Evaluation of a Brief Online Sexual Health Program for Adolescents: A Randomized Controlled Trial.

Adolescents are at increased risk of acquiring sexually transmitted infections (STIs) and experiencing unintended pregnancy. In particular, adolescents from marginalized communities experience significant sexual health disparities compared to their more advantaged peers. Digital sexual health programs, such as HEART (Health Education and Relationship Training), may be effective in reducing these risks and addressing these disparities. HEART is a web-based intervention focused on the promotion of positive sexual health outcomes, such as sexual decision-making skills, sexual communication skills, sexual health knowledge, and sexual norms and attitudes. The current study evaluates the efficacy of HEART, and examines whether effects were moderated by gender, socioeconomic status (SES), race, English as a second language, and sexual orientation to ensure the program is effective for diverse groups of adolescents. Participants were 457 high school students (Meanage=15.06, 59% girls, 35% White, 78% heterosexual, 54% receive free or reduced-price lunch). Students were randomized to HEART or an attention matched control and assessed at pretest and immediate posttest. HEART was effective in increasing sexual assertiveness, sexual communication intentions, HIV/STI knowledge, condom attitudes, and safer sex self-efficacy compared to the control condition. There were no significant interactions by gender, SES, race, English as a second language, or sexual orientation, suggesting the program worked equally well for all groups of youth. The findings of this study suggest that HEART may be a promising avenue for the promotion of positive sexual health outcomes for diverse groups of youth.

Associations between parental and adolescent alcohol use: The role of gender and familism support.

INTRODUCTION: This study examined the role of gender and familism support in the associations between parental and adolescent drinking behaviors in a sample of Mexican adolescents. METHOD: Mexican adolescents (49% girls; N = 724) aged 12-19 completed measures assessing familism support, self-reported drinking behaviors, and perceptions of parental drinking behaviors. RESULTS AND CONCLUSION: Findings suggest that both gender and familism support moderate the relationship between parental drinking behaviors and adolescent drinking behaviors. For instance, the association between mothers' alcohol use frequency and adolescent binge drinking was stronger for girls. In contrast, the association between fathers' amount per drinking day and adolescent binge drinking was stronger for boys. Mother's amount per drinking day was associated with less alcohol use per drinking day among adolescents reporting high familism support. The current study expands our understanding of parental modeling on Mexican adolescent drinking behavior.

Adolescent Barriers to Sexual Communication with Their Parents: Differences by Sexual and Gender Identity.

Parent-adolescent sexual communication has important health benefits for adolescents, yet not all families openly communicate about sex. In particular, adolescents often report various barriers to engaging in sexual communication with their parents. The purpose of this study was to address gaps in past research by examining barriers to communication with both mothers and fathers, separately, as well as to explore the unique barriers to communication among queer and trans adolescents. Participants were recruited via Instagram (n = 566; Mage = 16.0; 57.6% cisgender girls; 41.4% heterosexual). The most endorsed barrier to communicating with mothers was the adolescent believing they already knew enough about sexual topics. The most endorsed barrier for communicating with fathers was embarrassment. The least endorsed barriers included mother's lack of knowledge, and perceptions of anger from fathers when discussing sexuality. Several differences emerged by sexual and gender identity: cisgender girls and trans adolescents tended to agree more with barriers to communication with parents compared to cisgender boys. Additionally, queer adolescents tended to agree more with barriers to communication with parents than their heterosexual peers, although group differences depended on the particular barrier. These findings highlight specific barriers to parent-adolescent sexual communication faced by various groups of youth.

PACT: Developing and Evaluating a Digital Sexual Consent Program for Youth.

Understanding affirmative sexual consent is crucial for violence prevention and health promotion, yet few adolescents receive adequate consent education. The current study aimed to evaluate the acceptability and preliminary efficacy of a brief online program designed to teach adolescents information and skills about communicating and interpreting affirmative sexual consent (PACT: Promoting Affirmative Consent among Teens) in a randomized controlled trial with a national sample of 833 U.S. adolescents (ages 14-16; 42% White, 17% Asian, 17% Black, 13% Latinx; 53% girls, 31% boys, 12% non-binary; 45% heterosexual; 29% sexually active). PACT, grounded in health behavior change and persuasion theories, was developed using feedback from youth advisors and usability testers. Participants considered the program generally acceptable. Compared to youth who completed a control program, PACT was efficacious at shifting three measures of affirmative consent cognitions (i.e., knowledge, attitudes, self-efficacy) from baseline to immediate posttest. Youth who completed PACT also demonstrated more accurate affirmative consent knowledge at 3 months post-baseline. PACT's effects on consent cognitions were generally similar among youth with various gender, racial/ethnic, and sexual identities. We discuss next steps for this program, including the possibilities of expanding to include additional concepts and tailoring to address the unique needs of specific youth.

National trends and disparate access to formal and informal sex education among youth involved with the child welfare system in the USA.

This study aimed to understand whether youth involved with the child welfare system in the USA are receiving formal and informal sex education. Data come from the Second National Survey of Child and Adolescent Wellbeing, a nationally representative sample of children and adolescents in contact with child protective services. Participants included young people (n=1093, aged 11-21) involved with the child welfare system. Participants reported whether they had received formal sex education about a) abstinence only; b) contraceptives/condoms only; c) abstinence and contraceptives/condoms; or d) none. They also reported whether they knew where to access family planning services. We examined the prevalence of sex education experiences and differences in sex education access and knowledge based on participants' pregnancy history and sociodemographic characteristics. Only half (49%) of participants had received any form of formal sex education. Pregnant youth were less likely to have received any sex education compared to non-pregnant youth (p=.045). 72% of adolescents who had received sex education about contraceptives/condoms reported knowing where to access family planning services compared to only 46% of adolescents who had not received sex education about contraceptives/condoms (p=.014). There is a pressing need for comprehensive sex education among young people involved with the child welfare system in the USA.

An Internship Approach to Strengthen the Pathway for Historically Underrepresented Groups in Health Sciences Research: The North Carolina Diversity and Inclusion Pathway Program.

BACKGROUND: To increase engagement of historically underrepresented groups in health sciences research, we created the North Carolina Diversity and Inclusion Pathway Program (NC-DIPP). This year-long, paid internship provides undergraduate and graduate students from 2 historically Black colleges and universities an opportunity to gain real-world experience under the mentorship of expert faculty. METHODS: To evaluate the early experiences with the NC-DIPP program, we conducted semi-structured interviews with interns and program leaders. Faculty mentors completed an online questionnaire to describe their experiences to date. A thematic approach was used to analyze the findings. RESULTS: In March-April 2023, 7 of 8 interns (88%), 6 of 11 mentors (54%), and 4 of 4 program leaders (100%) participated in various evaluation components. Overall, respondents agreed about the importance of programs like NC-DIPP, which further engage historically underrepresented groups in the health sciences. Interns had positive feedback about the internship, including real-world work experience, connections to experienced mentors, and early career planning. On a scale of 1 (poor) to 10 (excellent), interns rated their experience as a median of 8.3 (range: 4.5-10.0). Mentors had favorable but slightly lower scores (median: 7.0, range: 5.0-8.0). Areas for improvement were noted, including clearer expectations, improved logistical support, and central engagement of interns across projects. CONCLUSIONS: This early evaluation of NC-DIPP was generally favorable across all stakeholder groups. By providing a long-term experience in health science research, such programs can contribute to work experience, career planning, and professional networking.

Patterns of Sexual Well-Being in Mexican Adolescents and Associations with Psychological Adjustment: A Latent Profile Analysis Approach.

We examined Mexican adolescent sexual well-being tasks, defined as the positive cognitive and emotional evaluations of one's sexuality. We assessed three dimensions: acceptance of sexual desire, sexual decision-making involving mutual consent, and, when sexually active, the practice of safe sex. We utilized a person-centered approach to examine how patterns marked by different aspects of sexual well-being predict psychological adjustment. Participants were 1123 Mexican high or middle school (72%) students (54% girls; Mage = 15.1, SD = 1.52). We found a 6-profile model: 1) Average Sexual Health (40%); 2) High Protective Low Acceptance (20%); 3) Multidimensional Healthy (19%); 4) Multidimensional Risky (11%); 5) High Acceptance Low Contraception and Consent (6%); and 6) High Consent Low Contraception (4%). These profiles included some adolescents who experienced both low and high sexual scores on different sexual well-being indicators. For example, adolescents who belonged to the High Protective, Low Acceptance profile understood the importance of safe sex and mutual consent; but still felt sexual guilt. Profile membership was associated with gender, religion, age, and sexual experience. Adolescents in classes marked by high levels of well-being reported high levels of psychological adjustment. Findings may help educators develop more targeted sexual risk and violence prevention programs.