Study of Long-term Efficacy and Mechanisms Underlying the Impact of a Web-based Sexual and Relationship Health Promotion Program With Young Adult Community College Students
- Conditions
- Sexual BehaviorViolence, DomesticSexual Assault
- Registration Number
- NCT04950686
- Lead Sponsor
- Innovation Research & Training
- Brief Summary
Community college students are an underserved and at-risk population in terms of their sexual and relationship health. This is a three-arm randomized control trial to evaluate the long-term efficacy of a web-based sexual and relationship health promotion program among U.S. community college students (expected N = 2010) and explore the mechanisms underlying the program efficacy.
- Detailed Description
Community college students are an underserved and at-risk population in terms of their sexual and relationship health. One promising avenue for improving sexual decision making among this population is media literacy education (MLE). Though studies show MLE is an effective approach to sexual health promotion there is a need to better understand the mechanisms by which MLE programs impact health outcomes. The ultimate goals of this study are to 1) advance theoretical frameworks of media literacy to better understand the underlying mechanisms that lead to sexual health behavior change and 2) enhance the sexual and relationship health of community college students by identifying successful methods of health promotion and strategies to implement health programs at community colleges. This study is a three-arm randomized control trial (RCT) with 2010 community college students (ages 18-19) from 30 colleges across the U.S. All components of this study (i.e., interventions, surveys) are web-based.
Participating students will be randomized to one of three conditions: 1) students who receive a sexual health program grounded in MLE (Media Aware); 2) students who receive a sexual health program with no MLE; and 3) a wait-list control group. Participants will complete pretest, posttest, 6-month follow-up, and 12-month follow-up surveys to examine changes across the three groups in our primary outcomes (e.g., risky sexual behavior) and secondary outcomes (e.g., sexual health knowledge, rape myth acceptance, perceived realism of media messages).
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 2184
- Students must be 18 or 19 years of age.
- Students must attend one of the community colleges from which this study is recruiting participants.
- Students must have an email address to receive study communication.
- Students must have access to a computer, tablet, or phone device with internet access as the questionnaires and programs are web-based.
- Students must be able to speak and read English because the study materials (e.g., questionnaires, programs) are in English.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Frequency of condom use during vaginal sex 12-month follow-up 3-items used to calculate change in frequency of condom use during vaginal sex \[e.g., "In the past month, how often did you or your partner(s) use a condom when having vaginal sex?"\]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always); higher scores indicate more frequent condom use; Only participants who indicated they had had sex responded to these items.
Frequency of birth control use 12-month follow-up 3-items used to calculate change in frequency of birth control use \[e.g., "In the past month, how often did you or your partner(s) use one of the following forms of birth control? Birth control pills, The Shot (DepoProvera), The Patch, The Ring (Nuvaring), IUD (Mirena, Paraguard, Skyla), The Implant (Implanon, Nexplanon), or other FDA approved methods."\]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always); higher scores indicate more frequent birth control use; Only participants who indicated they had had sex responded to these items.
Contraceptive use at last vaginal sex 12-month follow-up 1-item ("Did you use any contraceptive method the last time you had vaginal sex?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had sex responded to this item
Relationship satisfaction 12-month follow-up 7-items (e.g., "How well does your partner meet your needs?"; Hendrick, 1988); rated on a 5-point Likert-type scale from 1 (poorly) to 5 (extremely well); higher scores indicate greater relationship satisfaction; range = 1-5; Only participants who indicated they were currently in a relationship responded to these items.
Relationship violence perpetration 12-month follow-up 10-items (e.g., "I spoke to my partner in a hostile or mean tone of voice."; adapted from Wolfe et al., 2001); Participants were asked to rate how often these things happened with their current or ex-dating partner in the last 6 months (and at pretest and 4-week posttest, in the last month) on a 4-point Likert-type scale from 1 (never) to 4 (often); higher scores indicate more frequent relationship violence; range = 1-4; Only participants who indicated they were currently in a relationship responded to these items.
Risky sexual behaviors 12-month follow-up 4-items (e.g., How many times have you had oral, vaginal, or anal sex with a casual partner?; Turchik, 2007); Participants were asked to report how many times each behavior happened in the last 6 months (and at pretest and 4-week posttest, in the last month); higher scores indicate greater sexual risk taking; Only participants who indicated they had had sex responded to these items.
Use of protection at last oral sex 12-month follow-up 1-item ("Did you use a condom and/or dental dam the last time you had oral sex?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had sex responded to this item
Condom use at last anal sex 12-month follow-up 1-item ("Did you use a condom during your last anal intercourse?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had sex responded to this item
Relationship violence victimization 12-month follow-up 10-items (e.g., "My partner spoke to me in a hostile or mean tone of voice"; adapted from Wolfe et al., 2001); Participants were asked to rate how often these things happened with their current or ex-dating partner in the last 6 months (and at pretest and 4-week posttest, in the last month) on a 4-point Likert-type scale from 1 (never) to 4 (often); higher scores indicate more frequent relationship violence; range = 1-4; Only participants who indicated they were currently in a relationship responded to these items.
Frequency of use of protection during oral sex 12-month follow-up 3-items used to calculate change in frequency of use of protection during oral sex \[e.g., "In the past month, how often did you or your partner(s) use a condom or dental dam when having oral sex?"\]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always); higher scores indicate more frequent use of protection; Only participants who indicated they had had sex responded to these items.
Frequency of condom use during anal sex 12-month follow-up 3-items used to calculate change in frequency of condom use during anal sex \[e.g., "In the past month, how often did you or your partner(s) use a condom when having anal sex?"\]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always); higher scores indicate more frequent condom use; Only participants who indicated they had had sex responded to these items.
Identity abuse 12-month follow-up 7-items (e.g., "My partner threatened to tell my employer, family, or others about my sexual orientation or gender identity"; Woulfe \& Goodman, 2018); Participants were asked to rate how often these things happened in the last 6 months (and at pretest and 4-week posttest, in the last month) on a 7-point Likert-type scale from 0 (never) to 6 (more than 20 times); higher scores indicate more frequent identity abuse; range = 0-7; Only participants who indicated they were currently in a relationship AND they were not heterosexual responded to these items.
- Secondary Outcome Measures
Name Time Method Gender role norms 12-month follow-up 6-items (e.g., "Raising children is primarily a woman's responsibility"; adapted from Foshee et al., 2005); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate more traditional gender role norms; range = 1-4
Intent to intervene as bystander 12-month follow-up 4-items (e.g., "Approach a friend if I thought they were in an abusive relationship and let them know that I am here to help"; Banyard, 2008); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to intervene as a bystander; range = 1-4
Perceived media message completeness 12-month follow-up 1-item ("How complete is the information in this advertisement?"; Scull et al., 2019); Participants view an advertisement and then answer questions about the advertisement on a 4-point Likert-type scale from 1 (incomplete) to 4 (complete); higher scores indicate less critical media analysis; range = 1-4
Identification with media 12-month follow-up 3-items (e.g., "I want to do the things that people my age in the media do"; adapted from Austin and Johnson, 1997); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants identify more with media; range = 1-4
Media skepticism 12-month follow-up 6-items (e.g., "The media are dishonest about what happens when people drink alcohol"; Scull et al., 2014, 2018); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants have more media skepticism; range = 1-4
Attitudes toward risky sexual behaviors 12-month follow-up 5-items (e.g., "It is okay to...have sex with someone who has had many sexual partners"; adapted from Turchik \& Garske, 2009); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards risky sexual behaviors; range = 1-4
Self-efficacy to refuse unprotected sex 12-month follow-up 1-item ("I can easily say 'no' to sex if we do not have protection even if I really want to have sex with that person"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to refuse unprotected sex; range = 1-4
Perceived similarity to media messages 12-month follow-up 7-items (e.g., "The things I do in my life are similar to what I see in the media"; adapted from Austin and Johnson, 1997); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater perceived similarity; range = 1-4
Dating violence norms 12-month follow-up 4-items (e.g., "It is OK for people to hit their girlfriends/boyfriends/partners if they did something to make them mad"; adapted from Foshee et al., 2005); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate worse dating violence norms; range = 1-4
Sex refusal self-efficacy 12-month follow-up 5-items (e.g., "I can easily say 'no' to someone who is pressuring me to have sex"; Soet, Dudley, \& Dilorio, 1999); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater sex refusal self-efficacy; range = 1-4
Self-efficacy to use protection 12-month follow-up 2-items (e.g., "I can use a condom correctly or explain to my partner how to use a condom correctly"; Soet, Dudley, \& Dilorio, 1999); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to use protection; range = 1-4
Risky sexual behavior intentions 12-month follow-up 5-items (e.g., "In the next 6 months, how likely is it that you will have oral, anal, or vaginal sex with a casual partner"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to engage in risky sexual behaviors; range = 1-4
Injunctive norms - friends 12-month follow-up 2-items (e.g., "My friends think I should use protection when I have sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores less risky injunctive norms; range = 1-4
Self-efficacy to communicate with partners and medical professionals about sex 12-month follow-up 4-items (e.g., "I can discuss preventing STIs with my partner"; Soet, Dudley, \& Dilorio, 1999); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to communicate; range = 1-4
Cognitive elaboration of advertisement 12-month follow-up 3-items (e.g., "How much time did you spend thinking about this advertisement?"; adapted from Shiv, Edell Britton, \& Payne, 2004); Participants view an advertisement and then answer questions about the advertisement on a 4-point Likert-type scale from 1 (not much at all) to 4 (a lot); higher scores indicate more cognitive elaboration; range = 1-4
Perceived realism of media messages 12-month follow-up 6-items (e.g., "People my age in the media...have sexual contact as often as average people my age"; adapted from Austin and Johnson, 1997); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants think media is more realistic; range = 1-4
Efficacy to intervene as bystander 12-month follow-up 5-items (e.g., "I could talk to a friend who I suspected is in an abusive relationship"; Banyard et al., 2005); participants rate their confidence that they could do the action on a scale from 0-100; higher scores indicate greater bystander efficacy; range = 0-100
Attitudes toward contraception/protection 12-month follow-up 9-items (e.g., "It is wrong to use birth control"; adapted from Turchik \& Garske, 2009); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate more favorable attitudes towards contraception; range = 1-4
Attitudes toward communication with partners and medical professionals 12-month follow-up 4-items (e.g., "Before deciding to have sex, people should...talk with their partner about HIV/AIDS and other STIs"; Scull et al., 2018); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards communication; range = 1-4
Descriptive norms of risky sexual activity 12-month follow-up 5-items (e.g., "What percentage of people your age...have had oral, anal, or vaginal sex with someone who has not been tested for STIs or whose STI status is unknown?"); participants write in their estimate of what percentage of their peers are engaging in each behavior; higher scores indicate participants think more of their peers are engaging in risky contraception use/protection practices; range = 0-100
Rape myth acceptance 12-month follow-up 13-items (e.g., "If a girl is raped while she is drunk, she is at least somewhat responsible for letting things get out of hand"; McMahon \& Farmer, 2011); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater rape myth acceptance; range = 1-4
Descriptive norms of unprotected sex 12-month follow-up 1-item (e.g., "What percentage of people your age have had unprotected sex?"); participants write in their estimate of what percentage of their peers are engaging in the behavior; higher scores indicate participants think more of their peers are engaging in unprotected sex; range = 0-100
Intentions to have unprotected sex 12-month follow-up 1-item ("In the next 6 months, how likely is it that you will...have unprotected sex?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to have unprotected sex; range = 1-4
Sexual health knowledge 12-month follow-up 23-items (e.g., "True or False: You can tell if someone has an STI by looking at him/her"; Scull et al., 2018); For each item, participants who answer correctly will receive a "1" and participants who answer incorrectly will receive a "0"; items will be summed; higher scores indicate greater sexual health knowledge; range = 0-23
Attitudes toward unprotected sex 12-month follow-up 1-item \["It is okay to...have unprotected sex (not including when people are trying to get pregnant)"\]; rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards unprotected sex; range = 1-4
Intentions to use protection/contraception 12-month follow-up 3-items (e.g., "If you were to decide to have sexual intercourse in the next 6 months, how likely would you be to...use a condom?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to use protection/contraception; range = 1-4
Willingness to have unprotected sex 12-month follow-up 1-item (e.g., "Suppose you were with your boyfriend/girlfriend/partner. He/she wants to have sex, but neither of you have any form of protection. In this situation, how willing would you be to go ahead and have sex anyway?"; adapted from Gibbons, Gerrard, Blanton, \& Russell, 1998); rated on a 4-point Likert-type scale from 1 (very unwilling) to 4 (very willing); higher scores indicate greater willingness to have unprotected sex; range = 1-4
Willingness to engage in risky sexual behaviors 12-month follow-up 5-items (e.g., "Suppose you wanted to have sex with someone but you did not know their STI status. In this situation, how willing would you be to have sex anyway?"; adapted from Gibbons, Gerrard, Blanton, \& Russell, 1998); rated on a 4-point Likert-type scale from 1 (very unwilling) to 4 (very willing); higher scores indicate greater willingness to engage in risky sexual behaviors; range = 1-4
Advertisement deconstruction skills 12-month follow-up Participants are shown an advertisement and asked to describe it in detail including noting marketing strategies and any missing information (e.g., How are advertisers trying to get someone to buy this product?). Qualitative responses to the questions are coded by trained project staff members once inter-coder reliability is established, and scores will be summed to create an overall deconstruction skills composite variable. (adapted from Kupersmidt, Scull, \& Benson, 2012)
Injunctive norms - most people 12-month follow-up 3-items (e.g., "Most people believe that it is okay for people my age to have unprotected sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate riskier injunctive norms; range = 1-4
Frequency of communication with sexual partner 12-month follow-up 6-items used to calculate change in frequency of sexual communication with a partner(s) \[e.g., "In the past month, how often did you talk to your partner(s) about...sexually transmitted infections (STIs)?"\]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always); higher scores indicate more frequent communication; Only participants who indicated they had had sex responded to these items.
Intentions to communicate with partners and medical professionals about sex 12-month follow-up 6-items (e.g., "If you were to decide to engage in sexual activity with a new partner in the next 6 months, how likely would you be to...talk with a partner about HIV/AIDS or other STIs?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to communicate; range = 1-4
Descriptive norms - people like me 12-month follow-up 1-item ("Most people like me use protection when they have sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores less risky descriptive norms; range = 1-4
Frequency of communication with doctor 12-month follow-up 3-items used to calculate change in whether participants communicated with a doctor about sex \[e.g., "In the past month, had you talked to a doctor or other medical professional about sex, contraception, and/or relationships?"\]; participants answered "yes" (1) or "no" (0)
Trial Locations
- Locations (1)
innovation Research and Training
🇺🇸Durham, North Carolina, United States
innovation Research and Training🇺🇸Durham, North Carolina, United States