Bayes had the highest Recall (98.1%) and the most performant AUC (91.4%), while RF had the highest Precision (70.8%). The ANN had an accuracy of 89%, a precision of 70.4%, a recall of 78.7% and an AUC of 85.1%. Conclusions Our study highlighted the effectiveness of ML algorithms like AdaBoost and SVM in predicting MS among Tunisian adults, offering potential as early detection tools. However, further validation with larger datasets is necessary to solidify their utility in healthcare settings. Key messages • Metabolic syndrome, a complex of cardiovascular risk factors, presents a substantial global public health challenge and is particularly pronounced in Tunisia. • Machine learning algorithms, notably AdaBoost and Support Vector Machine, demonstrate promise in forecasting and addressing metabolic syndrome.in Tunisian adults.

Sexual health communication targeting adolescents in public service Media: the case of Finland

Abstract Background Given the substantial time adolescents spend online, sexual health promotion and education through online media constitute a promising public health action. However, monitoring of sexual health-related online media content is warranted, and considering the scope and aims of public service media, this forum can be regarded as being of particular interest. This study aimed to analyze how and to what extent sexuality and sexual health-related content targeting adolescents is communicated and portrayed in public service media in Finland, with a particular interest in health promotion perspectives and participatory practices. Methods Based on predetermined inclusion criteria and guidance from professionals at the Finnish public service company Yle, podcasts were specified as the media format of interest. Three Finnish podcasts (a total of 66 episodes) produced during the years 2021-2023, targeting young people and focusing on sexual health, were included in this study and subject to critical content analysis. Results Most podcast episodes focused equally on the sexual health resource and risk perspectives, while a third emphasized a resource perspective. Concerning participatory practices, adolescents participate in only five episodes in total, and most often, the podcast hosts’ own experiences are at the center of the episodes. Conclusions The findings highlight how sexuality and sexual health content is communicated in public service media podcasts targeting adolescents in Finland, as well as how the communication aligns with health education and promotion guidelines. The study sheds light on participatory practices, emphasizing a lack of stakeholder involvement, i.e., dialogue between podcast hosts and listeners. Results carry implications for developing sexual health promotion through public service media targeting young people in Finland and other European countries alike. Key messages • The findings highlight how sexuality and sexual health content is portrayed in public service media podcasts in Finland and how the communication aligns with health promotion values and principles. • The findings show a lack of participatory practices in Finnish public service media podcasts targeting adolescent sexual health - a health promotion concern also pertinent to other countries.

Capacity mapping of comprehensive sexuality education in Gabon: A qualitative analysis

Abstract Background Access to comprehensive sexuality education (CSE) is crucial for adolescent health and well-being. Following UNESCO’s recommendations, Gabon revised its sex education policy in 2017 to better address adolescents’ sexual health needs. This study aims to map the capacities of the public health and education sector to implement Gabon’s CSE policy. Methods Semi-structured interviews were held with 15 professionals from ministries, NGOs, and development partners. Thematic analysis guided by Aluttis et al’s public health capacity model allowed to assess the existing capacities and gaps in leadership, organizational structures, partnerships, resources, and knowledge development for CSE. Results The implementation of CSE in Gabon is hindered by sociocultural and political factors, including the taboo on adolescent sexuality influencing perceptions of CSE content, natalist policies, and socio-economic disparities. Governmental involvement in CSE is limited to key ministries. Organizational structures for CSE lack cohesion due to changes in governance regimes and a lack of support for civil society organizations. Human resources are unevenly distributed, and financial constraints impede government initiatives, causing a strong reliance on external funding. An important role in supporting CSE is played by development partners and partnerships between stakeholders. While knowledge development for CSE is underway, monitoring and evaluation procedures are insufficient, and evidence mobilization by key professionals is insufficient. Conclusions Enhancing stakeholder collaboration, addressing structural constraints, and mobilizing human and financial resources are critical for effective CSE implementation in Gabon. Addressing these barriers requires coordinated efforts among stakeholders and addressing systemic challenges. This study provides insights for policymakers and practitioners to strengthen CSE programs and promote adolescent sexual health in Gabon. Key messages • CSE implementation is hindered by taboos on adolescent sexuality, natalist policies, and socio-economic gaps. • Evaluation and evidence mobilization deficits limit effectiveness.