How public health nurses' deal with sexting among young people: a qualitative inquiry using the critical incident technique

Identification and responses by nurses to sexual exploitation of young people

BACKGROUND

Nurses are uniquely positioned to identify and respond to the sexual exploitation of young people. They treat sexually transmitted infections, unplanned pregnancies, and mental health issues, often collaborating with social services and law enforcement to safeguard young people.

AIM

This narrative review explores the pivotal role of nurses in identifying and responding to sexual exploitation among young people.

METHODS

Empirical evidence from 1997 to 2021 was examined through a comprehensive search of databases such as CINAHL-EBSCO, ASSIA, PubMed (including Medline), and manual screening of abstracts. The PRISMA guideline was applied. Thematic analysis of 12 selected studies revealed three overarching themes.

FINDINGS

The themes identified were the influence of technology on the sexual exploitation of young people, identification and response to sexual exploitation in both clinical and non-clinical settings, and organisational support.

CONCLUSION

These findings shed light on sexual exploitation and underscore the significance of a person-centred approach to nursing care that addresses the health and social impacts of sexual exploitation. It emphasises the importance of interagency collaboration and appropriate clinical interventions to effectively support young people at risk. Increased professional development, support, and supervision for nurses are relevant to identifying, responding to, and preventing the sexual exploitation of young people.

WITHDRAWN: Risk assessment of group psychology health in the evolution of public health emergencies in colleges and universities

Ahead of Print article withdrawn by publisher.

Prevalence and Correlates of Sext-Sharing Among a Representative Sample of Youth in the Netherlands

Many adolescents use their electronic devices to send each other sexually explicit texts, photos, and videos of themselves-commonly known as sexting. This can be fun and is not usually problematic. However, if the intended recipient decides to share these sexts with a broader audience, the consequences for the depicted can be detrimental. The purpose of this study was to investigate the prevalence of (non-consensual) sext-sharing among Dutch adolescents and explore the characteristics of those who do, to gain a better understanding of factors involved in dissemination. We used data from "Sex under the age of 25," a representative national survey on sexual health among a sample of 20,834 Dutch 12-24-year-olds. The prevalence of sext-sharing was estimated using Complex Samples. Logistic regressions were used to assess associations between demographics, school-based sexting education, sexual- and online behavior, and mental health and sext-sharing. About 4% of the adolescents reported having shared someone else's sext in the last six months. Being male, aged 12-14 years, frequent social media usage, watching online porn, sexual experience, and being subjected to sext-sharing themselves associated most strongly with sext-sharing. Our findings show that the likelihood of sext-sharing is lower in older adolescents and that it associates with the extent of adolescents' sexual curiosity and online activity. The overlap between sharing sexts of others and having one's own sext shared suggests that dissemination of personal sexual content might be normalized or used as an act of retribution. Further research could be helpful to explain the mechanisms underlying this overlap. The results of this study illustrate the importance of exposing adolescents to evidence based preventive educational interventions on sexting from 12 years onwards and not just within the context of traditional school-based sex education, but also as a part of the (online) media-literacy curriculum.

Management of non-consensually shared youth-produced sexual images: A Delphi study with adolescents as experts

There is an increased availability of online child abuse images, a proportion of which is created by young people in coercive and non- coercive relationships (sexting).

OBJECTIVES

This Delphi study with adolescents as "experts" who had taken and shared sexual images, was conducted to identify appropriate responses to sexting where images are shared without consent and identify indicators of distress and ways to facilitate disclosure when the sharing of images causes anxiety or is associated with further victimization.

PARTICIPANTS AND SETTING

124 adolescents from the United Kingdom completed an online survey. All self-identified as taking and sharing sexual images of themselves. 45 provided full survey responses (73% female; mean age 16.24) and of these 23 completed the second round. Recruitment was through social media and local schools.

METHODS

An online two-round Delphi method was completed using a vignettes-based questionnaire. To assess consensus, a defined average percentage agreement (80% cut-off) was used. Qualitative content analysis identified relevant themes in responses to Round 1 which informed the Round 2 items.

RESULTS

In the first round 60 items were identified that endorsed views of problem identification, facilitation of disclosure, proportionate responding, and problem management. Overall, participants agreed that the clear majority of statements identified in Round 2 were important and thus achieved consensus.

CONCLUSIONS

This study represents a novel and inclusive approach through the formation of an expert panel of young people. These views may inform appropriate victim-centered management of cases where images have been shared without permission.

"I keep hearing reports on the news that it's a real problem at the moment": Public health nurses' understandings of sexting practices among young people

Over the past decade, the potential harms regarding young people's use of technology have attracted mounting political, media and research attention worldwide. One practice engaged in by many young people is that of "sexting" and the sharing of partially, or complete nude images ("selfies"). Such images are not always retained within private spaces and are prone to be shared, with significant psychosocial consequences for young people involved. A significant risk is the hidden nature of some online interactions, with potential for grooming and child sexual exploitation. As key professionals working with young people, public health nurses have potential to educate and explore the risks with them. Yet to date, to our knowledge there has been no research in relation to public health nurses' understandings of the practices involved or their potential harms. A qualitative study was undertaken drawing theoretically on the common-sense model (CSM) to frame the analysis. Eighteen semi-structured interviews were conducted with public health nurses in a region of England in 2016. Data were analysed through thematic analysis, and mapped to the five domains of CSM. Public health nurses' understandings of young people's sexting practices were shaped largely by media reports, rather than scientific, disciplinary knowledge. Sexting did not resonate with many public health nurses' own experiences of being a young person and was therefore difficult to understand. All were able to express an opinion about the causes and consequences of sexting and we present these as a "perceived hierarchy of risk". All public health nurses acknowledged the importance of their role in dealing with harm reduction associated with sexting among young people, but they need education and support to do this effectively and confidently. Findings can be transferred carefully to many contexts and countries because sexting is a practice among young people that transcends geographical boundaries.

Sexting, Web-Based Risks, and Safety in Two Representative National Samples of Young Australians: Prevalence, Perspectives, and Predictors

BACKGROUND

The rapid uptake of information and communication technology (ICT) over the past decade-particularly the smartphone-has coincided with large increases in sexting. All previous Australian studies examining the prevalence of sexting activities in young people have relied on convenience or self-selected samples. Concurrently, there have been recent calls to undertake more in-depth research on the relationship between mental health problems, suicidal thoughts and behaviors, and sexting. How sexters (including those who receive, send, and two-way sext) and nonsexters apply ICT safety skills warrants further research.

OBJECTIVE

This study aimed to extend the Australian sexting literature by measuring (1) changes in the frequency of young people's sexting activities from 2012 to 2014; (2) young people's beliefs about sexting; (3) association of demographics, mental health and well-being items, and internet use with sexting; and (4) the relationship between sexting and ICT safety skills.

METHODS

Computer-assisted telephone interviewing using random digit dialing was used in two Young and Well National Surveys conducted in 2012 and 2014. The participants included representative and random samples of 1400 young people aged 16 to 25 years.

RESULTS

From 2012 to 2014, two-way sexting (2012: 521/1369, 38.06%; 2014: 591/1400, 42.21%; P=.03) and receiving sexts (2012: 375/1369, 27.39%; 2014: 433/1400, 30.93%; P<.001) increased significantly, not sexting (2012: 438/1369, 31.99%; 2014: 356/1400, 25.43%; P<.001) reduced significantly, whereas sending sexts (2012: n=35/1369, 2.56%; 2014: n=20/1400, 1.43%; P>.05) did not significantly change. In addition, two-way sexting and sending sexts were found to be associated with demographics (male, second language, and being in a relationship), mental health and well-being items (suicidal thoughts and behaviors and body image concerns), and ICT risks (cyberbullying others and late-night internet use). Receiving sexts was significantly associated with demographics (being male and not living with parents or guardians) and ICT risks (being cyberbullied and late-night internet use). Contrary to nonsexters, Pearson correlations demonstrated that all sexting groups (two-way, sending, and receiving) had a negative relationship with endorsing the ICT safety items relating to being careful when using the Web and not giving out personal details.

CONCLUSIONS

Our research demonstrates that most young Australians are sexting or exposed to sexting in some capacity. Sexting is associated with some negative health and well-being outcomes-specifically, sending sexts is linked to suicidal thoughts and behaviors, body image issues, and ICT safety risks, including cyberbullying and late-night internet use. Those who do sext are less likely to engage in many preventative ICT safety behaviors. How the community works in partnership with young people to address this needs to be a multifaceted approach, where sexting is positioned within a wider proactive conversation about gender, culture, psychosocial health, and respecting and caring for each other when on the Web.

The Critical Incident Technique: Method or Methodology?

The critical incident technique (CIT) is a qualitative research tool that is frequently used in health services research to explore what helps or hinders in providing good quality care or achieving satisfaction with care provision. However, confusion currently exists on the nature of the CIT: Is it a method for data collection and analysis or a methodology? In this article, I explain why this distinction is important and I argue that the CIT is a methodology (and not a method) for the following reasons: Key methodological dimensions are described for the CIT; it has a clear focus; studies that apply this technique make use of various methods for data collection and analysis; it describes, explains, evaluates, and justifies the use of a specific format for those methods; it implies philosophical and practical assumptions; and studies that use the CIT cannot easily make use of additional methodologies simultaneously.