Study protocol for a randomized controlled trial to evaluate a web-based comprehensive sexual health and media literacy education program for high school students

Abstract

Background: School-based comprehensive sexual health education can improve adolescent health outcomes, and web-based programs are a promising approach to overcoming challenges associated with teacher-led formats by ensuring that students receive content that is consistent, unbiased, and medically accurate. However, many adolescents do not receive high-quality sexual health education and turn to the media for information about sex and relationships. Consumption of sexual media messages is related to early and risky sexual behaviors. Media literacy education (MLE) is a proven approach to adolescent sexual health promotion, yet there are no rigorously evaluated web-based MLE programs to promote sexual and relationship health among high school students. Methods: This study will test the efficacy, in a randomized controlled trial, of Media Aware, a web-based comprehensive sexual health promotion program for high school students that uses an MLE approach. Participants will be students in 9th and 10th grade health classes in participating schools. Randomization will take place at the school level, and data collection will take place at three time points (i.e., pretest, posttest, and 3 months follow-up). Students in the intervention classrooms will receive Media Aware between pretest and posttest, and students in the delayed-intervention classrooms will receive Media Aware after study completion (i.e., after 3 months follow-up data collection). Students in the delayed-intervention classes will receive their standard health education programming, and teachers in the delayed-intervention classes will be asked to refrain from teaching sexual health or MLE during the study timeframe. The primary outcome variables are intentions, willingness, and behaviors related to sexual health and sexual activity. Discussion: There are currently no evidence-based comprehensive sexual health programs for high school students that are web-based and use an MLE approach. Media Aware has the potential to be an engaging, less expensive, and effective sexual and relationship health program for high school students. Media Aware is unique in two important ways: (1) the web-based format reduces many of the challenges to fidelity of implementation associated with teacher-led sexual health education; and (2) the MLE approach addresses a commonly ignored influence on adolescent sexual and relationship health, namely, media.

Brazilian transgender children and adolescents: Attributes associated with quality of life

“…Thus, when discussions about sex, gender, and sexuality are proposed in the school/educational setting, the focus is largely on issues of Sexually Transmitted Infections (STIs), means of prevention, reproductive functions, body physiology, non-desired pregnancy, contraceptive methods, among others. Consequently, sex education is reduced to reproductive and biological functions, leaving aside the associated historical, subjective, political, and socio-cultural aspects ( 36 , 42 - 43 , 45 ) .…”

“…Considering the important role of the school in the socialization of children and adolescents, it is important that issues related to sexual and gender diversity are adequately addressed and discussed in these environments (42)(43)(44) . For this, it is necessary to prepare teachers and staff to deal with these issues, as there subjective, political, and socio-cultural aspects (36,(42)(43)45) .…”

A Media Literacy Education Approach to High School Sexual Health Education: Immediate Effects of Media Aware on Adolescents’ Media, Sexual Health, and Communication Outcomes

“…An Institutional Review Board approved of the methods and measures used in this study. For detailed information on study procedures, see the protocol paper for this study (Scull, Malik, Morrison, & Keefe, 2020 ). Participating schools were randomized to either the intervention group ( n = 9 teachers; 23 classes; 478 students) and control group ( n = 8 teachers; 16 classes; 307 students).…”

“…The questionnaires were exactly the same, except for the posttest for the intervention group, which included several program evaluation questions. Example items for scaled constructs can be found in the protocol paper (Scull, Malik, Morrison, & Keefe, 2020 ).…”

“…Prior to data collection, for the sake of parsimony, two edits were made to the analysis plan previously published in the study protocol paper (Scull, Malik, Morrison, & Keefe, 2020 ): 1) perceived similarity was dropped from the outcome analyses and 2) intentions to have sexual activity was reduced from a four-item scale to the most proximal item (i.e., in the next year). In response to psychometric analyses and prior to the outcome analyses, three other variables were revised.…”