An Interactive Web-Based Sexual Health Literacy Program for Safe Sex Practice for Female Chinese University Students: Multicenter Randomized Controlled Trial

Autor: Yongda Wu, Man Ping Wang, Marie Tarrant, Herman H. M. Lo, Janet Yuen Ha Wong, Wen Zhang, Hextan Y.S. Ngan, Fei Wan Ngai, Wendy Siuyi Wong, Daniel Y. T. Fong, Edmond Pui Hang Choi, Jasmine H. M. Chio, Hau Lin Cherry Tam
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Safe Sex
medicine.medical_specialty
China
Health Knowledge
Attitudes
Practice
Adolescent
Universities
media_common.quotation_subject
Sexual Behavior
sexual health
Health Informatics
Health literacy
lcsh:Computer applications to medicine. Medical informatics
Literacy
law.invention
Sexual coercion
Condoms
03 medical and health sciences
Young Adult
0302 clinical medicine
Condom
Randomized controlled trial
law
medicine
Health belief model
Humans
030212 general & internal medicine
Child
Students
Reproductive health
media_common
Original Paper
Internet
030505 public health
business.industry
lcsh:Public aspects of medicine
lcsh:RA1-1270
women's health
Health Literacy
Sexual minority
Family medicine
lcsh:R858-859.7
eHealth
Female
sex education
0305 other medical science
business
Psychology
Internet-Based Intervention
Zdroj: Journal of Medical Internet Research
Journal of Medical Internet Research, Vol 23, Iss 3, p e22564 (2021)
ISSN: 1438-8871
1439-4456
Popis: Background Sexual health concerns among young adults worldwide help to motivate preventative practices against sexually transmitted infections. To foster better sexual health, sexual health literacy must be enhanced. Little research has been conducted on the impact of gender power dynamics on sexual health, such as sexual coercion, even though the prevalence of sexual coercion remains high in China. Objective This study describes the development and systematic evaluation of a web-based sexual health literacy intervention called “Smart Girlfriend” for female Chinese university students. Methods A multicenter randomized controlled trial was conducted with 781 female university students at 5 universities with dormitories in Hong Kong. Inclusion criteria were used to select unmarried, female, Chinese university students who were ≥18 years old and had not received a sexual health intervention in the past 12 months. Participants were randomly assigned to 2 groups: one group received an interactive web-based sexual health literacy intervention and the other group received a single webpage of online information about condom use. The intervention content was based on the Health Belief Model and the Continuum of Conflict and Control theory. The primary outcome was self-reported consistency of condom use with every partner at 3-month and 6-month follow-up assessments, analyzed using zero/one inflated beta (ZOIB) regression. The secondary outcome was an appraisal of the knowledge, attitudes, norms, and self-efficacy of condom use using the 25-item Multidimensional Condom Attitudes Scale (MCAS). The intention to treat was applied in analyses. Results Of 1503 individuals that were screened, 781 (52%) were randomized into 2 groups. The retention rates at the 3-month and 6-month follow-ups were 92% and 91%, respectively. Most participants were born locally (536/746, 72%), and 18% (134/746) self-reported as a sexual minority. ZOIB results regarding the consistency of condom use were not significant [model 1: odds ratio (OR) 2.25 with a 95% credible interval (CrI) of 0.84-6.36; model 2: OR 8.03 (95% CrI 0.22-330.31); model 3: OR 1.21 (95% CrI 0.78-1.86)]. Consistency in the intervention group was 5% higher (95% CI −1.90 to 11.63) than the control group at the 3-month follow-up, and 1% higher (95% CI −5.81 to 8·02) at the 6-month follow-up. MCAS scores at the 3-month follow-up were significantly higher in the intervention group (mean 122.51, SD 15.97) than the control group (mean 119.86, SD 15.85; P=.02). Conclusions An interactive web-based sexual health literacy program did not significantly increase the consistency of condom use compared to a single webpage of condom use information; however, it did temporarily improve knowledge, attitudes, norms, and self-efficacy regarding condom use. Future revisions of this intervention should be personalized and delivered with a proactive approach. Trial Registration ClinicalTrials.gov NCT03695679; https://clinicaltrials.gov/ct2/show/NCT03695679
Databáze: OpenAIRE
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