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Leiva L, Torres-Cortés B, Antivilo-Bruna A, Zavala-Villalón G. Gender-transformative school-based sexual health intervention: study protocol for a randomized controlled trial. Trials 2024; 25:360. [PMID: 38835035 DOI: 10.1186/s13063-024-08191-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND There is general agreement that sexuality is a central aspect of human development; it is key in sexual health and reproductive education during adolescence. However, in spite of the existing interventions on this topic and the evidence generated, the inclusion of a gender focus in sexuality is relatively recent and there is little evidence available, thus structured and corroborated interventions with a gender-transforming perspective in sexuality are required. METHODS We will use a mixed method experimental design with a parallel cluster-randomized trial (GRTs) that will evaluate the effectiveness of a comprehensive gender-transformative intervention of sexual education (ENFOCATE -Focus-on-), which will be complemented with qualitative studies to understand the implementation process. The participants will be 609 10th and 11th-grade students. The randomization will be by grade, and the data will be collected at three moments (pre-intervention, post-intervention, and a 3-month follow-up). DISCUSSION Comprehensive, gender-focused, and culturally pertinent interventions in sexuality are needed for adolescents of countries with high, middle, and low incomes. These produce better results in terms of sexual health, and including a gender-transformative focus contributes to equity in health. Focus-on is unique since it uses a comprehensive gender-transformative intervention in sexual education that will allow putting into practice a program based both on international evidence and that which arises from the object population. It also uses a culturally-sensitive focus, since it is designed based on the characteristics of the object population; it will allow adapting some activities to the needs of the context in which it is developed. TRIAL REGISTRATION The study was prospectively registered on June 6, 2023, at ClinicalTrials.gov ID: NCT05896540. Protocol version number 1.0. May 22, 2023.
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Affiliation(s)
- Loreto Leiva
- Department of Psychology, University of Chile, Santiago, Chile.
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Chin HB, Howards PP, Kramer MR, Johnson CY. Understanding the roles of state demographics and state policies in epidemiologic studies of maternal-child health disparities. Am J Epidemiol 2024; 193:819-826. [PMID: 38055631 DOI: 10.1093/aje/kwad240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 11/20/2023] [Accepted: 12/04/2023] [Indexed: 12/08/2023] Open
Abstract
Disparities in maternal-child health outcomes by race and ethnicity highlight structural differences in the opportunity for optimal health in the United States. Examples of these differences include access to state-level social policies that promote maternal-child health. States vary in their racial and ethnic composition as a result of the complex history of policies and laws related to slavery, Indigenous genocide and relocation, segregation, immigration, and settlement in the United States. States also vary in the social policies they enact. As a result, correlations exist between the demographic makeup of a state's population and the presence or absence of social policies in that state. These correlations become a mechanism by which racial and ethnic disparities in maternal-child health outcomes can operate. In this commentary, we use the example of 3 labor-related policies actively under consideration at state and federal levels (paid parental leave, paid sick leave, and reasonable accommodations during pregnancy) to demonstrate how correlations between state demographics and presence of these state policies could cause or exacerbate racial and ethnic disparities in maternal-child health outcomes. We conclude with a call for researchers to consider how the geographic distribution of racialized populations and state policies could contribute to maternal-child health disparities.
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Affiliation(s)
- Helen B Chin
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA 22030, United States
| | - Penelope P Howards
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, United States
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, United States
| | - Candice Y Johnson
- Department of Family Medicine and Community Health, School of Medicine, Duke University, Durham, NC 27705, United States
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Sharp G, Kellermann V, Mehta Y, Fernando AN, West ML. Exploration of parental consent for adolescent involvement in genital body image education research. Body Image 2024; 49:101717. [PMID: 38718469 DOI: 10.1016/j.bodyim.2024.101717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 05/31/2024]
Abstract
Genital body image is a highly understudied concept but is important for sexual health and broader body image satisfaction. Effective genital body image interventions for adolescents have been developed, however, parental consent can be a barrier to adolescent participation. The aim of this study was to conduct a novel exploration of parental consent for genital body image education research and factors related to this consent. Participants were 125 parents of adolescents in Australia who completed an online questionnaire including measures of demographic characteristics, personality traits and attitudes, and likelihood of consent for an adolescent son and daughter participating in hypothetical genital body image education research. The vast majority of parents indicated that they definitely would consent to their adolescent sons' and daughters' involvement in this hypothetical research. There was no significant difference in likelihood of consent based on the gender of the adolescent. Parents having more conservative attitudes towards sex was the only factor tested that reduced the likelihood of providing consent. Overall, our results suggest parents are generally supportive of adolescent involvement in genital body image education research. This concept should be included in broader body image educational programs so adolescents gain exposure to this important but neglected topic.
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Affiliation(s)
- Gemma Sharp
- Department of Neuroscience, School of Translational Medicine, 99 Commercial Road, Melbourne, Victoria 3004, Australia.
| | - Vanessa Kellermann
- Health Services & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, David Goldberg Centre, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Yukti Mehta
- Department of Neuroscience, School of Translational Medicine, 99 Commercial Road, Melbourne, Victoria 3004, Australia
| | - Anne Nileshni Fernando
- Department of Neuroscience, School of Translational Medicine, 99 Commercial Road, Melbourne, Victoria 3004, Australia
| | - Madeline L West
- Department of Neuroscience, School of Translational Medicine, 99 Commercial Road, Melbourne, Victoria 3004, Australia
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Curtiss SL, Stoffers M. Service models for providing sex education to individuals with intellectual disabilities in the United States. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:434-452. [PMID: 36927105 DOI: 10.1177/17446295231164662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Individuals with intellectual and developmental disabilities face barriers to accessing sex education, including a lack of professional ownership over providing sex education. Limited information exists regarding educator training background, funding structure, and who they serve. We interviewed 58 sex educators of individuals with intellectual and developmental disabilities. We integrated thematic analysis and composite narratives to identify service models and the benefits and challenges associated with them. We identified seven service delivery models: clinic-based board-certified behavior analysis; mental health therapists; small businesses; public health not-for-profits; disability programs; high school-based educators; and university-based educators; and three themes that addressed the strengths and challenges of these service models: Instructional Implications of the Short-term, Drop-in Approach; Getting on the Same Page; and Questioning Who Should Teach Sex Education. Understanding these typologies and their strengths and challenges provide insights into how we can build capacity for sex education services.
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Affiliation(s)
- Sarah L Curtiss
- School of Education, University of Delaware, Newark, DE, USA
| | - Melissa Stoffers
- Human Development and Family Sciences, University of Delaware, Newark, DE, USA
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Castleton P, Meherali S, Memon Z, Lassi ZS. Understanding the contents and gaps in sexual and reproductive health toolkits designed for adolescence and young adults: a scoping review. Sex Med Rev 2024:qeae032. [PMID: 38736215 DOI: 10.1093/sxmrev/qeae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/05/2024] [Accepted: 04/12/2024] [Indexed: 05/14/2024]
Abstract
INTRODUCTION Adolescence is a crucial stage of physical and sexual maturation and development and a period in which understanding sexual and reproductive health (SRH) is important. SRH interventions and toolkits provide a range of valuable resources and information to young people, educators, and members of the community on numerous topics, including contraception and puberty. OBJECTIVES The usefulness and reliability of these available toolkits have not been previously studied, thus limiting our understanding of their appropriateness and contents. Hence, this scoping review aimed to synthesize the available toolkits aimed at the SRH of adolescents and young adults to understand the contents, design, and information gaps. METHODS A systematic search was conducted of 6 medical databases and 12 gray literature sites. Sixteen toolkits published globally before May 2023 were included in our review. RESULTS The majority of toolkits (n = 12) contained information related to general SRH knowledge and contraception, whereas only 3 contained information on teenage pregnancy. We found that aiming the toolkits toward educators and health care workers was a favorable design over targeting adolescents and young adults directly and that vulnerable youth-including LGBTQI+ (lesbian, gay, bisexual, transgender, queer or questioning, asexual or allied, intersex, and additional identities) and youth from humanitarian settings-were not well represented. CONCLUSION We identified key gaps in the inclusion of information in a range of SRH topics, such as LGBTQI+ sexuality, teenage pregnancy, and safe abortion, in the currently available SRH toolkits and their lack of applicability in a global context. Furthermore, we provide recommendations for areas of improvement to encourage adolescents' agency in their SRH education.
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Affiliation(s)
- Patience Castleton
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, 5000, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, 5000, Australia
| | - Salima Meherali
- Faculty of Nursing, University of Alberta, Edmonton, T6G 2R3, Canada
| | - Zahid Memon
- Department of Community Health Sciences, Aga Khan University, Karachi, 74800, Pakistan
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, 74800, Pakistan
| | - Zohra S Lassi
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, 5000, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, 5000, Australia
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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] [Abstract] [Key Words] [MESH Headings] [Grants] [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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Santinele Martino A, Moumos E, Uliki N, Robbins M. "She Couldn't Say the Word Penis": Experiences of 2SLGBTQ+ People with Developmental and Intellectual Disabilities with Sex Education in Alberta, Canada. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1927-1939. [PMID: 38308107 DOI: 10.1007/s10508-023-02755-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/15/2023] [Accepted: 11/19/2023] [Indexed: 02/04/2024]
Abstract
This exploratory qualitative study sought to better understand the experiences of Two-Spirit, lesbian, gay, bisexual, transgender, queer (2SLGBTQ+) disabled people when learning about sexuality, sexual orientation, and gender identity. We conducted 31 semi-structured, in-depth interviews with adults labeled/with developmental and intellectual disabilities in Alberta, Canada. Findings showed a significant lack of comprehensive sex education available to 2SLGBTQ+ disabled people. Sexual and gender identities were rarely discussed in formal school-based education settings and most parents and caregivers did not feel comfortable addressing these topics either. As a result, many participants had to do their own research and use other sources for information and advice. Participants then provided recommendations in terms of what they wish they had learned in sex education as well as potentially effective ways of delivering that content to disabled people.
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Affiliation(s)
- Alan Santinele Martino
- Department of Community Health Sciences, University of Calgary, Calgary, AB, T2N 1N4, Canada.
| | - Eleni Moumos
- Department of Community Health Sciences, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Noah Uliki
- Department of Community Health Sciences, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Meghan Robbins
- Department of Community Health Sciences, University of Calgary, Calgary, AB, T2N 1N4, Canada
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Wesche R, Toman M, Grafsky EL, Gupta S, Tarantino MR. Developing an Inclusive Model of Young Heterosexual and Sexual Minority Women's Sexual Decision-Making. JOURNAL OF SEX RESEARCH 2024:1-15. [PMID: 38687300 DOI: 10.1080/00224499.2024.2320260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Efforts to improve sexual health outcomes among young cisgender women require in-depth understanding of how women with diverse sexual identities make decisions about their sexual health. We conducted semi-structured interviews with 31 young cisgender women with diverse sexual identities and histories (age range 18-29 (M = 23.32); 81% White; 29% bisexual, 26% heterosexual, 16% lesbian, 13% queer, 10% pansexual, 3% gay, 3% demisexual) about their decision-making surrounding sexual risk reduction. By conducting thematic analysis, we found that, regardless of partner sex or gender, women adapted sexual health strategies based on how much commitment, trust, and communication existed in their relationships. Because heteronormative structural influences limited access to information and safer sex options, women had to rely on trust and communication more with other women and partners with vaginas, compared to men and partners with penises. Women did not consider safer sex strategies with partners with vaginas (e.g. hand washing) risk-reduction techniques; instead, they considered them general hygiene or a way to take care of a partner. We propose that an inclusive model of young women's sexual decision-making should: (a) highlight the influence of relationships; (b) frame prevention in terms of overall health instead of pregnancy and STIs; and (c) acknowledge that structural factors, such as heteronormativity and sex-negativity, constrain women's decisions.
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Affiliation(s)
- Rose Wesche
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Madelyn Toman
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Erika L Grafsky
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Shivangi Gupta
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Mari R Tarantino
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
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Wagman JA, Gresbach V, Cheney S, Kayser M, Kimball P. Protocol for designing and evaluating an undergraduate public health course on sexual and reproductive health at a public university in California. Heliyon 2024; 10:e28503. [PMID: 38644866 PMCID: PMC11033060 DOI: 10.1016/j.heliyon.2024.e28503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Comprehensive sexuality education (CSE) is associated with positive sexual and reproductive health (SRH) outcomes, including increased contraceptive use, lower rates of unintended pregnancy and prevention of sexual violence. However, implementation of and requirements for CSE vary across the United States which can negatively impact students, both during and beyond high school, including among college students. Methods and Analysis: This paper describes the research protocol for a multi-staged approach for designing, implementing and evaluating an SRH course for up to 60 undergraduate students at a public university in California. Before the class is offered, we will conduct 20 in-depth interviews with current students, educators and course design experts to learn from their experiences and seek their guidance on course design. To evaluate the course, enrolled students will complete a pre-course and a post-course survey before and after class is taught, to assess students' attitudes and values relevant to educational concepts and the format and delivery of the course and its modules and activities. Approximately 20 students will take part in an in-depth exit interview, after completing the course, to gather perceptions about how the course impacted their knowledge and behavior. The goal is to refine materials for future in-person course offerings and develop a prototype for a fully online version of the course. Discussion This study introduces a novel university-level course to provide young adult students comprehensive, evidence-based education on sexual and reproductive health from a public health perspective. The program leverages existing CSE efforts, enhancing them with academic rigor, inclusive content and digital inclusion. This approach, inclusive of diverse sexual orientations, content on pleasure and sexual violence prevention, aims to fill existing gaps in university curricula and also set a new standard in CSE. The project's innovative and multidisciplinary design offers a model for broader impact within a large public university system and beyond.
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Affiliation(s)
- Jennifer A. Wagman
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Science, University of California Los Angeles (UCLA), Los Angeles, CA, United States
| | - Victoria Gresbach
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Science, University of California Los Angeles (UCLA), Los Angeles, CA, United States
| | - Samantha Cheney
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Science, University of California Los Angeles (UCLA), Los Angeles, CA, United States
| | - Mark Kayser
- UCLA Online Teaching and Learning Initiative, University of California Los Angeles, Los Angeles, CA, United States
| | - Paul Kimball
- UCLA Online Teaching and Learning Initiative, University of California Los Angeles, Los Angeles, CA, United States
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Saaka SA, Pienaah CKA, Stampp Z, Antabe R. Safe sex negotiation and HIV risk reduction among women: A cross-sectional analysis of Burkina Faso 2021 Demographic and Health Survey. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003134. [PMID: 38656996 PMCID: PMC11042694 DOI: 10.1371/journal.pgph.0003134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024]
Abstract
Women are biologically more susceptible to the Human Immunodeficiency Virus (HIV) and other sexually transmitted Infections (STIs) because receptive sex is riskier than insertive. Despite condom use being the staple preventive method for HIV infection (over 80% efficacy), in Sub-Saharan African countries like Burkina Faso, a high burden of HIV and the unmet need for condom use coexist. Moreover, even though women in SSA are disproportionately HIV positive, they are reportedly less capable of negotiating condom use for HIV risk reduction. Thus, using the Health Believe Model (HBM), this study explored the factors that influence condom use among women within the context of HIV prevention, with a key interest in condom use negotiation. Using the women's dataset of the 2021 Burkina Faso Demographic and Health Survey and applying logistic regression models, this study examined the factors associated with condom use for HIV risk reduction. Women who had confidence to negotiate condom use with their partners (OR = 1.57, P<0.001, 95%CI: 1.29, 1.91), those with secondary education (OR = 1.38, P<0.05, 95%CI: 1.07 1.77), from richest households (OR = 1.64, P<0.05, 95%CI: 1.08, 2.47), the employed (OR = 1.23, P<0.05, 95%CI: 1.02, 1.49), women with knowledge of sexually transmitted infections (OR = 1.58, P<0.001, 95%CI: 1.26, 1.97), those who have ever been tested for HIV (OR = 1.85, P<0.001, 95%CI: 1.52 2.24), as well as those who knew that a healthy-looking person can have HIV (OR = 2.64, P<0.001, 95%CI: 2.15, 3.24) were all significantly more likely to practice condom use for HIV risk reduction. Also, religion and geographical location of participants significantly predicted condom use for HIV risk reduction in the study context. The ability to negotiate condom use, knowledge of HIV and STIs, the socioeconomic status of women, as well as their geographical location, influence their practice of safer sex for HIV risk reduction in Burkina Faso.
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Affiliation(s)
| | | | - Zakara Stampp
- Department of Geography and Environment, University of Western Ontario, London, Canada
| | - Roger Antabe
- Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
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Schieber E, Cottrell L, Deveaux L, Li X, Taylor M, Adderley R, Marshall S, Forbes N, Wang B. Teachers' Perceptions of the Impact of the COVID-19 Pandemic and Their Implementation of an Evidence-based HIV Prevention Program in the Bahamas. AIDS Behav 2024:10.1007/s10461-024-04345-8. [PMID: 38642212 DOI: 10.1007/s10461-024-04345-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 04/22/2024]
Abstract
Information on how school-based programs is implemented and sustained during crises is limited. In this study, we assessed the impact of the COVID-19 pandemic on the implementation of a HIV prevention intervention in The Bahamas. Data were collected from 139 Grade 6 teachers in 2021-2022. Teachers attended virtual training and received implementation monitoring from coordinators. On average, teachers taught 26.4 (SD = 9.2) of the 35 core activities, and 7.4 (SD = 2.4) out of 9 sessions. More than half (58.3%) of teachers completed 28 or more core activities; 69.1% covered eight or all nine sessions, which is equivalent to 80% of the HIV intervention curriculum. Almost half of the teachers (43%) reported that the pandemic negatively impacted their ability to teach the program; 72% of teachers maintained that the program remained "very important" during times of crisis. Greater self-efficacy and supports increased implementation fidelity.
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Affiliation(s)
- Elizabeth Schieber
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Lesley Cottrell
- Department of Pediatrics, West Virginia University, 959 Hartman Run Road. Morgantown, WV, Morgantown, 26506, USA.
| | - Lynette Deveaux
- Office of HIV/AIDS, Ministry of Health, Shirley Street, Nassau, Bahamas
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, 915 Greene Street, Columbia, SC, 29208, USA
| | - Marcellus Taylor
- Government and Public Policy Institute, University of The Bahamas, Oakes Field Campus University Drive, Nassau, Bahamas
| | - Richard Adderley
- Office of HIV/AIDS, Ministry of Health, Shirley Street, Nassau, Bahamas
| | - Sharon Marshall
- Department of Pediatrics, Wayne State University School of Medicine, 400 Mack Avenue, Detroit, MI, 48201, USA
| | - Nikkiah Forbes
- Office of HIV/AIDS, Ministry of Health, Shirley Street, Nassau, Bahamas
| | - Bo Wang
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
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Kieu TKT, Galper EF, Sorin CR, Bloom BE. Using an intersectional life course perspective to understand familial environment and its impact on sexuality development among Asian American sexual minority college students. CULTURE, HEALTH & SEXUALITY 2024:1-19. [PMID: 38639035 DOI: 10.1080/13691058.2024.2341832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 04/08/2024] [Indexed: 04/20/2024]
Abstract
There is a dearth of research understanding the sexual health of Asian American adolescents, and even more so for those who identify as sexual minorities (lesbian, gay, bisexual, queer, asexual, and other sexual orientations). This study is a secondary qualitative analysis focused on young adults' recollections of their formal and informal sex education experiences in childhood and adolescence using a sub-sample of in-depth interviews from students who self-identified as both Asian and sexual minorities living in the USA (n = 9). Results were organised into three sections: (1) latent cultural factors (e.g. stigma surrounding sex, self-sufficiency, filial piety); (2) the downstream effects of latent cultural factors (e.g. sex-related discussions, rules disallowing dating, role of lateral family members); and (3) the impact of deficient familial sex-related discussions (e.g. Internet, resentment). Study findings underscore the links between identity concealment and relationship concealment that are unique to Asian sexual minority individuals. We suggest that interventions involving Asian American US youth and their families should be culturally informed and promote cross-generational sex-related discussion. Future research should further explore the role of chosen family and non-parental family members as a point of intervention as they can be helpful sources of informal sex education.
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Affiliation(s)
- Talia Kim-Thanh Kieu
- Department of Health Behavior, Gillings School of Global Public Health, University of NC, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Emily F Galper
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
| | - Cierra Raine Sorin
- Department of Sociology, University of CA Santa Barbara, Santa Barbara, CA, USA
| | - Brittnie E Bloom
- University of California Global Health Institute Women's Health, Gender, and Empowerment Center of Expertise, Los Angeles, CA, USA
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
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13
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Jayne PE, Szucs LE, Lesesne CA, Grose RG, Johns MM. "I wouldn't have felt so alone": The sexual health education experiences of transgender and gender diverse youth living in the southeastern United States. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2024. [PMID: 38623631 DOI: 10.1111/psrh.12258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Transgender and gender diverse youth experience multiple disproportionate adverse sexual health outcomes. Sexual health education teaches knowledge, attitudes, and skills for promoting sexual health, including reducing risk for sexually transmitted infection, HIV acquisition, and unintended pregnancy. Provision of sexual health education may be protective, but research remains scarce. METHODS We conducted a multi-stage thematic analysis of 33 in-depth interviews among transgender and gender diverse youth (ages 15-24) living in the southeastern United States on their sexual health education experiences. RESULTS Our study participants described school-based sexual health education as unhelpful due to a lack of relevant information, inadequately prepared teachers, and a perceived negative tone toward sexuality. They reported relying on online sources of sexual health information, finding relevant content and community despite some limitations. Participants desired content and pedagogy that expands beyond binary and white-centric presentations of sexuality and gender and sought resources that provide relevant, accurate, and judgment-free information while holding positive framing around sexuality and gender. CONCLUSION There is much work needed to improve the breadth, quality, and relevance of school-based sexual health education. Sexual health education can improve by strengthening critical media literacy skills of youth; raising staff cultural competency on gender, race, and sexual identity through training and supports; using culturally relevant and inclusive curricula; and partnering with community-based organizations. Transgender and gender diverse youth would benefit from sexual health education from multiple sources which is queer-friendly, affirms their existence, and provides information on gender, race, and sexuality in positive and expansive ways.
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Affiliation(s)
- Paula E Jayne
- U.S. Centers for Disease Control and Prevention's Division of Adolescent and School Health, Atlanta, Georgia, USA
| | - Leigh E Szucs
- U.S. Centers for Disease Control and Prevention's Division of Adolescent and School Health, Chamblee, Georgia, USA
| | | | - Rose Grace Grose
- Colorado School of Public Health, Community Health Education, University of Northern Colorado, Greeley, Colorado, USA
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14
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Baumann SE, Leeson L, Raonivololona M, Burke JG. Exploring the multi-level impacts of a youth-led comprehensive sexuality education model in Madagascar using Human-centered Design methods. PLoS One 2024; 19:e0297106. [PMID: 38598416 PMCID: PMC11006148 DOI: 10.1371/journal.pone.0297106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/24/2023] [Indexed: 04/12/2024] Open
Abstract
Comprehensive sexuality education (CSE) is recognized as a critical tool for addressing sexuality and reproductive health challenges among adolescents. However, little is known about the broader impacts of CSE on populations beyond adolescents, such as schools, families, and communities. This study explores multi-level impacts of an innovative CSE program in Madagascar, which employs young adult CSE educators to teach a three-year curriculum in government middle schools across the country. The two-phased study embraced a participatory approach and qualitative Human-centered Design (HCD) methods. In phase 1, 90 school principals and administrators representing 45 schools participated in HCD workshops, which were held in six regional cities. Phase 2 took place one year later, which included 50 principals from partner schools, and focused on expanding and validating findings from phase 1. From the perspective of school principals and administrators, the results indicate several areas in which CSE programming is having spill-over effects, beyond direct adolescent student sexuality knowledge and behaviors. In the case of this youth-led model in Madagascar, the program has impacted the lives of students (e.g., increased academic motivation and confidence), their parents (e.g., strengthened family relationships and increased parental involvement in schools), their schools (e.g., increased perceived value of schools and teacher effectiveness), their communities (e.g., increased community connections), and impacted broader structural issues (e.g., improved equity and access to resources such as menstrual pads). While not all impacts of the CSE program were perceived as positive, the findings uncovered opportunities for targeting investments and refining CSE programming to maximize positive impacts at family, school, and community levels.
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Affiliation(s)
- Sara E. Baumann
- University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA, United States of America
| | | | | | - Jessica G. Burke
- University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA, United States of America
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15
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Moore M, Balascio P, Bonner-Johnson T, Garth J, Brinkman B, Hill AV. Implementing Comprehensive Sex and Sexuality Education in Kindergarten-Grade 12 Schools: Guiding Practices and Examples. THE JOURNAL OF SCHOOL HEALTH 2024; 94:374-379. [PMID: 38351584 DOI: 10.1111/josh.13431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 12/08/2023] [Accepted: 12/20/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND Comprehensive sex and sexuality education (CSE) is an evidence-based intervention associated with improved sexual and reproductive health outcomes. Currently, there are no standardized requirements for sex and sexuality education in the United States, despite expert recommendations. CONTRIBUTIONS TO THEORY In the United States, a Whole School, Whole Community, Whole Child theoretical model proposed by the Centers for Disease Control, and current examples of school sex education policy is used to make recommendations for the standardization of comprehensive sexual health education in K-12 schools. This article describes the necessary components to adopt CSE equitably, and provides an example of the process implemented to improve CSE in 1 school district in Pittsburgh, PA. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Understanding the key components of legislation that align with recommended standards, and the process of advocating for school policy change, allows local advocacy groups and education policymakers to create and pass feasible legislation that will ensure appropriate instruction. There is additional room for improvement in states and local districts that have current CSE legislation, to adopt approaches grounded in frameworks that critically evaluate social determinants of health and amend legislation to further improve health equity. CONCLUSIONS Several states and local districts have passed CSE regulations, and are implementing and evaluating their efficacy, providing support and examples for other regions interested in adopting similar policies and processes. Pittsburgh Public Schools can be used as an example adapting current legislation and adopting more comprehensive language.
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Affiliation(s)
- Mikaela Moore
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Phoebe Balascio
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Tausha Bonner-Johnson
- Health & Wellness Workgroup, Black Girls Equity Alliance, New Voices for Reproductive Heath, Pittsburgh, PA
| | - José Garth
- Health & Wellness Workgroup, Black Girls Equity Alliance, Gwen's Girls, Pittsburgh, PA
| | - Britney Brinkman
- Black Girls Equity Alliance, Gwen's Girls, Pittsburgh, Pennsylvania; Department of Psychology, Point Park University, Pittsburgh, PA
| | - Ashley V Hill
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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16
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Versloot-Swildens MC, de Graaf H, Twisk JWR, Popma A, Nauta-Jansen LMC. Effectiveness of a Comprehensive School-Based Sex Education Program for Young Adolescents in the Netherlands. J Youth Adolesc 2024; 53:998-1014. [PMID: 38055133 DOI: 10.1007/s10964-023-01903-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/11/2023] [Indexed: 12/07/2023]
Abstract
Most sexual education programs traditionally focused on providing sexual information regarding the risks of sex. However, current studies on sexual behavior in youth show a need for truly comprehensive sex education approaches with a sex-positive focus on sexuality, that effectively improve sexual competence. Therefore, in the current study the effectiveness of "Love is…", a four lesson school-based program based on the Sexual Interactional Competence model and Attitude-Social-Influence-Self-Efficacy-model was studied. A cluster-randomized controlled trial on the effectiveness of "Love is…" was conducted in 2018-2020. The sample consisted of 1160 adolescents in grades 8 and 9 from nine schools in the Netherlands. The sample was 48% female, 34% Dutch/Caucasian, 41% none-religious and 50% higher educated. They were randomized at class level into a program group [n = 32 classes; 567 students (Mage = 13.74 (SD = 0.74))] and a control group [n = 31 classes; 593 students (Mage = 13.86 (SD = 0.73))]. Results showed that "Love is…" increased sexual knowledge, that adolescents in the program group showed less cyber victim blaming attitudes and increased in communications skills after the program. In conclusion, the current study shows that "Love is…" was effective not only on the knowledge level, but also regarding sexual attitudes and competences. However, due to the developmental process of sexuality, there is a necessity to continue lessons in following grades through booster sessions by reinforcing competences as communicating comfortably about sexuality.On 12 November 2019 the study design and hypotheses were registered in the Dutch Trial Registration, number NL8150. ( https://onderzoekmetmensen.nl/nl/trial/26676 ).
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Affiliation(s)
- M C Versloot-Swildens
- Department of Child and Adolescent Psychiatry Amsterdam UMC, Amsterdam, the Netherlands.
| | - H de Graaf
- Rutgers, Dutch Centre of Expertise on Sexual and Reproductive Health and Rights, Utrecht, the Netherlands
| | - J W R Twisk
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - A Popma
- Department of Child and Adolescent Psychiatry Amsterdam UMC, Amsterdam, the Netherlands
| | - L M C Nauta-Jansen
- Department of Child and Adolescent Psychiatry Amsterdam UMC, Amsterdam, the Netherlands
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17
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SmithBattle L, Flick LH. Reproductive Justice as an Alternative to the Pregnancy Planning Paradigm for Teens. J Obstet Gynecol Neonatal Nurs 2024:S0884-2175(24)00039-X. [PMID: 38575116 DOI: 10.1016/j.jogn.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 04/06/2024] Open
Abstract
In this critical commentary, we describe the many limitations of the pregnancy planning paradigm as applied to pregnant and parenting teens. We describe how this paradigm, in characterizing pregnancies as intended or unintended, has shaped campaigns to prevent teen pregnancy and remains largely embedded in formal sex education and family planning programs in the United States. We argue that a paradigm shift is long overdue and describe how the reproductive justice framework addresses the limitations of the pregnancy planning paradigm. Although reproductive justice is endorsed by a growing number of organizations, recommended policies face formidable obstacles given that comprehensive sex education, contraception, and legal abortion are increasingly at risk in a post-Dobbs world.
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18
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Balén Z, Pliskin E, Cook E, Manlove J, Steiner R, Cervantes M, Garrido M, Nuñez-Eddy C, Day M. Strategies to develop an LGBTQIA+-inclusive adolescent sexual health program evaluation. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1327980. [PMID: 38590517 PMCID: PMC11000634 DOI: 10.3389/frph.2024.1327980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Adolescent sexual health interventions are increasingly incorporating content that is inclusive of LGBTQIA+ youth (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other marginalized sexualities and genders). Evaluations of such programs must also be inclusive to enhance the validity of evaluation results and avoid further marginalization. We present strategies for increasing LGBTQIA+-inclusivity based on our evaluation of SafeSpace, a sexual health curriculum. Methods To design an LGBTQIA+-inclusive program evaluation, we leveraged LGBTQIA+ research staff's insights, pursued a parental consent waiver, developed an inclusive recruitment plan, and crafted demographic and sexual behavior survey measures with input from youth and equity experts. We conducted a pilot study with 42 youth ages 14-17 to assess the feasibility and efficacy of our strategies. Results We obtained a parental consent waiver and recruited a majority LGBTQIA+ pilot study sample (62%). Using themes from cognitive interviews with youth and experts regarding inclusive framing and use of plain language, we refined demographic measures and expanded sexual behavior measures. Conclusion Findings suggest that the strategies used to enhance LGBTQIA+-inclusivity in our evaluation of SafeSpace were effective in respectfully and more accurately capturing a fuller range of experiences and identities of LGBTQIA+ and cis-straight youth. The strategies and survey measures developed for this study can be applied to increase LGBTQIA+-inclusivity in other adolescent sexual health program evaluations.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Maeve Day
- Child Trends, Rockville, MD, United States
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19
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Ketterer T, Sieke E, Min J, Quidgley-Martin M, Barral RL, Akers A, Adams A, Miller E, Miller MK, Mollen C. Contraception Initiation in the Emergency Department: Adolescent Perspectives. J Adolesc Health 2024:S1054-139X(24)00112-5. [PMID: 38493394 DOI: 10.1016/j.jadohealth.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 01/26/2024] [Accepted: 02/14/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE The purpose of this study was to identify factors affecting contraceptive intention and behavior among adolescent females in the pediatric Emergency Department. METHODS We conducted a qualitative interview study nested within a larger prospective cohort study examining adolescent contraceptive counseling for females ages 15-18 years at-risk of unintended pregnancy presenting to the pediatric Emergency Department. Interviews were conducted in a subset of participants. The ecologically expanded Theory of Planned Behavior, expert opinion, and literature review informed the interview guide. Interviews were recorded, transcribed, coded and monitored for thematic saturation. RESULTS Twenty-eight interviews were analyzed. Mean age was 17.1 years. Themes were mapped to ecologically expanded Theory of Planned Behavior constructs. Within health system influences, prior contraceptive experiences and patient-clinician interactions were described. Within community influences, contraceptive education, knowledge and misinformation, teen pregnancy norms, and social media impacts were described. Within attitudes influences, side-effect and safety concerns, contraceptive motivations and teen pregnancy beliefs were described. Within subjective norm influences, peer and family impacts were described. Within perceived behavioral control, Emergency Department (ED) counseling intervention impacts were described. DISCUSSION We identified factors affecting contraceptive initiation/behavior among an ED adolescent population that otherwise may not have received contraceptive education in similar detail as provided by study clinicians. Adolescents' prior contraceptive and clinician interactions, limited access to contraceptive education, knowledge and misinformation, and side-effect and safety concerns affected initiation. Peer/family sharing and social media were leading contraceptive information sources. Future studies should incorporate insights into adolescent ED intervention design to make optimal use of resources while maximizing potential benefit.
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Affiliation(s)
- Tara Ketterer
- Policylab, Children's Hospital of Philadelphia (CHOP), Roberts Center for Pediatric Research, Philadelphia, Pennsylvania.
| | - Erin Sieke
- Department of Pediatrics, CHOP, Philadelphia, Pennsylvania
| | - Jungwon Min
- Department of Biomedical and Health Informatics, CHOP, Roberts Center for Pediatric Research, Philadelphia, Pennsylvania
| | | | - Romina L Barral
- Division of Adolescent Medicine, Children's Mercy Hospital and Clinics, University of Missouri-Kansas City School of Medicine, University of Kansas School of Medicine, Children's Mercy at the University of Kansas Hospital, Kansas City, Kansas
| | - Aletha Akers
- Division of Adolescent Medicine, CHOP, Specialty Care Center, Philadelphia, Pennsylvania
| | - Amber Adams
- Department of Emergency Medicine, Children's Mercy Hospital (CMH), Kansas City, Missouri
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Public Health and Clinical and Translational Science, University of Pittsburgh School of Medicine, University Center, Pittsburgh, Pennsylvania
| | - Melissa K Miller
- Department of Emergency Medicine, CMH, University of Missouri-Kansas City School of Medicine, University of Kansas School of Medicine, Kansas City, Missouri
| | - Cynthia Mollen
- Department of Pediatrics, Department of Emergency Medicine, CHOP, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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20
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Luz do Nascimento BH, Figueira JR, Rosa-E-Silva ACJDS, Reis RM, Andrade MCR, Brito LGO, Lara LADS. Management of hypoactive sexual desire dysfunction at a specialized service in women's sexual health. JOURNAL OF SEX & MARITAL THERAPY 2024; 50:542-553. [PMID: 38482856 DOI: 10.1080/0092623x.2024.2329081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Hypoactive sexual desire dysfunction (HSDD) is prevalent among women. This retrospective cohort study aimed to verify the results of the strategies used by Gynecologists and Obstetricians (Ob-gyn) residents in the management of female HSDD. For this, we conducted a data collection of patient medical records of women with HSDD from the Human Sexuality Studies outpatient clinic of the Human Reproduction Center, Department of Gynecology and Obstetrics of FMRP-USP, from 2005 to 2019. Among the 437 women included, 361 (82.6%) answered the question concerning the effect of the protocol to which they were submitted, whereas 234 (64.8%) reported improvements in sexual desire. The univariate model showed that patients without chronic pelvic pain were 19.0% less likely to report improvements in HSDD than those with chronic pelvic pain (p = 0.03). Patients without depression and without orgasmic dysfunction were, respectively 32% and 23% more likely to show improvements in their HSDD than those who had depression or orgasmic dysfunction (respectively p = 0.001, p = 0.008). However, the multivariate model did not identify any associations. The assistance regarding HSDD by the Ob-gyn resident in training to deal with female sexual complaints may be effective in improving sexual complaints.
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Affiliation(s)
| | | | | | - Rosana Maria Reis
- Ribeirão Preto Medical School, São Paulo University, Ribeirão Preto, SP, Brazil
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21
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Russell DH, Trew S, Harris L, Dickson J, Walsh K, Higgins DJ, Smith R. Engaging Parents in Child-Focused Child Sexual Abuse Prevention Education Strategies: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241235895. [PMID: 38477488 DOI: 10.1177/15248380241235895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Parents are their children's first teachers and there are long-standing calls for their involvement in child sexual abuse prevention. In this rapid systematic review, we asked the following questions: what rationales are used to justify parental involvement in child-focused child sexual abuse (CSA) prevention programs? what approaches are used for parental engagement in child-focused CSA prevention programs? and what are the facilitators and barriers to parental involvement in child-focused CSA prevention programs? We searched CINAHL, Cochrane, ERIC, Medline, PsycInfo, Scopus, and SocINDEX in May 2021. A total of 57 papers met our inclusion criteria, comprised of 50 empirical studies, and 7 program descriptions. Rationales for parental involvement included monitoring and shaping parental attitudes toward CSA program delivery in schools; reinforcing children's learning at home; promoting parent-child communication about CSA prevention; building parent capacity to respond to child disclosures; and supporting program delivery for preschoolers. Types of parental involvement included the following: communication, learning at home, volunteering, decision-making, and collaboration with the community. Barriers to parent involvement included ineffective program engagement modalities, and parental fears and misconceptions.
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Affiliation(s)
- Douglas Hugh Russell
- Institute of Child Protection Studies, Australian Catholic University, Melbourne, VIC, Australia
| | - Sebastian Trew
- Institute of Child Protection Studies, Australian Catholic University, Canberra, ACT, Australia
| | - Lottie Harris
- Institute of Child Protection Studies, Australian Catholic University, Sydney, NSW, Australia
| | - Jessica Dickson
- Library Academic and Research Services, Australian Catholic University, Fitzroy, VIC, Australia
| | - Kerryann Walsh
- Queensland University of Technology, Brisbane, Australia
| | - Daryl John Higgins
- Library Academic and Research Services, Australian Catholic University, Fitzroy, VIC, Australia
| | - Rhiannon Smith
- Queensland University of Technology, Kelvin Grove, Australia
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22
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Wolford LL, Jansen KL. Who Helps Children With Communication Disorders Access Sex Education? Practice Patterns of Speech-Language Pathologists and Psychologists. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:848-865. [PMID: 38118453 DOI: 10.1044/2023_ajslp-23-00326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
PURPOSE Children with communication disorders are often systematically excluded from sex education curricula. They may also have difficulty accessing the curricula because of the materials' linguistic and pragmatic complexity. Even curricula written for children with intellectual disabilities do not typically include considerations for communication disorders. This places them at risk for sexually transmitted infections, sexual health misinformation, and sexual assault. Yet, it is unclear which professionals are assisting children with communication disorders to access sex education. METHOD North American speech-language pathologists (SLPs) and clinical psychologists (N = 112) completed a survey that asked about their practice patterns in helping children access sex education, as well as their beliefs about the importance of sex education, how disabilities affect sex education, perceived barriers, and their self-efficacy and role in addressing sex education. RESULTS Although SLPs and clinical psychologists believed that communication disorders could affect sex education and consent and felt they had some responsibility for helping their clients in accessing sex education, they did not regularly assist their clients in this area. Both groups of clinicians were divided in their views of their own roles and responsibility. SLPs were especially polarized; every question about their role in addressing sex education included SLPs who fully agreed and some who fully disagreed with the statement. CONCLUSIONS Children with communication disorders do not consistently receive assistance accessing sex education curricula from either SLPs or clinical psychologists. Clinicians need education to support them addressing sex education and clear guidance about their roles in this area.
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Affiliation(s)
- Laura L Wolford
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Kate L Jansen
- Department of Clinical Psychology, Midwestern University, Glendale, AZ
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23
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Power J, Kauer S, Fisher C, Bourne A. Acceptance and use of condoms among school-aged young people in Australia. Sex Health 2024; 21:SH23173. [PMID: 38507903 DOI: 10.1071/sh23173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/29/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Despite availability of vaccines or medical prophylaxis for some sexually transmissible infections (STIs), promoting condom use remains an important public health strategy for the prevention of STIs. Recent research shows that regular condom use among young people in Australia has declined over the past decade, while the rate of common STIs has increased. METHOD In this paper, we report findings from a large survey of school-aged young people in Australia (14-18years old) in which we looked at the association between condom use and positive feelings about sex, beliefs about social acceptability of condoms and confidence talking with partners about sex and condoms. RESULTS Communication and relational factors supported more consistent condom use. Participants were more likely to regularly use condoms if they discussed condom use with a sexual partner, perceived condom use to be easy (a measure that included perceived ease of discussing condoms with a partner) and perceived condom use to offer social or relational benefits, including perceiving condom use as a demonstration of care for a partner. Young men were more likely to report positive feelings about sex and regular condom use than young women. Young women were less likely than young men or trans and non-binary young people to report regular condom use. CONCLUSIONS The study shows the importance of supporting young people to build confidence expressing sexual needs and wants with partners. Public health approaches to STI prevention need to consider condom promotion in the context of young people's contemporary sexual, gendered and relationships cultures.
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Affiliation(s)
- Jennifer Power
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building Nr6, Bundoora, Vic. 3086, Australia
| | - Sylvia Kauer
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building Nr6, Bundoora, Vic. 3086, Australia
| | - Christopher Fisher
- Victoria University, VU Online, PO Box 14428, Melbourne, Vic. 8001, Australia
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building Nr6, Bundoora, Vic. 3086, Australia; and Kirby Institute, UNSW, Wallace Wurth Building (C27), UNSW, Kensington, Sydney, NSW, 2052, Australia
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24
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Shigeto A, Anders KM. "It's Almost Boring When It Should Be Enjoyable and Fun": College Students' Definitions of Bad Sex. JOURNAL OF SEX RESEARCH 2024:1-13. [PMID: 38411575 DOI: 10.1080/00224499.2024.2319258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Some of the primary reasons for sexual activities among college students include self-focused motives such as pleasure, along with other-focused motives that facilitate relatedness such as intimacy and emotional connection. However, college students' motivations for sex (or lack thereof) may also be impacted by the meaning they make of their own or peers' experience of "bad sex" - sex that is consensual yet "bad" or "negative" in some way. Therefore, the current study qualitatively explored college students' definitions of "bad sex." A total of 300 college-attending emerging adults (ages 18-25) provided open-ended responses regarding their definition of "bad sex" that is not sexual assault or rape. Using a thematic analytic approach, we identified six main themes on how participants defined what constituted "bad sex": (1) Lack of Pleasure, (2) Negative Outcomes (3) Unmet Expectations, (4) Sexual Violence, (5) Lack of Connection, and (6) Bad Partner. Additionally, the themes were examined based on gender identity, sexual activity status, sexual orientation, and relationship status. Implications for college sex education along with areas of future research with diverse populations and qualitative methodology are discussed.
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Affiliation(s)
- Aya Shigeto
- Department of Psychology and Neuroscience, Nova Southeastern University
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25
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Mousavi ZS, Janighorban M, Noroozi M. Development, implementation, and evaluation of the effectiveness of an intervention program to improve the sexual competence of young adult women about to get married: a protocol study. Reprod Health 2024; 21:24. [PMID: 38365733 PMCID: PMC10874025 DOI: 10.1186/s12978-024-01754-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/09/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Having competence in initiating sexual interactions is one of the challenges of sexual health in any society. Given that the social, cultural, and religious background of some societies can prevent the acquisition of sexual competence in young women, this study will be done to design, implement, and determine the effectiveness of an intervention program to improve the sexual competence of young women on the eve of marriage. METHODS The current research is a mixed-method study in a qualitative-quantitative sequence. In the first phase, a qualitative study will be conducted to explore the needs of sexual competence in young adult women about to get married and ways to improve it. Then, after the literature review and combining it with the results of the qualitative study, a draft of the intervention program will be developed. After reviewing the content of the program and validating it in the panel of experts, the final program will be developed. In the second phase, the effect of the program to promote the sexual competence of adult women about to get married will be determined in a quantitative study with a two-group quasi-experimental method. DISCUSSION Providing a comprehensive and practical intervention program to promote sexual competence based on cultural, social, and religious background can help to improve the quality of sexual interactions of young women about to get married, reduce harm caused by lack of sexual competence, and ensure women's sexual health.
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Affiliation(s)
- Zahra Sadat Mousavi
- Sexual and Reproductive Health, Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Janighorban
- Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mahnaz Noroozi
- Department of Midwifery and Reproductive Health, Isfahan University of Medical Sciences, Isfahan, Iran
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26
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Naroji S, Tomlin K. NASPAG Position Statement: Comprehensive Sexuality Education for Adolescents. J Pediatr Adolesc Gynecol 2024; 37:7-8. [PMID: 37820852 DOI: 10.1016/j.jpag.2023.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Swetha Naroji
- Pediatric and Adolescent Gynecology, Children's National Medical Center, Washington, DC.
| | - Kristl Tomlin
- Pediatric and Adolescent Gynecology, Prisma Health-Midlands/University of South Carolina School of Medicine, Columbia, South Carolina
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Jacques-Aviñó C, Alarcón Guitiérrez M, Barbera MJ, Fuertes I, Martin-Ezquerra G, Lopez-Contreras J, Vives Á, Rodriguez R, Ros M, Rius C, de Olalla PG. Epidemiological Characteristics and Factors Associated with Repeat Sexually Transmitted Infections in Barcelona, Spain Over a Decade. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:735-744. [PMID: 37875628 PMCID: PMC10844332 DOI: 10.1007/s10508-023-02711-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 10/26/2023]
Abstract
In the last few years, the frequency of sexually transmitted infections (STI) has increased, as has the number of people with multiple infections. The aim of our study was to describe the epidemiological characteristics of persons with repeated bacterial STI and to determine the risk factors for these episodes in persons living in Barcelona during the period 2007-2018. We studied all cases of bacterial STI included in the STI registry of Barcelona. Repeated STI were defined as a diagnosis of gonorrhea, syphilis, or lymphogranuloma venereum (LGV) after a first episode of one of these infections. Analysis was stratified by sex and place of birth. The factors associated with time to reinfection were determined by Kaplan-Meier estimates, while the factors associated with risk of infection were determined by a Cox proportional hazards model. Of 9927 persons with a diagnosis of bacterial STI, 1690 (17.0%) had at least two episodes of STI during the study period. On multivariate analysis, repeat STI were independently associated with male sex assigned at birth (HR: 3.45; 95%CI 2.22-5.36), age less than 34 years (HR: 1.22; 95%CI 1.10-1.35); gay, bisexual, and other men who have sex with men, and transgender o transsexual woman (GBSMS/Trans) (HR: 4.03; 95%CI 3.24-5.03), having gonorrhea as first diagnosis (HR:1.49, 95%CI 1.34-1.66) or LGV (HR:1.75; 95%CI 1.47-2.08) and coinfection with HIV (HR:1.98; 95%CI 1.78-2.21). Sexual health programs should be strengthened to prevent STI and reinfection in key populations.
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Affiliation(s)
- Constanza Jacques-Aviñó
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain.
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Gran Via Corts Catalanes, 587, àtic, 08007, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès (Barcelona), Bellaterra, Spain.
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.
| | - Miguel Alarcón Guitiérrez
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès (Barcelona), Bellaterra, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - María Jesús Barbera
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Irene Fuertes
- Dermatology Department, Hospital Clinic, Barcelona, Spain
| | - Gemma Martin-Ezquerra
- Dermatology Department, Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain
| | - Joaquín Lopez-Contreras
- Infectious Diseases Unit-Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Raquel Rodriguez
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Miriam Ros
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Cristina Rius
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Patricia Garcia de Olalla
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
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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] [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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Liddell JL, Sheffield SM, Johnson KM, Lederer AM. College Student Perceptions of the Root Causes of Sexual Violence Before and After a Curricular Intervention. Violence Against Women 2024; 30:551-574. [PMID: 36310436 DOI: 10.1177/10778012221132300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Campus sexual violence is prevalent and consequential. After a climate survey at our university revealed high rates of sexual violence, a semester-long academic course was designed as a curricular intervention for first-year students. This study examines an assignment completed at the beginning and end of the course. Students were asked: "What are the root causes of sexual violence?" Thematic analysis of papers revealed that many students altered or expanded their thinking to more complex, structural factors compared to their initial perceptions. An academic course may broaden students' understanding of the determinants of sexual violence.
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Affiliation(s)
| | | | | | - Alyssa M Lederer
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA
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Adhia A, Casanova N, Rogers M, Bekemeier B. Using Cognitive Interviews to Adapt Interpersonal Violence Measures for Use With Middle School Youth. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:897-909. [PMID: 37655633 PMCID: PMC10775639 DOI: 10.1177/08862605231197748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Experiences of interpersonal violence are common among youth. Starting prevention programming early (e.g., middle school) may be beneficial for primary prevention. Evaluating whether such programs are effective often requires collecting self-report data from youth, but many existing measures have been developed for high school and college-aged youth. This study aimed to assess adolescents' comprehension of self-report survey items on interpersonal violence with middle school youth. We conducted virtual cognitive interviews with 15 youth in grades 6 to 8. A content analysis was used to identify patterns and to classify the nature and type of comprehension issues youth experienced. Nearly all students found most questions clear and understandable. We identified the following comprehension issues: (1) uncertainty with how the intent of a perpetrator factored into a victim's experience (e.g., distinguishing the difference between joking and bullying, or intentional versus unintentional behavior); (2) lack of familiarity with certain expressions of sexualized violence (e.g., "sexual looks") or sex-related terminology (e.g., intercourse); and (3) narrow interpretations of question prompts (e.g., interpreting "forced" as physically forced, not psychologically coerced). Students suggested including language describing dating relationships, types of social media platforms where cyber abuse takes place, and additional examples alongside items to enhance relevance and clarity. Survey questions to measure interpersonal violence may need to be adapted for use among middle school youth. Our findings highlight potential considerations for improving the measurement of interpersonal violence in this age group.
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Kimmins S, Anderson RA, Barratt CLR, Behre HM, Catford SR, De Jonge CJ, Delbes G, Eisenberg ML, Garrido N, Houston BJ, Jørgensen N, Krausz C, Lismer A, McLachlan RI, Minhas S, Moss T, Pacey A, Priskorn L, Schlatt S, Trasler J, Trasande L, Tüttelmann F, Vazquez-Levin MH, Veltman JA, Zhang F, O'Bryan MK. Frequency, morbidity and equity - the case for increased research on male fertility. Nat Rev Urol 2024; 21:102-124. [PMID: 37828407 DOI: 10.1038/s41585-023-00820-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/14/2023]
Abstract
Currently, most men with infertility cannot be given an aetiology, which reflects a lack of knowledge around gamete production and how it is affected by genetics and the environment. A failure to recognize the burden of male infertility and its potential as a biomarker for systemic illness exists. The absence of such knowledge results in patients generally being treated as a uniform group, for whom the strategy is to bypass the causality using medically assisted reproduction (MAR) techniques. In doing so, opportunities to prevent co-morbidity are missed and the burden of MAR is shifted to the woman. To advance understanding of men's reproductive health, longitudinal and multi-national centres for data and sample collection are essential. Such programmes must enable an integrated view of the consequences of genetics, epigenetics and environmental factors on fertility and offspring health. Definition and possible amelioration of the consequences of MAR for conceived children are needed. Inherent in this statement is the necessity to promote fertility restoration and/or use the least invasive MAR strategy available. To achieve this aim, protocols must be rigorously tested and the move towards personalized medicine encouraged. Equally, education of the public, governments and clinicians on the frequency and consequences of infertility is needed. Health options, including male contraceptives, must be expanded, and the opportunities encompassed in such investment understood. The pressing questions related to male reproductive health, spanning the spectrum of andrology are identified in the Expert Recommendation.
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Affiliation(s)
- Sarah Kimmins
- Department of Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- The Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
- The Département de Pathologie et Biologie Cellulaire, Université de Montréal, Montreal, Quebec, Canada
| | - Richard A Anderson
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Christopher L R Barratt
- Division of Systems Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Hermann M Behre
- Center for Reproductive Medicine and Andrology, University Hospital, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Sarah R Catford
- Hudson Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Melbourne, Victoria, Australia
| | | | - Geraldine Delbes
- Institut National de la Recherche Scientifique, Centre Armand-Frappier Sante Biotechnologie, Laval, Quebec, Canada
| | - Michael L Eisenberg
- Department of Urology and Obstetrics and Gynecology, Stanford University, Stanford, CA, USA
| | - Nicolas Garrido
- IVI Foundation, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Brendan J Houston
- School of BioSciences and Bio21 Institute, The University of Melbourne, Parkville, Melbourne, Australia
| | - Niels Jørgensen
- Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Csilla Krausz
- Department of Experimental and Clinical Biomedical Sciences, 'Mario Serio', University of Florence, University Hospital of Careggi Florence, Florence, Italy
| | - Ariane Lismer
- Department of Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Robert I McLachlan
- Hudson Institute of Medical Research and the Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
- Monash IVF Group, Richmond, Victoria, Australia
| | - Suks Minhas
- Department of Surgery and Cancer Imperial, London, UK
| | - Tim Moss
- Healthy Male and the Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Allan Pacey
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Lærke Priskorn
- Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Stefan Schlatt
- Centre for Reproductive Medicine and Andrology, University of Münster, Münster, Germany
| | - Jacquetta Trasler
- Departments of Paediatrics, Human Genetics and Pharmacology & Therapeutics, McGill University and Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Leonardo Trasande
- Center for the Investigation of Environmental Hazards, Department of Paediatrics, NYU Grossman School of Medicine, New York, NY, USA
| | - Frank Tüttelmann
- Institute of Reproductive Genetics, University of Münster, Münster, Germany
| | - Mónica Hebe Vazquez-Levin
- Instituto de Biología y Medicina Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina, Fundación IBYME, Buenos Aires, Argentina
| | - Joris A Veltman
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Feng Zhang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Moira K O'Bryan
- School of BioSciences and Bio21 Institute, The University of Melbourne, Parkville, Melbourne, Australia.
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Koch M, Tyson N, Bhuinneain GMN, Kasliwal A, Conry J, Sridhar A. FIGO position statement on comprehensive sexuality education. Int J Gynaecol Obstet 2024; 164:531-535. [PMID: 38219018 DOI: 10.1002/ijgo.15319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
Now is a pivotal moment in the fight for reproductive health and justice internationally. Well-established research has recognized the benefits of comprehensive sexuality education for youth and adolescents-including vast reproductive health benefits, decreased interpersonal violence, and improvements on measures of academic success and well-being. Despite these established benefits, challenges to the implementation of culturally sensitive and holistically framed sexuality education are intensifying across the globe. The International Federation of Gynecology and Obstetrics (FIGO) stands firmly in its support of comprehensive sexuality education and re-emphasizes the importance of the implementation of scientifically accurate, age-appropriate, culturally relevant, and inclusive education. Successful implementation relies on active youth leadership, physician involvement, and a renewed focus on high-quality monitoring mechanisms to assess impact and accountability at all levels. Most importantly, future efforts to improve and scale comprehensive sexuality education must emphasize the importance of an inclusive curriculum that addresses previously marginalized youth, such as LGTBQ+ and disabled individuals, through a reproductive justice lens. FIGO commits, and encourages the international healthcare community, to provide continued advocacy for the rights to health, education, and equality, in order to achieve improvement in health outcomes for young people across the globe.
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Affiliation(s)
- Mikaela Koch
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
| | - Nichole Tyson
- Stanford University School of Medicine, Stanford, California, USA
- FIGO Committee on Contraception, London, UK
| | - G Meabh Ni Bhuinneain
- Royal College of Physicians of Ireland (RCPI), Dublin, Ireland
- FIGO Committee on Well Woman Health Care, London, UK
| | - Asha Kasliwal
- FIGO Committee on Contraception, London, UK
- Manchester Foundation Trust, Manchester, UK
| | | | - Aparna Sridhar
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
- FIGO Committee on Contraception, London, UK
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Fong TCT, Cheung DYT, Choi EPH, Fong DYT, Ho RTH, Ip P, Kung MC, Lam MWC, Lee AM, Wong WCW, Lam TH, Yip PSF. Latent Heterogeneity of Online Sexual Experiences and Associations With Sexual Risk Behaviors and Behavioral Health Outcomes in Chinese Young Adults: Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e50020. [PMID: 38277190 PMCID: PMC10858424 DOI: 10.2196/50020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/07/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Online sexual experiences (OSEs) are becoming increasingly common in young adults, but existing papers have reported only on specific types of OSEs and have not shown the heterogeneous nature of the repertoire of OSEs. The use patterns of OSEs remain unclear, and the relationships of OSEs with sexual risk behaviors and behavioral health outcomes have not been evaluated. OBJECTIVE This study aimed to examine the latent heterogeneity of OSEs in young adults and the associations with sexual risk behaviors and behavioral health outcomes. METHODS The 2021 Youth Sexuality Study of the Hong Kong Family Planning Association phone interviewed a random sample of 1205 young adults in Hong Kong in 2022 (male sex: 613/1205, 50.9%; mean age 23.0 years, SD 2.86 years) on lifetime OSEs, demographic and family characteristics, Patient Health Questionnaire-4 (PHQ-4) scores, sex-related factors (sexual orientation, sex knowledge, and sexual risk behaviors), and behavioral health outcomes (sexually transmitted infections [STIs], drug use, and suicidal ideation) in the past year. Sample heterogeneity of OSEs was analyzed via latent class analysis with substantive checking of the class profiles. Structural equation modeling was used to examine the direct and indirect associations between the OSE class and behavioral health outcomes via sexual risk behaviors and PHQ-4 scores. RESULTS The data supported 3 latent classes of OSEs with measurement invariance by sex. In this study, 33.1% (398/1205), 56.0% (675/1205), and 10.9% (132/1205) of the sample were in the abstinent class (minimal OSEs), normative class (occasional OSEs), and active class (substantive OSEs), respectively. Male participants showed a lower prevalence of the abstinent class (131/613, 21.4% versus 263/592, 44.4%) and a higher prevalence of the active class (104/613, 17.0% versus 28/592, 4.7%) than female participants. The normative class showed significantly higher sex knowledge than the other 2 classes. The active class was associated with male sex, nonheterosexual status, higher sex desire and PHQ-4 scores, and more sexual risk behaviors than the other 2 classes. Compared with the nonactive (abstinent and normative) classes, the active class was indirectly associated with higher rates of STIs (absolute difference in percentage points [Δ]=4.8%; P=.03) and drug use (Δ=7.6%; P=.001) via sexual risk behaviors, and with higher rates of suicidal ideation (Δ=2.5%; P=.007) via PHQ-4 scores. CONCLUSIONS This study provided the first results on the 3 (abstinent, normative, and active) latent classes of OSEs with distinct profiles in OSEs, demographic and family characteristics, PHQ-4 scores, sex-related factors, and behavioral health outcomes. The active class showed indirect associations with higher rates of STIs and drug use via sexual risk behaviors and higher rates of suicidal ideation via PHQ-4 scores than the other 2 classes. These results have implications for the formulation and evaluation of targeted interventions to help young adults.
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Affiliation(s)
- Ted C T Fong
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Derek Yee Tak Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Daniel Y T Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Rainbow T H Ho
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China (Hong Kong)
- Department of Social Work & Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Patrick Ip
- Department of Paediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Man Chun Kung
- Family Planning Association of Hong Kong, Hong Kong, China (Hong Kong)
| | | | - Antoinette Marie Lee
- Department of Psychology, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - William Chi Wai Wong
- Department of Family Medicine & Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Tai Hing Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Paul S F Yip
- Department of Social Work & Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China (Hong Kong)
- Centre for Suicide Research and Prevention, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China (Hong Kong)
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Díaz-Rodríguez MV, Perelló VBI, Granero-Molina J, Fernández-Medina IM, Ventura-Miranda MI, Jiménez-Lasserrotte MDM. Insights from a Qualitative Exploration of Adolescents' Opinions on Sex Education. CHILDREN (BASEL, SWITZERLAND) 2024; 11:110. [PMID: 38255423 PMCID: PMC10814457 DOI: 10.3390/children11010110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Adolescence is a crucial time in the development of young people's identity, and sexuality is a key issue. Comprehensive sex education provides the knowledge and skills to help adolescents protect their sexual and reproductive health and rights. Policies on sex education in secondary schools are highly influential in the development of quality programmes that support comprehensive sex education. The aim of this study was to explore, describe and understand adolescents' experiences of sex education. METHODS A qualitative study based on Gadamer's phenomenology was used. Two focus groups and four in-depth interviews were conducted with 12 private school students, followed by inductive data analysis using ATLAS.ti software 9.0. RESULTS Two main themes were identified in the analysis: (1) sex education is a challenge for secondary schools and (2) student expectations of sex education. CONCLUSION It is essential for adolescents to have access to comprehensive sex education that is adapted to the different stages of their development, is provided by specialised teachers, and involves their families in the process.
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Affiliation(s)
| | - Vicent Bataller i Perelló
- Facultad Ciencias de la Salud, Universidad de Almería, 04120 Almería, Spain; (M.V.D.-R.); (V.B.i.P.)
| | - José Granero-Molina
- Department of Nursing Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (I.M.F.-M.); (M.I.V.-M.); (M.d.M.J.-L.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago 7500000, Chile
| | - Isabel María Fernández-Medina
- Department of Nursing Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (I.M.F.-M.); (M.I.V.-M.); (M.d.M.J.-L.)
| | - María Isabel Ventura-Miranda
- Department of Nursing Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (I.M.F.-M.); (M.I.V.-M.); (M.d.M.J.-L.)
| | - María del Mar Jiménez-Lasserrotte
- Department of Nursing Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (I.M.F.-M.); (M.I.V.-M.); (M.d.M.J.-L.)
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Berglas NF, Harrison S, Romero J, Borgen N, Decker MJ. Implementation of a Booster Sexual Health Education Curriculum for Older Adolescents in Rural Communities. Health Promot Pract 2024:15248399231221156. [PMID: 38180021 DOI: 10.1177/15248399231221156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Ongoing education on sexual health and other health promotion topics is critical as young people transition into adulthood. A "booster" round of education may be an effective strategy to reinforce information previously taught and expand to additional topics relevant later in adolescence. In partnership with a Youth Advisory Council, we co-designed READY, Set, Go!, a booster curriculum for older adolescents with modules covering adult preparation skills, sexual identity, relationships, reproductive health, and mental health. From November 2021 to January 2023, we provided the curriculum to 21 cohorts of 12th grade students (N = 433) in rural communities of Fresno County, CA, and conducted an implementation evaluation to assess its feasibility in school settings, acceptability by participants, and changes in short-term outcomes. Health educators completed implementation logs to track program adaptations. Youth completed pretest/posttest surveys to assess changes in outcomes and participant satisfaction. We used descriptive statistics to examine program adaptations and satisfaction. We used multivariable regression models to examine changes in outcomes, adjusted for sociodemographic characteristics. Health educators completed most activities as planned, with adaptations occurring in response to youth needs and scheduling limitations. Sexual health knowledge, confidence in adult preparation skills, awareness of local sexual and mental health services, and willingness to seek health services all increased significantly from pretest to posttest. Youth feedback was strongly positive. We conclude that booster sexual health education is a promising strategy to address critical knowledge gaps and support health promotion, especially in rural and other under-resourced communities.
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Affiliation(s)
| | - Salish Harrison
- University of California, San Francisco, San Francisco, CA, USA
| | - Julio Romero
- Fresno Economic Opportunities Commission, Fresno, CA, USA
| | - Natasha Borgen
- University of California, San Francisco, San Francisco, CA, USA
| | - Martha J Decker
- University of California, San Francisco, San Francisco, CA, USA
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Godwin EG, Moore LM, Sansfaçon AP, Nishman MM, Rosal MC, Katz-Wise SL. Experiences of cisgender youth with a transgender and/or nonbinary sibling. FAMILY PROCESS 2024. [PMID: 38171537 DOI: 10.1111/famp.12957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 10/15/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024]
Abstract
While recent research has begun to address the effects of family support on transgender and/or nonbinary youth (TNY), almost no studies have directly examined how cisgender siblings in families with TNY navigate their sibling's gender disclosure and affirmation within both their families and their larger communities. We conducted an exploratory secondary analysis of in-person, semi-structured interviews with 15 adolescent and young adult siblings (age 13-24 years) of TNY from the northeastern United States from the baseline wave of the community-based, longitudinal, mixed methods Trans Teen and Family Narratives Project. Interview transcripts were analyzed using immersion/crystallization and template organizing approaches. Analyses yielded three main themes: gender-related beliefs and knowledge, peri- and post-disclosure family dynamics, and assessing responses to their sibling. Subthemes included anticipation of their sibling's TN identity, expectations post-disclosure, participants' level of involvement in gender-related family processes, perceptions of changes in family relationships, concern for their sibling (including a high degree of attunement to gender-affirming name and pronoun usage), and concern for themselves. Findings from this study suggest the need to engage directly with siblings of TNY to further elucidate their intrapersonal, intra-familial, and extra-familial experiences related to having a TN sibling and determine their unique support needs. Implications for families, clinicians, and communities are discussed.
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Affiliation(s)
- Eli G Godwin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Lb M Moore
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Annie Pullen Sansfaçon
- School of Social Work and the Centre for Public Health Research, University of Montréal, Montréal, Quebec, Canada
| | | | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Sabra L Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Rao TSS, Tripathi A, Manohar S, Tandon A. Promoting sexual well-being. Indian J Psychiatry 2024; 66:S262-S271. [PMID: 38445287 PMCID: PMC10911331 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_612_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/08/2023] [Accepted: 01/05/2024] [Indexed: 03/07/2024] Open
Affiliation(s)
| | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India E-mail:
| | - Shivanand Manohar
- Department of Psychiatry, JSS Medical College, Mysore, Karnataka, India
| | - Abhinav Tandon
- Department of Psychiatry, MLN Medical College, Prayagraj, Uttar Pradesh, India
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Hawkins SS. Expansion of Comprehensive Sexuality Education. J Obstet Gynecol Neonatal Nurs 2024; 53:14-25. [PMID: 38072008 DOI: 10.1016/j.jogn.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024] Open
Abstract
School-based sex education has always been and continues to be controversial and mired in politics, and gaps persist in the content and skills that children and adolescents receive about sexual health. State policies dictate whether sex and HIV education are mandated, medically accurate, or include life skills such as providing consent to sexual activity, and these policies have important implications for population health. In this column, I review research findings about abstinence only versus sex education or comprehensive sexuality education, identify gaps in research and content related to sex education programs, review state sex education policies, and provide recommendations from professional organizations on expanding school-based programming to include comprehensive sexuality education.
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Kockelkoren A, Rahmah A, Pangestu MRD, Sawitri E, Widyastuti ESA, Astiti NLEP, Michielsen K, Van Reeuwijk M. How can civil society organizations contribute to the scale-up of comprehensive sexuality education? Presentation of a scaling framework illustrated with examples from Indonesia. Reprod Health 2023; 20:186. [PMID: 38124182 PMCID: PMC10734146 DOI: 10.1186/s12978-023-01725-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
Comprehensive sexuality education (CSE) can substantially contribute to the health and well-being of young people. Yet, most CSE interventions remain limited to the small piloting or research phase and scale-up is often an afterthought at the end of a project. Because of the specificities of CSE, including it being a controversial topic in many contexts and a topic on the fringe between health, education and youth, a specific scaling approach to CSE is needed. The commentary presents a practical framework to support civil society organisations (CSOs), to address barriers to scaling up CSE in their contexts. The utilization and relevance of the framework is demonstrated in this article, by featuring examples from the scale up process of CSE in Indonesia. The framework identifies key principles for scaling up, including: taking a scaling mindset from the start, government ownership and political commitment for scale-up, and identifying the added value of CSOs. The framework starts with a self-assessment by the CSO and then follows four phases: making the case, engaging in dialogue, establishing building blocks and implementation and scale-up. Each of these phases are illustrated with examples from Indonesia.This framework is a call to action with practical guidelines to support CSOs to take on this role, because with the right scaling strategies, the largest generation of young people ever alive can become healthy, empowered and productive adults.
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Affiliation(s)
- Ardan Kockelkoren
- Rutgers, the Netherlands Centre on Sexuality, Arthur van Schendelstraat 696, 3511 MJ, Utrecht, The Netherlands.
| | - Amala Rahmah
- Rutgers Indonesia, Graha Inti Fauzi, 9th Floor, Pasar Minggu, Greater Jakarta, Indonesia
| | | | - Ely Sawitri
- Rutgers Indonesia, Graha Inti Fauzi, 9th Floor, Pasar Minggu, Greater Jakarta, Indonesia
| | | | - Ni Luh Eka Purni Astiti
- PKBI Bali, Jl. Gatot Subroto IV No.6, Dangin Puri Kaja, Kec. Denpasar Utara, Kota Denpasar, Bali, 80233, Indonesia
| | - Kristien Michielsen
- Department of Neurosciences, Faculty of Medicine, Institute for Family and Sexuality Studies, KU Leuven, Herestraat 49, 3000, Louvain, Belgium
| | - Miranda Van Reeuwijk
- Rutgers, the Netherlands Centre on Sexuality, Arthur van Schendelstraat 696, 3511 MJ, Utrecht, The Netherlands
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Schindele AC, Källberg H, Areskoug Josefsson K, Lindroth M. Perceived knowledge gained from school-based sexuality education - results from a national population-based survey among young people in Sweden. Sex Health 2023; 20:566-576. [PMID: 37925747 DOI: 10.1071/sh23093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND School-based sexuality education is a core component of securing young people's right to attain health equity regarding sexual and reproductive health and rights. This paper aims to explore how perceived knowledge (sufficient or insufficient) of taking care of one's sexual health is associated with knowledge gained from school-based sexuality education and social determinants. METHODS The data material is drawn from a population-based survey conducted in Sweden in 2015. The survey had 7755 respondents and a response rate of 26%. To explore the aim descriptive statistics and logistic regression models were used. RESULTS Our results show that perceived insufficient knowledge from school-based sexuality education was associated with higher odds of reporting not being able to take care of one's sexual health. The highest significant excess risk for insufficient knowledge was found among young people from sexual minorities. CONCLUSIONS Young people in Sweden do not have equal abilities to receive knowledge needed to take care of their sexual health and thus attain sexual health literacy. There is an unequal distribution of perceived knowledge, and LGBTQI+ youth particularly face barriers in using school-based sexuality education as a resource for sexual health literacy.
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Affiliation(s)
- Anna ChuChu Schindele
- Faculty of Health and Society, Institution for Social Work, Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden; and Unit for Sexual Health and HIV Prevention, Department of Communicable Disease Control and Health Protection, The Public Health Agency of Sweden, Stockholm, Sweden
| | - Henrik Källberg
- Unit for Analysis, Department of Public Health Analysis and Data Management, The Public Health Agency of Sweden, Stockholm, Sweden
| | - Kristina Areskoug Josefsson
- Department of Health Sciences, University West, Trollhättan, Sweden; and Department of Behavioural Science, Oslo Metropolitan University, Oslo, Norway
| | - Malin Lindroth
- Faculty of Health and Society, Institution for Social Work, Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden; and Department of Behavioural Science, Oslo Metropolitan University, Oslo, Norway
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Iwahata Y, Takae S, Iwahata H, Matsumoto K, Hirayama M, Takita J, Manabe A, Cho Y, Ikeda T, Maezawa T, Miyachi M, Keino D, Koizumi T, Mori T, Shimizu N, Woodruff TK, Suzuki N. Investigation of Fertility Preservation Education Videos for Pediatric Patients Based on International and Historical Survey. J Adolesc Young Adult Oncol 2023; 12:835-842. [PMID: 37155199 DOI: 10.1089/jayao.2022.0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Purpose: Recently, direct communication with children about cancer seems to have shifted, but little is known about communication regarding discussions of future infertility risk due to cancer therapy. This study conducted cross-cultural comparisons between Japan and the United States to clarify communication patterns about cancer notification and develop appropriate information about fertility issues. Methods: An online survey was distributed to members of the Japanese Society of Pediatric Hematology/Oncology in July 2019 and the American Society of Pediatric Hematology/Oncology in July 2020. Based on the results from the survey, we developed three types of educational videos: a prepubertal version A, B, and a pubertal version. Next, we conducted a survey to assess whether these were appropriate for clinical practice. Results: We analyzed 325 physicians in Japan and 46 in the United States. In Japan, 80.5%, 91.7%, and 92.1% of the physicians notified patients aged 7-9, 10-14, and 15-17 years of their cancer diagnosis directly, respectively, compared within the United States, where the rate was 100%, regardless of age. Further, 9% and 45% of physicians in Japan and the United States, respectively, discuss fertility issues directly with patients aged 7-9 years. In the survey to assess the educational videos, 85% of the physicians preferred to use the educational videos in clinical practice. Conclusion: This is the first step in bringing concordance to communication patters for emerging cancer care around the globe and that this study and its intervention arm provide guidance in ways that ensure global equity in care.
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Affiliation(s)
- Yuriko Iwahata
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hideyuki Iwahata
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kimikazu Matsumoto
- National Center for Child Health and Development, Children's Cancer Center, Tokyo, Japan
| | - Masahiro Hirayama
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Junko Takita
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University, Sapporo, Japan
| | - Yuko Cho
- Department of Pediatrics, Hokkaido University, Sapporo, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University, Tsu, Japan
| | - Tadashi Maezawa
- Department of Obstetrics and Gynecology, Mie University, Tsu, Japan
| | - Mitsuru Miyachi
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Dai Keino
- Division of Hematology/Oncology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tomoe Koizumi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
- International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Tetsuya Mori
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Naoki Shimizu
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Teresa K Woodruff
- Department of Obstetrics and Gynecology, Michigan State University, East Lansing, Michigan, USA
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
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Zeglin A, Lazebnik R. Teaching About Contraception: Adolescent Attitudes Surrounding Sexual Education. Open Access J Contracept 2023; 14:181-188. [PMID: 38059115 PMCID: PMC10697143 DOI: 10.2147/oajc.s402443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/14/2023] [Indexed: 12/08/2023] Open
Abstract
Purpose Adolescent pregnancy remains an important public health issue in the United States as it has profound health consequences for both mother and child. Evidence shows that improved contraception use is a critical factor in decreasing rates of adolescent pregnancy. In order to provide effective and engaging contraception education, it is important to understand adolescents' attitudes, questions, and misconceptions around the topic and its delivery. Methods Two searches were conducted using PubMed. Articles were limited to those published in the last 10 years that were written in English. The first search was completed using the search terms "Adolescent attitudes on sex education in the United States", and resulted in 688 articles. The second search was completed using the search terms "Adolescent attitudes on contraception in the United States", and resulted in 840 articles. Articles including contraception but focusing more on HIV, pre-exposure prophylaxis (PrEP), LGBTQ+ health and practices, human papillomavirus (HPV) vaccination, and studies completed in other countries were excluded. Remaining articles were screened by the authors for inclusion, and articles were included if they addressed information on adolescent attitudes on both contraception for pregnancy prevention and sex education, including education by schools, community organizations, the media, peers, parents, and physicians. A total of 56 articles were included in the review. Results The overwhelming theme that emerged from the review is that adolescents prefer comprehensive sex education in a safe space that allows for exploration and questioning. Adolescents want to ask their parents questions about sexual health without fear of punishment, and they desire the opportunity to learn from their physicians in a confidential environment. Conclusion The foundation of effective sex education is a non-judgmental, confidential, and safe space where adolescents can ask questions. There are multiple resources that adolescents use to gather information and establish their preferences and attitudes.
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Affiliation(s)
- Alissa Zeglin
- Internal Medicine and Pediatrics, Froedtert and the Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rina Lazebnik
- General Pediatrics and Adolescent Medicine, Rainbow Babies and Children’s Hospital, Cleveland, OH, USA
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43
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VanTreeck K, Elnakib S, Chandra-Mouli V. A reanalysis of the Institute for Research and Evaluation report that challenges non-US, school-based comprehensive sexuality education evidence base. Sex Reprod Health Matters 2023; 31:2237791. [PMID: 37548507 PMCID: PMC10408562 DOI: 10.1080/26410397.2023.2237791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
Comprehensive sexuality education (CSE) prepares young people to make informed decisions about their sexuality. A review by the Institute of Research and Evaluation that analysed 43 CSE studies in non-US settings found the majority to be ineffective and concluded that there was little evidence of the effectiveness of CSE. We reanalysed the review to investigate its validity. We found several weaknesses with the review's methodology and analysis: (1) there was an absence of a clearly articulated search strategy and specific eligibility criteria; (2) the authors put forth criteria for programme effectiveness but included studies that did not collect the data needed to show programme effectiveness and thus several studies were determined to be ineffective by default; (3) the analytical framework minimised positive intervention effects and privileged negative intervention effects; and (4) there were errors in the data extracted, with 74% of studies containing one or more discrepancies. Overall, our reanalysis reveals that the IRE review suffers from significant methodological flaws and contains many errors which compromise its conclusions about CSE. Our reanalysis is a tool for the international community to refute CSE opposition campaigns based on poor science.
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Affiliation(s)
- Kelly VanTreeck
- Consultant, Department of Sexual and Reproductive Health and Research, World Health Organization, Av. Appia 20, 1202Geneva, Switzerland
| | - Shatha Elnakib
- Consultant, Department of Sexual and Reproductive Health and Research, World Health Organization, Av. Appia 20, 1202Geneva, Switzerland
- Full-time faculty, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Venkatraman Chandra-Mouli
- Scientist, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Vega Casanova J, Blanco J, Rovira NB, Pulido Jaramillo DM, Pacheco KA, Camacho-Hubner AV. Tírala Plena: findings from the formative research to inform the initiative "Reaching those most left behind through comprehensive sexuality education for out-of-school young people" in Colombia. Sex Reprod Health Matters 2023; 31:2267202. [PMID: 37982434 PMCID: PMC10776069 DOI: 10.1080/26410397.2023.2267202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023] Open
Abstract
This paper presents the results of formative research conducted from January to June 2020 in the Department of Atlántico, Caribbean region of Colombia, whose findings were used as inputs to design the national strategy for comprehensive sexuality education (CSE) outside school - Tírala Plena - including its curriculum. This is within the framework of the multi-country project coordinated by UNFPA and WHO aimed at generating evidence on the role of facilitators in the delivery of CSE in non-school contexts. The research was carried out in four municipalities in northern Colombia, in rural and marginal urban contexts with conditions of vulnerability for the adolescent population, including a strong presence of migrant populations from Venezuela. A total of 150 male and female adolescents ages 10-17 participated in the formative research. Workshops such as patchwork quilt, body mapping and talking maps were used as methods to gather information. The groups were divided by sex and age (10-13 years old and 14-17 years old). Knowledge, attitudes and social norms regarding adolescent pregnancy, sexually transmitted infections, including human immunodeficiency virus, and gender-based violence, were identified in adolescents (schooled and not schooled, but with minimal or no access to CSE). All of the above enabled us to establish a set of recommendations for the strengthening of the CSE strategy Tírala plena.
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Affiliation(s)
- Jair Vega Casanova
- Professor, Department of Communication and researcher, PBX Research Group on Communication, Culture and Social Change, Universidad del Norte, Barranquilla, Colombia
| | - Johanna Blanco
- Advisor on Adolescence and Youth, UNFPA, Bogotá, Colombia
| | - Natalia Buitrago Rovira
- Research Assistant, PBX Research Group on Communication, Culture and Social Change, Universidad del Norte, Barranquilla, Colombia
| | | | - Karen Adrians Pacheco
- Research Assistant, PBX Research Group on Communication, Culture and Social Change, Universidad del Norte, Barranquilla, Colombia
| | - Alma Virginia Camacho-Hubner
- Regional Technical Adviser, Sexual and Reproductive Health, Regional Office for Latin America and the Caribbean, UNFPA, Panama, Panama
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Colarossi L, Collier KL, Dean R, Pérez S, Riquelme MO. Sexual and Reproductive Health Education for Youth with Intellectual Disabilities: a Mixed Methods Study of Professionals' Practices and Needs. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:150-162. [PMID: 37289271 PMCID: PMC10764499 DOI: 10.1007/s11121-023-01522-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 06/09/2023]
Abstract
We conducted formative research to inform the creation of innovative new tools and strategies to engage professionals in communicating with youth with intellectual disabilities about sexual health. The research was guided by a multidisciplinary network of experts and an advisory board of self-advocates with intellectual disabilities and caregivers that make up Project SHINE: the Sexual Health Innovation Network for Equitable Education. A cross-sectional mixed-methods study utilized survey data from 632 disability support professionals who provide services to youth ages 16-24 with intellectual disabilities (ID). We then conducted focus groups with 36 professionals to obtain more in-depth information related to organizational support needs and suitable contexts, methods, and tools for sexuality education. Participants included licensed/credentialed direct service professionals (social workers, nurses, teachers), non-licensed direct service providers (case managers, supportive care specialists, residential care line staff), and program administrators. Quantitative and qualitative data analyses triangulated the findings across four content areas: attitudes about providing sexual health information to youth with ID, preparedness to communicate about sexuality, current communication practices, and professional needs in the field for new teaching tools and methods. We discuss how findings can be used to guide the creation and successful implementation of innovative new sexual health learning tools for youth with intellectual disabilities.
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Affiliation(s)
- Lisa Colarossi
- Planned Parenthood of Greater New York, New York, NY, USA
| | - Kate L Collier
- Planned Parenthood of Greater New York, New York, NY, USA.
| | - Randa Dean
- Planned Parenthood of Greater New York, New York, NY, USA
| | - Siana Pérez
- Planned Parenthood of Greater New York, New York, NY, USA
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Silva M, Loll D, Ezouatchi R, Kassegne S, Nagbe RHY, Babogou L, Moussa F, Werwie TR, Portillo E, Adou D, Vondrasek C, Rajan R, Dougherty L. Evaluating a youth-designed sexual and reproductive health mass and social media campaign in Côte d'Ivoire: triangulation of three independent evaluations. Sex Reprod Health Matters 2023; 31:2248748. [PMID: 37728549 PMCID: PMC10512782 DOI: 10.1080/26410397.2023.2248748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
Abstract
Merci Mon Héros (MMH) is a youth-designed multi-media campaign seeking to improve sexual and reproductive health and family planning (SRH/FP) outcomes among youth living in nine francophone countries. A mixed methods approach was implemented to assess the MMH campaign progress and impact in Côte d'Ivoire. Three data sources were triangulated to evaluate the campaign: social media listening (October 2019-January 2021); a quantitative cross-sectional monitoring survey (September 2020) with 412 youth (aged 16-24) and 597 adults (aged 25-49); and a qualitative study using a Most Significant Change approach (March 2021), including a total of 24 focus group discussions with youth (aged 15-24) and adults (aged 25+) exposed to the MMH campaign. Data from all three studies were analysed independently and then brought together through a triangulation workshop where the study team compared findings to achieve convergence in evaluation results. Social listening results showed topic-specific online conversations related to MMH campaign spiked significantly during the two-week period after topic-specific campaign posts (p < .05), suggesting potential campaign impact. Survey results showed both adults and youth were more likely to have spoken with someone about FP in the past five months if exposed to the campaign (p < 0.01). Qualitative findings support the campaign's effect on shifting attitudes and behavioural uptake of intergenerational communication among adults and youth. This evaluation shows evidence of MMH's strong potential for impact in encouraging communication and the need to focus efforts on strategies to strengthen supportive adults' communication competencies and redefine what it means to act in support of SRH/FP for youth.
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Affiliation(s)
- Martha Silva
- Assistant Professor, Department of International Health and Sustainable Development, Tulane University Schools of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Dana Loll
- Research & Evaluation Officer, Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | | | | | | | | | | | - Timothy R. Werwie
- Research Officer, Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Erin Portillo
- Senior Program Officer, Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Denise Adou
- Program Officer, Johns Hopkins Center for Communication Programs, Abidjan, Côte d’Ivoire
| | - Claudia Vondrasek
- Senior Program Officer II, Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Radha Rajan
- Research & Evaluation Officer, Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
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Ventura-Miranda MI, Alcaraz-Córdoba A, Alcaraz-Córdoba T, Molina-Torres G, Fernandez-Medina IM, Ruíz-Fernández MD. Adolescents' Perceptions of Sexuality: A Qualitative Study. Healthcare (Basel) 2023; 11:2757. [PMID: 37893831 PMCID: PMC10606393 DOI: 10.3390/healthcare11202757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/08/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Adolescents have a greater risk of acquiring sexually transmitted infections (STIs), which is a serious public health problem. Education is an effective strategy to improve adolescent sexual health outcomes. However, Spanish adolescents have a lack of sex education. The aim of this study was to explore the perceptions and opinions of a sample of adolescents regarding sexually transmitted infections (STIs). Photovoice is a research method that uses the search for images of everyday events with the intention of bringing about social change. An exploratory, descriptive design was used with a qualitative approach based on the Photovoice methodology. The sample consisted of 26 high school and baccalaureate students of Almería (Spain) selected through a convenience sample. The age of the participants ranged from 14 to 17 years, with a mean age of 15.31 years. Two main categories were extracted from the data analysis: 'Towards a culture of preventing STIs and promoting healthy sexual practices' and 'Adolescents' needs from their perspective'. In conclusion, numerous changes take place at the biopsychosocial level during adolescence that imply a need to explore their sexuality in depth. A lack of knowledge and a carefree attitude during sexual initiation can increase the risk of developing STIs. The study's adolescents stated that they do not have adequate sex education to acquire sufficient knowledge about sexuality and sexual health, and therefore, request that the traditional format be modified in order to achieve better results.
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Affiliation(s)
- María Isabel Ventura-Miranda
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almería, Spain; (M.I.V.-M.); (T.A.-C.); (G.M.-T.); (I.M.F.-M.); (M.D.R.-F.)
| | - Andrea Alcaraz-Córdoba
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almería, Spain; (M.I.V.-M.); (T.A.-C.); (G.M.-T.); (I.M.F.-M.); (M.D.R.-F.)
- Distrito Sanitario Almería, Servicio Andaluz de Salud, 04009 Almería, Spain
| | - Tania Alcaraz-Córdoba
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almería, Spain; (M.I.V.-M.); (T.A.-C.); (G.M.-T.); (I.M.F.-M.); (M.D.R.-F.)
- Distrito Sanitario Almería, Servicio Andaluz de Salud, 04009 Almería, Spain
| | - Guadalupe Molina-Torres
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almería, Spain; (M.I.V.-M.); (T.A.-C.); (G.M.-T.); (I.M.F.-M.); (M.D.R.-F.)
| | - Isabel María Fernandez-Medina
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almería, Spain; (M.I.V.-M.); (T.A.-C.); (G.M.-T.); (I.M.F.-M.); (M.D.R.-F.)
| | - María Dolores Ruíz-Fernández
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almería, Spain; (M.I.V.-M.); (T.A.-C.); (G.M.-T.); (I.M.F.-M.); (M.D.R.-F.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia 7500912, Chile
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Todesco M, Breman J, Haryanto NN, Kok G, Massar K. Effect evaluation of a comprehensive sexuality education intervention based on socio-emotional learning among adolescents in Jakarta, Indonesia. Front Public Health 2023; 11:1254717. [PMID: 37854244 PMCID: PMC10580798 DOI: 10.3389/fpubh.2023.1254717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023] Open
Abstract
IntroductionThe field of comprehensive sexuality education (CSE) has switched from a focus on adolescents’ health to a more holistic approach, embracing the concept of sexual development with the aim of improving adolescents’ sexual well-being. The growing interest in the link between CSE and socio-emotional learning (SEL) competencies led to the development of the Journey4Life (J4L), a comprehensive sexuality education curriculum based on socio-emotional learning. In the current research, we evaluate the effectiveness of this program on perceived behavioral control, gender equality attitudes, norms, and intentions related to sexual and reproductive health and rights.MethodsTo this end, we conducted a Cluster Randomized Trial among 14 senior secondary schools in Jakarta, Indonesia. A questionnaire was administered before and after implementation of the J4L program among 16–17 year old pupils; n = 906 completed baseline measurement, n = 771 completed endline measurement. With a final matched sample of N = 466 (65.5% girls) we conducted a mixed model repeated measures ANOVA.ResultsUnfortunately, only limited and inconsistent results were found. We found that at endline, girls had stronger positive gender equality attitudes than boys; that overall attitudes towards reporting sexual violence were stronger for girls than for boys. However, contrary to our expectations, respondents had more positive attitudes toward child marriage at baseline than at endline.DiscussionInconsistency and non-statistical significance of results limit our ability to draw firm conclusions about the effectiveness of the Journey4Life. We discuss how complex comprehensive sexuality education interventions could best be evaluated, since our study highlights the need for better conceptualization, operationalization and measurement of the interconnection between comprehensive sexuality education and socio-emotional learning.
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Affiliation(s)
- Marina Todesco
- Department of Work & Social Psychology, Section of Applied Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
- Rutgers, Utrecht, Netherlands
| | | | | | - Gerjo Kok
- Department of Work & Social Psychology, Section of Applied Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Karlijn Massar
- Department of Work & Social Psychology, Section of Applied Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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Gyawali L, Atreya A, Kuinkel P, Sanyal R, Shah A. A case report of infanticide in rural Nepal: Sociocultural perspectives and forensic considerations. Clin Case Rep 2023; 11:e8078. [PMID: 37854264 PMCID: PMC10580692 DOI: 10.1002/ccr3.8078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023] Open
Abstract
This case highlights the complex interplay of mental health, stigma, and lack of contraceptive access underlying tragic instances of infanticide. Comprehensive medicolegal investigation paired with cross-sector efforts to expand reproductive services and transform cultural attitudes is crucial to protect vulnerable women and children.
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Affiliation(s)
| | - Alok Atreya
- Department of Forensic MedicineLumbini Medical CollegePalpaNepal
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50
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Rivas-Koehl M, Valido A, Espelage DL, Lawrence TI. Adults and Family as Supportive of Adolescent Sexual Development in the Age of Smartphones? Exploring Cybersexual Violence Victimization, Pornography Use, and Risky Sexual Behaviors. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2845-2857. [PMID: 37316619 DOI: 10.1007/s10508-023-02618-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 04/17/2023] [Accepted: 05/06/2023] [Indexed: 06/16/2023]
Abstract
Among adolescents, engagement in risky sexual behavior is an important public health concern. Research has begun to explore the impact of adolescents' online experiences with their social and behavioral health as approximately 95% of adolescents have access to a smartphone connected to the internet. However, little research has specifically examined how online experiences impact sexual risk behaviors among adolescence. To fill gaps in the existing research, the current study sought to investigate the association between two potential risk factors and three sexual risk behavior outcomes. We examined how experiencing cybersexual violence victimization (CVV) and using pornography during early adolescence was associated with condom use, birth control use, and use of alcohol and drugs before sex among U.S. high school students (n = 974). Additionally, we explored multiple forms of adult support as potential protective factors of sexual risk behaviors. Our findings suggest that CVV and porn use may be associated with risky sexual behaviors for some adolescents. In addition, parental monitoring and support from adults at school may be two ways to support healthy adolescent sexual development.
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Affiliation(s)
- Matthew Rivas-Koehl
- Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, 905 S. Goodwin Ave., Bevier 167, Urbana, IL, 61801, USA.
| | - Alberto Valido
- School of Education, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dorothy L Espelage
- School of Education, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Timothy I Lawrence
- School of Medicine, Department of Psychiatry and Behavioral Sciences, Texas A&M University, Bryan, TX, USA
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