Sexual Health Education Programs Research Articles

Where Are We in Terms of Sexual Health Education? An Ontario Perspective.

In the present study, sexual health educators in schools in the catchment area for the Children's Hospital of Eastern Ontario were surveyed to determine whether sexual health education programs were available to youth, whether the structure and content of sexual health education programs followed the guidelines, the instructors' qualifications and level of comfort with the material, and the need for additional resources that could be offered by health care professionals. Survey results showed that only 85% of participating schools had a sexual health education program in place. Only one-third of educators stated they had formal training on the topic of sexual health. Some schools still taught mostly about abstinence or advocated condom use for contraception. The results showed that many of these schools did not follow established Canadian guidelines for sexual health education. Nonetheless, 80% of Canadian adolescents report school as their most valuable source of information on sexuality.

Islamic parents’ attitudes and beliefs towards school-based sexual and reproductive health education programmes in Oman

ABSTRACTSchool-based comprehensive sexuality education (CSE) programmes play an important role in reducing young people’s sexual risk behaviour and promoting health and well-being. There is limited evidence regarding the attitudes and beliefs of parents towards the implementation of school-based CSE programmes in Islamic cultural settings, including Oman, which this mixed-method study set out to explore. A convenience sample of 250 parents, with equal numbers of mothers and fathers of children aged 12–14 years (grades 7–9) at two urban public pre-secondary schools in Saham, completed a paper-based self-administered questionnaire in Arabic. We found most parents (72.8%) supported school-based CSE programmes that conformed to Islamic requirements of pre-marital sexual abstinence, but there was some opposition. Almost all parents supported comprehensive age-appropriate CSE being taught to students aged 10–15 years, including topics perceived as controversial in Omani culture, except for birth control and safer sex. Most parents considered themselves, school teachers and school nurses to be important sources of CSE. The study findings which suggest strong parental support for CSE programmes can facilitate education policy, CSE curriculum decision-makers and school healthcare-providers in Oman, other Middle Eastern countries, and countries with Muslim immigrant populations.

The use of technology in the sexual health education especially among minority adolescent girls in the United States

The purpose of this review is to examine current sexual health education technologies for adolescents and identify gaps in knowledge. Disparities in sexual health education are prominent and mainly affect young women of color. As a result, the use of technology to reach these marginalized populations could potentially invoke change. Thus, it is crucial to determine the viability of technology as a mechanism to bridge the knowledge gap regarding sexual health for adolescents that are most at risk of sexually transmitted infections and unwanted pregnancies. With a lack of standardized, evidenced-based sexual health education programs in the United States, the future of comprehensive sexual health education is moving toward smartphone apps. Many sexual health technologies exist that target adolescents, most of which have been proven to demonstrate positive effects. Use of mobile apps, especially for vulnerable populations, can be more effective because of privacy and widespread dissemination. Ultimately, more research needs to be conducted to determine the most effective content for these sexual health apps. Additionally, more research should be conducted on effective sexual health apps for marginalized populations to determine whether technology is a viable solution.

Improving Sexual Health Education Programs for Adolescent Students through Game-Based Learning and Gamification.

An effective innovative pedagogy for sexual health education is required to meet the demands of technology savvy digital natives. This study investigates the extent to which game-based learning (GBL) and gamification could improve the sexual health education of adolescent students. We conducted a randomized control trial of GBL and gamification experimental conditions. We made a comparison with traditional teaching as a control condition in order to establish differences between the three teaching conditions. The sexual health education topics were delivered in a masked fashion, 40-min a week for five weeks. A mixed-method research approach was uses to assess and analyze the results for 120 students from a secondary school in Dar Es Salaam, Tanzania. Students were divided into groups of 40 for each of the three teaching methods: GBL, gamification, and the control group (the traditional teaching method). The average post-test scores for GBL (Mean = 79.94, SD = 11.169) and gamification (Mean = 79.23, SD = 9.186) were significantly higher than the control group Mean = 51.93, SD = 18.705 (F (2, 117) = 54.75, p = 0.001). Overall, statistically significant differences (p ≤ 0.05) were found for the constructs of Motivation, Attitude, Knowledge, and Engagement (MAKE). This study suggests that the two innovative teaching approaches can be used to improve the sexual health education of adolescent students. The methods can potentially contribute socially, particularly in improving sexual health behaviour and adolescents’ knowledge in regions plagued by years of sexual health problems, including HIV/AIDS.

Reaching High-Need Youth Populations With Evidence-Based Sexual Health Education in California.

To explore the programmatic reach and experience of high-need adolescents who received sexual health education in 3 distinct implementation settings (targeted-prevention settings, traditional schools, and alternative schools) through a statewide sexual health education program. Data are from youth surveys collected between September 2013 and December 2014 in the California Personal Responsibility Education Program. A sample of high-need participants (n = 747) provided data to examine the impact of implementation setting on reach and program experience. Implementation in targeted-prevention settings was equal to or more effective at providing a positive program experience for high-need participants. More than 5 times as many high-need participants were served in targeted-prevention settings compared with traditional schools. Reaching the same number of high-need participants served in targeted-prevention settings over 15 months would take nearly 7 years of programming in traditional schools. To maximize the reach and experience of high-need youth populations receiving sexual health education, state and local agencies should consider the importance of implementation setting. Targeted resources and efforts should be directed toward high-need young people by expanding beyond traditional school settings.

Impact of sexual and Reproductive Health education Programme in Improving their Knowledge among school Going Adolescents: A Pre Experimental Pilot Study

Impact of sexual and Reproductive Health education Programme in Improving their Knowledge among school Going Adolescents: A Pre Experimental Pilot Study

Sexual History Taking’– Difficulties Faced by Undergraduate Medical Students and their Preferred Teaching Learning Methods

Background: Sexual history taking (SHT) for instance is described as an important clinical skill that formal medical school curricula have historically neglected. However, such skill deficit might not be overcome even after graduation. The deficiency in learning SHT skills might eventually affect students’ career choices. Aim: To assess the difficulties faced by undergraduate medical students while eliciting sexual history and to identify the pitfalls and the students preferences in the teaching learning methods for taking sexual history perceived by the students. Methodology: A cross-sectional study was conducted in our medical college hospital between Jan 2016 and June 2016 involving the students of final year medical students and CRRI’S. Total numbers of participants were 220 students. Questions related to their comfort and confident level in eliciting sexual history along with general history, prerequisites in obtaining sexual history and the ideal age and gender according to the students perception was all obtained in the questionnaire. Questions for assessing the barriers in eliciting sexual history among the medical student’s and the current teaching methods which were followed for obtaining the sexual history was obtained. Likerts scale was used for assessing the student’s attitude towards asking the sexual history. Finally suggestions were also asked in improving the teaching methods for obtaining the sexual history. Results: The CRRI’s were found to be more confident in eliciting sexual history than the final year MBBS students, as they had one more additional year of exposure and females in both the groups were found to be slightly more confident than the males in eliciting the sexual history. Most of the students in both the groups felt that cultural and religious differences are the major barriers in eliciting the sexual history and they were also able to recognise their own limitations. Majority of the students agree to the point that they had not been adequately trained in eliciting sexual history. Students felt that they have to be taught by means of role play, video clips and simulated patients which would practically guide them in eliciting sexual history to the patient in a much more skilful and confident manner. Conclusions: Lack of confidence in approaching the subject of sexual health, inadequate preparation were some of the barriers identified. The delivery of sexual health education program should incorporate confidence building and to make students feel comfortable to take a sexual history from patients.

Causes of unwanted pregnancy among adolescents in Bali Province: a qualitative study

Background and purpose: Teenage pregnancy is a major contributing factor of high maternal and infant mortality rates in Indonesia. Unwanted pregnancy among adolescents is increasing, therefore an understanding of its causes is essential. This study aims to explore causes of unwanted pregnancy among adolescents.Methods: A qualitative study was conducted in Bali Province. Data were obtained through in-depth interviews with 10 adolescents aged between 12-21 years who experienced unwanted pregnancy. Data were collected between September and October 2016. Data were analysed thematically and presented using a narrative approach.Results: Our study revealed that determinants associated to unwanted pregnancy among adolescents included the lack of systematic education on sexual and reproductive health both at home and school, as well as the lack of self-efficacy of teenage girls to reject pre-marital sex with their partner. Our study found that this pre-marital sex was done as an expression of love, because of being forced by the partner, and due to stressful home environments.Conclusions: The main causes of unwanted pregnancy among adolescents are the lack of sexual and reproductive health education and a weak self-efficacy of teenage girls to reject pre-marital sex demanded by their partner. Given the complexities of teenage pregnancy, overarching policy to facilitate an early comprehensive sexual and reproductive health education program at home, schools, and youth-friendly health facilities is warranted.

English

Unwanted pregnancy can occur due to unprotected sexual intercourse and condom breakage. To prevent such problem, emergency contraceptives is the only method that can be used after unprotected sex. This study aimed to assess emergency contraceptive utilization and associated factors among regular undergraduate female students of Wollo University. A cross sectional study was conducted from April 1 to 15, 2017. Simple random sampling was used and 508 study subjects participated with response rate of 100%. Among the total respondents, 41.9% had sexual intercourse at least once prior to this study. Of those who had sexual intercourse, 19.7% had sexual intercourse without condom/contraception. From all respondents, 68.1% of the respondents have ever heard about emergency contraception, but only 30.9% used emergency contraception after unprotected sexual intercourse. Currently, unmarried students were 3.8 times more likely to use emergency contraceptive than currently married students (AOR: 3.8, 95% CI: 0.904 to 0.269). Those students who began sexual intercourse at age 13 years or less were 4.7 times more likely to use emergency contraceptive than those students who began sexual intercourse above age 13 years (AOR: 4.7, 95% CI: 1.403 to 15.769). Emergency contraceptive utilization was low among sexually active students after unprotected sexual debut. Sexual and reproductive health education program should be set up for the university students to avail accurate information about emergency contraception. Key words: Emergency cotraceptive use, Wollo University, female students.

Men's perspectives on cancer prevention behaviors associated with HPV.

The human papillomavirus (HPV) is associated with the diagnosis of anal, penile, and oropharyngeal cancers in men. Evidence indicates that correct condom use in addition to obtaining the HPV vaccine provides the greatest protection from HPV infections. To explore young men's beliefs and behavioral intention in relation to receiving the HPV vaccine and using a condom correctly and consistently for sexual contact. A cross-sectional study underpinned by the theory of planned behavior (TPB) was conducted with male participants (n=359, 18-28years) who completed an online survey. Descriptive, correlational, and hierarchical regression analyses were performed on both status variables and variables of the TPB. Subjective norms (β=0.519, P<.001) was identified as the most influential predictor in relation to men's intention to receive the HPV vaccine, while relationship status (β=-0.215, P<.001) and attitudes (β=0.394, P<.001) presented as the most significant predictors of intention to use a condom. Summarily, 51% of the variance in intention to receive the HPV vaccine and 44% in intention to use a condom were explained by the TPB model. Results from this study will impact on future sexual health research, education programs, and interventions for both HPV preventative behaviors towards the elimination of HPV-related cancers in men.

‘You shouldn’t be making people feel bad about having sex’: exploring young adults’ perceptions of a sex-positive sexual health text message intervention

Young adults are disproportionately affected by negative sexual health outcomes, such as sexually transmitted infections. One strategy for reducing such negative outcomes involves the use of comprehensive sexual health education. As comprehensive sexual health education programmes are adopted, there is a need to evaluate the messaging approaches that might best connect with young people. Sex-positive approaches, which describe sex as a healthy practice and personal choice, are becoming popular, but whether this strategy works has not been tested from a message design perspective. This study examines the reactions of young adults to sex-positive or sex-negative messages, framed as a gain or loss, designed for a text message-based intervention. Participants quantitatively evaluated 24 messages on their mobile phones. Gain frames were preferred over loss frames, and sex-positive messages were rated as more believable and persuasive. An interaction between the two concepts was also found. Results highlight how sex-positive messages that focus on the benefits of certain behaviours tend to resonate better with young adults. Implications for health educators and practitioners are discussed.

Student Voices: Perspectives on Peer-to-Peer Sexual Health Education.

This process study is a companion to a randomized evaluation of a school-based, peer-led comprehensive sexual health education program, Teen Prevention Education Program (Teen PEP), in which 11th- and 12th-grade students are trained by school health educators to conduct informative workshops with ninth-grade peers in schools in North Carolina. The process study was designed to understand youth participants' perspectives on the program in order to gain insight into program effectiveness. This is a mixed-methods study in 7 schools, with online surveys (N = 88) and 8 focus groups with peer educators (N = 116), end-of-program surveys (N = 1122), 8 focus groups with ninth-grade workshop participants (N = 89), and observations of the Teen PEP class and workshops during the semester of implementation in each school, 2012-2014. Both peer educators and ninth graders perceived benefits of participating in Teen PEP across a range of domains, including intentions, skills, and knowledge and that the peer education modality was important in their valuation of the experience. Our findings suggest that the peer-led comprehensive sexual health education approach embodied in Teen PEP can be an important educational mechanism for teaching students information and skills to promote sexual health.

Effect of Forced Sexual Intercourse on Associations Between Early Sexual Debut and Other Health Risk Behaviors Among US High School Students.

Previous research on associations between early sexual debut and other health risk behaviors has not examined the effect of forced sexual intercourse on those associations. We analyzed data from a nationally representative sample of 19,240 high school students in the United States, age ≥16 years, to describe the effect of forced sexual intercourse on associations between early sexual debut and other health risk behaviors using adjusted prevalence ratios (APR). Early sexual debut and forced sexual intercourse were simultaneously and independently associated with sexual risk-taking, violence-related behaviors, and substance use. For example, even after controlling for forced sexual intercourse and race/ethnicity, students who experienced their first sexual intercourse before age 13 years were more likely than students who initiated sexual intercourse at age ≥16 years to have had ≥4 sexual partners during their lifetime (girls, APR = 4.55; boys, APR = 5.82) and to have not used a condom at last sexual intercourse (girls, APR = 1.74; boys, APR = 1.47). Associations between early sexual debut and other health risk behaviors occur independently of forced sexual intercourse. School-based sexual health education programs might appropriately include strategies that encourage delay of initiation of sexual intercourse, and coordinate with violence and substance use prevention programs.

Toward the Tailoring of Sexual Health Education Messages for Young Women: A Focus on Tourist Experiences

Perceived anonymity and decreased influence of sexual double standards in tourism provide female travelers with opportunities for sexual experimentation and risk taking. The purpose of this study was (a) to identify the clusters of risk takers among young women based on their perceptions of and motivations for sexual risk taking in tourism and (b) to profile the clusters with respect to the psychological, sexual, demographic, and tourist characteristics. The data were collected through an online survey of 853 women (age in years: M = 23.5, SD = 6.67). Five clusters of sexual risk takers emerged based on their factor-analyzed risk perceptions and motivations. These clusters were interpreted as (a) diversely motivated broad risk perceivers; (b) fun-seeking broad risk perceivers; (c) diversely motivated physical risk perceivers; (d) anonymity- and empowerment-seeking risk disregarders; and (e) unmotivated broad risk perceivers. Women in these clusters differed in their intentions to engage in sexual risk taking in tourism, sensation-seeking propensities, perceptions of tourist characteristics, levels of sexual experience, and demographic backgrounds. Results suggest tailoring sexual health promotion messages based on cluster affiliation, leveraging cluster-specific risk perceptions, motivations, and personal characteristics. This study provides recommendations for individually tailored, context-specific, age-appropriate, and gender-sensitive sexual health education programs.

Effects of a sexual health education programme on school psychological counsellor candidates’ sexism tendencies in Turkey

This study examined the effects of a sexual health curriculum developed for school psychological counsellors in Turkey on the sexual health knowledge of the participating candidates, their beliefs in sexual myths and their tendencies towards ambivalent sexism and sexism in romantic relationships. The study adopted a semi-experimental design. Study participants included an experimental group of 59 students from a programme of guidance and psychological counselling in Ege University’s Faculty of Education and a comparison group of 33 students from the Department of Psychology in the Faculty of Letters. Findings suggested that the sexual health education curriculum increased knowledge of sexuality, decreased beliefs in sexual myths, and decreased ambivalent sexism and sexism in romantic relationships among the candidates.

Evaluation of a Collegiate Women's Sexual Health Promotion and Education Program

Evaluation of a Collegiate Women's Sexual Health Promotion and Education Program

Premarital sexual relationships: Contraceptive knowledge and practice among iranian youths

Objective: The youths' sexual behaviors are counted as the main priorities of the public health due to the high prevalence of unwanted pregnancies, illegal abortions, and sexually transmitted infections. This research was carried out to explain the youths' contraceptive knowledge and practice in premarital sexual relationships. Methods: This qualitative research was carried out on 30 single boys and girls aged 18–24, living in Isfahan, Iran, who had already started sexual activities. Data collection was done with semi-structured interviews. The data were analyzed by using conventional content analysis. Results: Two main categories were extracted including inadequate awareness regarding contraception (with subcategories “unreliable information sources” and “gender inequality in familiarity with contraceptive methods”) and inappropriate contraceptive practice (with sub-categories “use of unreliable contraceptive methods” and “gender inequality in applying contraceptive methods”). Conclusion: Sexual health education programs should equip the youths with adequate knowledge on contraception and use of reliable contraceptive methods. Furthermore, attempts should be made along with tackling gender inequality is very significant for youths' sexual and reproductive health security.

Evaluating school-based sexual health education programme in Nepal: An outcome from a randomised controlled trial

This study explored the effectiveness of teaching sex education programme to the secondary school children in Nepal.The study included four schools which were randomised to two groups; control and experimental schools. The teachers in the control schools delivered the sex education curriculum in a conventional way whereas the trained health facilitator in the experimental schools used a participatory teaching approach. The results were analysed by using z-score to identify the distribution patterns of pupils’ responses. There was significant number of school children reporting the increment of sexual health knowledge in the experimental schools. This suggests that the health facilitator led sex education programme is more effective in improving the sexual health knowledge of the school children.

Assessment of a Culturally-Tailored Sexual Health Education Program for African American Youth.

African American youth are affected disproportionately by sexually transmitted infections (STIs), human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), and teenage pregnancy when compared to other racial groups. This paper evaluates the effectiveness of the To Help Young People Establish (2 HYPE) Abstinence Club, a behavioral intervention designed to promote delayed sexual activity among African American youth ages 12–18 in Atlanta, Georgia. The intervention included 20 h of curriculum and creative arts instruction. Pre- and post-intervention survey data collected from 2008–2010 were analyzed to determine the effectiveness of the intervention. Intervention (n = 651) and comparison (n = 112) groups were compared through analysis of variance and multivariate logistic regression models. There was a statistically significant increase in intervention youth who were thinking about being abstinent (p = 0.0005). Those who had not been engaged in sexual activity were two times more likely to plan abstinence compared to participants that had been previously sexually active previously (odds ratio 2.41; 95% confidence interval 1.62, 3.60). Significant results hold implications for subsequent community-based participatory research and practice that broadens the understanding of the relevance of marriage, as just one among other life success milestones that may hold more importance to African American youth in positioning the value of delayed and responsible sexual activity towards effective STIs, HIV/AIDS, and teen pregnancy risk reduction interventions.

Teen Dating Violence Victimization, Perpetration, and Sexual Health Correlates Among Urban, Low-Income, Ethnic, and Racial Minority Youth.

This study explores the associations between teen dating violence (TDV) perpetration, victimization, sexual risk behaviors, and pregnancy among a sample of low-income, urban, and predominately African-American and Latino youth age 15 to 21 years ( N = 513). Findings suggest that youth who experienced TDV victimization were more likely to report inconsistent condom use in the past 12 months ( OR = 1.6) and pregnancy ( OR = 2.2) compared with nonvictimized youth. Youth who reported perpetrating dating violence were more likely to be female ( OR = 3.8) and to report multiple sex partners ( OR = 2.0), inconsistent condom use ( OR = 2.6), and prostitution in the past 12 months ( OR = 6.7). TDV perpetration and victimization were highly associated (χ2 = 127.00, p < .001); that is, 30% of the sample reported both victimization and perpetration in their previous or current romantic relationships. Findings from this study highlight the need to integrate culturally informed TDV prevention and intervention strategies into existing adolescent sexual and reproductive health education programs.