Innovatively Supporting Teachers' Implementation of School-Based Sex Education: Developing A Web-Based Coaching Intervention From Problem to Solution.

BACKGROUND: Full program implementation is crucial for effectiveness but is often overlooked or insufficiently considered during development of behavioral change interventions. For school-based health promotion programs, teachers are key players in program implementation, but teacher support in this phase is mostly limited to technical support and information. To ensure optimal implementation of the Dutch school-based sexual health program Long Live Love, a Web-based coaching website was developed to support teachers in completeness and fidelity of program implementation. OBJECTIVE: The aim of this paper is to provide insight into the process of systematic development of a Web-based coaching intervention to support teachers in their implementation of a school-based sexual health program. METHODS: The intervention mapping (IM) protocol was applied for the development of a theory- and evidence-based intervention. The IM process begins with (1) a needs assessment, followed by (2) the formulation of change objectives, (3) the selection of theory-based intervention methods and practical applications that take the parameters for effectiveness into consideration, (4) integration of practical applications into an organized program, (5) planning for adoption, implementation, and sustainability of the program, and finally, (6) generating an evaluation plan to measure program effectiveness. RESULTS: Teacher's implementation behavior was characterized by inconsistently selecting parts of the program and not delivering (all) lessons as intended by program developers. Teachers, however, did not perceive this behavior as problematic, revealing the discrepancy between teacher's actual and perceived need for support in delivering Long Live Love lessons with completeness and fidelity. Teachers did, however, acknowledge different difficulties they encountered which could potentially negatively influence the quality of implementation. With the IM protocol, this Web-based coaching intervention was developed based on a concept of unobtrusive coaching, by and for teachers, to bring about change in teachers' implementation behavior. CONCLUSIONS: This paper provides an example of a Web-based intervention to bring about behavioral change in a target group of intermediaries who lack intrinsic motivation for coaching and who's perceptions differ from their actual problematic behavior. The IM protocol is a useful tool for guiding the scientific development of interventions and making them compatible with the needs and preferences of the target group.

Sexuality Education in the Digital Era: Intrinsic and Extrinsic Predictors of Online Sexual Information Seeking Among Youth.

This study aimed to identify demographic, intrinsic and extrinsic predictors of youth's online sexual information seeking. We used survey data from a large, representative sample of youth (12-24 years) in the Netherlands (N = 20,500). We focused on online sexual information seeking in general, and on two specific types of online sources: interactive user-generated content (UGC) and professional sexuality education content. Findings suggested that LGB youth and youth with more sexual knowledge were more likely to consult sexual information online, both via UGC and via professional websites about sex. Professional content specifically reaches female youth more than male youth, and is more likely to be consulted by youth with more sexual experience and sexual problems. Further, being male, having low sexual esteem and high sexual curiosity were linked to a higher use of interactive UGC. Finally, only communication with friends about sex, but not with parents or partners, nor the amount and appreciation of school-based sexuality education received, was related to a higher use of online sexual information seeking, notably expert sources of sexual information.

[Sex under the age of 25 in 2017: the sexual health of young people in the Netherlands]. / Onderzoek 'Seks onder je 25e 2017'.

OBJECTIVE: To gain insight in the sexual health of young people aged 12 to 25 in the Netherlands. Municipal health services and other stakeholders in the area of the promotion of sexual health were involved in various phases of this study, the results of which can be applied better to maintaining or improving the sexual health of young people. DESIGN: Large-scale representative study with a cross-sectional design which was previously conducted in 2005 and 2012. METHOD: We used data from students in secondary education (aged 12-16 years) as well as data from a sample drawn from the municipal population registers (aged 17-24 years). Fifteen municipal health services recruited extra respondents from their own regions, so that they obtained reliable and representative figures on the sexual health of young people at a local level. This investment also led to a total of 20,500 young people filling in a digital questionnaire containing questions on a wide range of sexuality-related topics. RESULTS: The study shows that young people are having their first sexual experiences at a later age and protect themselves well against pregnancy. New developments were also apparent in the use of online media for 'sexting' and meeting partners. Condom use was low, particularly with casual partners, and despite a reduction in sexual violence it still occurs too frequently. CONCLUSION: Sexual health among young people is generally good, but there are still concerns. The findings of this study were discussed with professionals working in the field of young people and sexual health. Their recommendations on interventions, care and policy resulting from these discussions will be included in a national action plan.

Offline and Online Sexual Risk Behavior among Youth in the Netherlands: Findings from "Sex under the Age of 25".

Sexually developing adolescents and emerging adults face sexual health risks as well as potentially negative outcomes of online sexual behaviors. The goal of this study was to describe three categories of sexual risk behavior: (1) behavior related to STI/HIV, (2) behavior related to unplanned pregnancy, and (3) online sexual risk behavior. In addition, we investigated whether these behaviors are actually related to negative (health) outcomes. For this purpose, we used data from a Dutch probability survey: "Sex under the age of 25." Adolescents and emerging adults aged 12 through 24 (8,053 boys and 12,447 girls) completed a digital questionnaire, including measures of the risk of STI/HIV and pregnancy, online sexual behavior and non-consensual sex. Chi-square tests and logistic regressions were used to test for gender and age differences and compute associations between risk behavior and negative outcomes. The results showed that the risk of unplanned pregnancy is low in the Netherlands. It seems that adolescents and emerging adults are less aware of the risk of STI/HIV than of the risk of pregnancy. About 11% of the participants had had more than one partner in the last 6 months and had not used condoms consistently with their last partner, and these participants had a 3.56 times higher likelihood of ever being diagnosed with an STI. Although many young people stop using condoms with their partner after a while, most of them did not get tested for STIs. More emerging adults (aged 18-24) engage in sexting (sending personal nude pictures and sex videos to others), but the chance that these images are shared with other people than the intended recipient is higher among adolescents (aged 12-17). The results of this study can guide professionals working in sex education and sexual health services to focus their efforts on the risk behaviors in the Netherlands that deserve most attention.