Skip to main content
Top
Published in: Trials 1/2020

01-12-2020 | Study protocol

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

Authors: Tracy M. Scull, Christina V. Malik, Abigail Morrison, Elyse M. Keefe

Published in: Trials | Issue 1/2020

Login to get access

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.

Trial registration

ClinicalTrials.gov, NCT04035694. Registered on 29 July 2019.
Contact for Scientific Queries: Tracy Scull, PhD (Principal Investigator); innovation Research & Training at 5316 Highgate Drive, Suite 121, Durham, North Carolina, USA 27713; tscull@irtinc.​us.
Appendix
Available only for authorised users
Literature
1.
go back to reference Kirby D, Laris BA. Effective curriculum-based sex and STD/HIV education programs for adolescents. Child Dev Perspect. 2009;3(1):21–9.CrossRef Kirby D, Laris BA. Effective curriculum-based sex and STD/HIV education programs for adolescents. Child Dev Perspect. 2009;3(1):21–9.CrossRef
2.
go back to reference Kirby D, Laris BA, Rolleri LA. Sex and HIV education programs for youth: their impact and important characteristics. Scotts Valley: Family Health International; 2006. Kirby D, Laris BA, Rolleri LA. Sex and HIV education programs for youth: their impact and important characteristics. Scotts Valley: Family Health International; 2006.
3.
go back to reference Schalet AT, Santelli JS, Russell ST, Halpern CT, Miller SA, Pickering SS, et al. Invited commentary: broadening the evidence for adolescent sexual and reproductive health and education in the United States. J Youth Adolesc. 2014;43(10):1595–610.PubMedPubMedCentralCrossRef Schalet AT, Santelli JS, Russell ST, Halpern CT, Miller SA, Pickering SS, et al. Invited commentary: broadening the evidence for adolescent sexual and reproductive health and education in the United States. J Youth Adolesc. 2014;43(10):1595–610.PubMedPubMedCentralCrossRef
6.
go back to reference Kann L, Telljohann SK, Hunt H, Hunt P. Health Education: results from the School Health Policies and Practices Study. Washington, DC.: Centers for Disease Control: Division of Adolescent and School Health; 2012. Kann L, Telljohann SK, Hunt H, Hunt P. Health Education: results from the School Health Policies and Practices Study. Washington, DC.: Centers for Disease Control: Division of Adolescent and School Health; 2012.
8.
go back to reference Shipman C, Kay K. The confidence code for girls. New York: HarperCollins; 2018. p. 1–9. Shipman C, Kay K. The confidence code for girls. New York: HarperCollins; 2018. p. 1–9.
9.
go back to reference Reidy DE, Brookmeyer KA, Gentile B, Berke DS, Zeichner A. Gender role discrepancy stress, high-risk sexual behavior, and sexually transmitted disease. Arch Sex Behav. 2016;45(2):459–65.PubMedCrossRef Reidy DE, Brookmeyer KA, Gentile B, Berke DS, Zeichner A. Gender role discrepancy stress, high-risk sexual behavior, and sexually transmitted disease. Arch Sex Behav. 2016;45(2):459–65.PubMedCrossRef
10.
go back to reference Espelage DL, Merrin GJ, Hatchel T. Peer victimization and dating violence among LGBTQ youth. Youth Violence Juvenile Justice. 2016;16(2):156–73.CrossRef Espelage DL, Merrin GJ, Hatchel T. Peer victimization and dating violence among LGBTQ youth. Youth Violence Juvenile Justice. 2016;16(2):156–73.CrossRef
11.
go back to reference Hayes RM, Abbott RL, Cook S. It's her fault: student acceptance of rape myths on two college campuses. Violence Against Women. 2016;22(13):1540–55.PubMedCrossRef Hayes RM, Abbott RL, Cook S. It's her fault: student acceptance of rape myths on two college campuses. Violence Against Women. 2016;22(13):1540–55.PubMedCrossRef
12.
go back to reference Shapiro S, Brown C. Sex education standards across the states. Washington, DC: Center for American Progress; 2018. Shapiro S, Brown C. Sex education standards across the states. Washington, DC: Center for American Progress; 2018.
14.
go back to reference PPFA. Consent survey results summary. New York: Planned Parenthood Federation of America Inc.; 2016. PPFA. Consent survey results summary. New York: Planned Parenthood Federation of America Inc.; 2016.
15.
go back to reference Smith SG, Zhang X, Basile KC, Merrick MT, Wang J, Kresnow M, et al. The National Intimate Partner and Sexual Violence Survey: 2015 data brief - updated release. Atlanta: National Center for Injury Prevention and Control and Centers for Disease Control and Prevention; 2018. Smith SG, Zhang X, Basile KC, Merrick MT, Wang J, Kresnow M, et al. The National Intimate Partner and Sexual Violence Survey: 2015 data brief - updated release. Atlanta: National Center for Injury Prevention and Control and Centers for Disease Control and Prevention; 2018.
16.
go back to reference Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Queen B, et al. Youth risk behavior surveillance - United States, 2017. Surveillance Summ. 2018;67(8):1–114.CrossRef Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Queen B, et al. Youth risk behavior surveillance - United States, 2017. Surveillance Summ. 2018;67(8):1–114.CrossRef
17.
go back to reference Wingood GM, DiClemente RJ, McCree DH, Harrington K, Davies SL. Dating violence and the sexual health of black adolescent females. Pediatrics. 2001;107(5):E72.PubMedCrossRef Wingood GM, DiClemente RJ, McCree DH, Harrington K, Davies SL. Dating violence and the sexual health of black adolescent females. Pediatrics. 2001;107(5):E72.PubMedCrossRef
18.
go back to reference Healthy Sexuality Education as Child Sexual Abuse Prevention. Enola: Pennsylvania Coalition Against Rape; 2016. Healthy Sexuality Education as Child Sexual Abuse Prevention. Enola: Pennsylvania Coalition Against Rape; 2016.
19.
go back to reference Crawford-Jakubiak JE, Alderman EM, Leventhal JM, Committee on Child Abuse and Neglect, AAA Committee on Adolescence. Care of the adolescent after an acute sexual assault. Pediatrics. 2017;139(3):e20164243.PubMedCrossRef Crawford-Jakubiak JE, Alderman EM, Leventhal JM, Committee on Child Abuse and Neglect, AAA Committee on Adolescence. Care of the adolescent after an acute sexual assault. Pediatrics. 2017;139(3):e20164243.PubMedCrossRef
20.
go back to reference Leonardi M, Frecker H, Scheim AI, Kives S. Reproductive health considerations in sexual and/or gender minority adolescents. J Pediatr Adolesc Gynecol. 2019;32(1):15–20.PubMedCrossRef Leonardi M, Frecker H, Scheim AI, Kives S. Reproductive health considerations in sexual and/or gender minority adolescents. J Pediatr Adolesc Gynecol. 2019;32(1):15–20.PubMedCrossRef
21.
go back to reference Rideout V. The Common Sense census: media use by tweens and teens. San Francisco: Common Sense Media, Inc.; 2015. Rideout V. The Common Sense census: media use by tweens and teens. San Francisco: Common Sense Media, Inc.; 2015.
22.
go back to reference Ward LM, Erickson SE, Lippman J, Giaccardi S. Sexual media content and effects. In: Nussbaum JF, editor. Oxford Research Encyclopedia of Communication. Oxford: Oxford University Press; 2016. Ward LM, Erickson SE, Lippman J, Giaccardi S. Sexual media content and effects. In: Nussbaum JF, editor. Oxford Research Encyclopedia of Communication. Oxford: Oxford University Press; 2016.
23.
go back to reference Ward LM. Media and sexualization: state of empirical research, 1995–2015. J Sex Res. 2016;53(4/5):560–77.PubMedCrossRef Ward LM. Media and sexualization: state of empirical research, 1995–2015. J Sex Res. 2016;53(4/5):560–77.PubMedCrossRef
24.
go back to reference Brown JD, Bobkowski PS. Older and newer media: patterns of use and effects on adolescents' health and well-being. J Res Adolesc. 2011;21(1):95–113.CrossRef Brown JD, Bobkowski PS. Older and newer media: patterns of use and effects on adolescents' health and well-being. J Res Adolesc. 2011;21(1):95–113.CrossRef
25.
go back to reference Brown JD, Halpern CT, L'Engle KL. Mass media as a sexual super peer for early maturing girls. J Adolesc Health. 2005;36(5):420–7.PubMedCrossRef Brown JD, Halpern CT, L'Engle KL. Mass media as a sexual super peer for early maturing girls. J Adolesc Health. 2005;36(5):420–7.PubMedCrossRef
26.
go back to reference Brown JD, L'Engle KL. X-Rated: sexual attitudes and behaviors associated with U.S. early adolescents' exposure to sexually explicit media. Commun Res. 2009;36(1):129–51.CrossRef Brown JD, L'Engle KL. X-Rated: sexual attitudes and behaviors associated with U.S. early adolescents' exposure to sexually explicit media. Commun Res. 2009;36(1):129–51.CrossRef
27.
go back to reference Ybarra ML, Strasburger VC, Mitchell KJ. Sexual media exposure, sexual behavior, and sexual violence victimization in adolescence. Clin Pediatr (Phila). 2014;53(13):1239–47.CrossRef Ybarra ML, Strasburger VC, Mitchell KJ. Sexual media exposure, sexual behavior, and sexual violence victimization in adolescence. Clin Pediatr (Phila). 2014;53(13):1239–47.CrossRef
28.
go back to reference Brown JD, L'Engle KL, Pardun CJ, Guo G, Kenneavy K, Jackson C. Sexy media matter: exposure to sexual content in music, movies, television, and magazines predicts black and white adolescent sexual behavior. Pediatrics. 2006;117(4):1018–27.PubMedCrossRef Brown JD, L'Engle KL, Pardun CJ, Guo G, Kenneavy K, Jackson C. Sexy media matter: exposure to sexual content in music, movies, television, and magazines predicts black and white adolescent sexual behavior. Pediatrics. 2006;117(4):1018–27.PubMedCrossRef
30.
go back to reference Vahedi Z, Sibalis A, Sutherland JE. Are media literacy interventions effective at changing attitudes and intentions towards risky health behaviors in adolescents? A meta-analytic review. J Adolesc. 2018;67:140–52.PubMedCrossRef Vahedi Z, Sibalis A, Sutherland JE. Are media literacy interventions effective at changing attitudes and intentions towards risky health behaviors in adolescents? A meta-analytic review. J Adolesc. 2018;67:140–52.PubMedCrossRef
31.
go back to reference Pinkleton BE, Austin EW, Chen YC, Cohen M. The role of media literacy in shaping adolescents' understanding of and responses to sexual portrayals in mass media. J Health Commun. 2012;17(4):460–76.PubMedCrossRef Pinkleton BE, Austin EW, Chen YC, Cohen M. The role of media literacy in shaping adolescents' understanding of and responses to sexual portrayals in mass media. J Health Commun. 2012;17(4):460–76.PubMedCrossRef
32.
go back to reference Scull TM, Malik CV, Kupersmidt JB. A media literacy education approach to teaching adolescents comprehensive sexual health education. J Media Literacy Educ. 2014;6(1):1–14. Scull TM, Malik CV, Kupersmidt JB. A media literacy education approach to teaching adolescents comprehensive sexual health education. J Media Literacy Educ. 2014;6(1):1–14.
33.
go back to reference Pinkleton BE, Austin EW, Cohen M, Chen YC, Fitzgerald E. Effects of a peer-led media literacy curriculum on adolescents' knowledge and attitudes toward sexual behavior and media portrayals of sex. Health Commun. 2008;23(5):462–72.PubMedCrossRef Pinkleton BE, Austin EW, Cohen M, Chen YC, Fitzgerald E. Effects of a peer-led media literacy curriculum on adolescents' knowledge and attitudes toward sexual behavior and media portrayals of sex. Health Commun. 2008;23(5):462–72.PubMedCrossRef
34.
go back to reference Scull TM, Kupersmidt JB, Malik CV, Keefe EM. Examining the efficacy of an mHealth media literacy education program for sexual health promotion in older adolescents attending community college. J Am Coll Heal. 2018;66(3):165–77.CrossRef Scull TM, Kupersmidt JB, Malik CV, Keefe EM. Examining the efficacy of an mHealth media literacy education program for sexual health promotion in older adolescents attending community college. J Am Coll Heal. 2018;66(3):165–77.CrossRef
35.
go back to reference Pinkleton BE, Austin EW, Chen Y-CY, Cohen M. Assessing effects of a media literacy-based intervention on US adolescents' responses to and interpretations of sexual media messages. J Child Media. 2013;7(4):463–79.CrossRef Pinkleton BE, Austin EW, Chen Y-CY, Cohen M. Assessing effects of a media literacy-based intervention on US adolescents' responses to and interpretations of sexual media messages. J Child Media. 2013;7(4):463–79.CrossRef
36.
go back to reference Cohen J. The effect size index: d. In: Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates; 1988. Cohen J. The effect size index: d. In: Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates; 1988.
37.
go back to reference Raudenbush SW, Spybrook J, Bloom H, Congdon R, Hill C, Martinez A. Optimal design software for multi-level and longitudinal research (Version 3.01) [Software]; 2011. Raudenbush SW, Spybrook J, Bloom H, Congdon R, Hill C, Martinez A. Optimal design software for multi-level and longitudinal research (Version 3.01) [Software]; 2011.
38.
go back to reference Gibbons FX, Gerrard M, Blanton H, Russell DW. Reasoned action and social reaction: willingness and intention as independent predictors of health risk. J Pers Soc Psychol. 1998;74(5):1164–80.PubMedCrossRef Gibbons FX, Gerrard M, Blanton H, Russell DW. Reasoned action and social reaction: willingness and intention as independent predictors of health risk. J Pers Soc Psychol. 1998;74(5):1164–80.PubMedCrossRef
39.
go back to reference L'Engle KL, Brown JD, Kenneavy K. The mass media are an important context for adolescents' sexual behavior. J Adolesc Health. 2006;38(3):186–92.PubMedCrossRef L'Engle KL, Brown JD, Kenneavy K. The mass media are an important context for adolescents' sexual behavior. J Adolesc Health. 2006;38(3):186–92.PubMedCrossRef
40.
go back to reference Jemmott LS, Jemmott JB. Applying the theory of reasoned action to AIDS risk behavior: condom use among black women. Nurs Res. 1991;40:228–34.PubMedCrossRef Jemmott LS, Jemmott JB. Applying the theory of reasoned action to AIDS risk behavior: condom use among black women. Nurs Res. 1991;40:228–34.PubMedCrossRef
41.
go back to reference Kupersmidt JB, Scull TM, Benson JW. Improving media message interpretation processing skills to promote healthy decision making about substance use: the effects of the middle school media ready curriculum. J Health Commun. 2012;17(5):546–63.PubMedCrossRef Kupersmidt JB, Scull TM, Benson JW. Improving media message interpretation processing skills to promote healthy decision making about substance use: the effects of the middle school media ready curriculum. J Health Commun. 2012;17(5):546–63.PubMedCrossRef
42.
go back to reference Scull T, Malik C, Keefe EM, Schoemann A. Evaluating the short-term Impact of Media Aware Parent, a web-based program for parents with the goal of adolescent sexual health promotion. J Youth Adolesc. 2019;28(9):1686–706.CrossRef Scull T, Malik C, Keefe EM, Schoemann A. Evaluating the short-term Impact of Media Aware Parent, a web-based program for parents with the goal of adolescent sexual health promotion. J Youth Adolesc. 2019;28(9):1686–706.CrossRef
43.
go back to reference Austin EW, Johnson KK. Effects of general and alcohol-specific media literacy training on children's decision making about alcohol. J Health Commun. 1997;2(1):17–42.PubMedCrossRef Austin EW, Johnson KK. Effects of general and alcohol-specific media literacy training on children's decision making about alcohol. J Health Commun. 1997;2(1):17–42.PubMedCrossRef
44.
go back to reference Foshee VA, Bauman KE, Ennett ST, Suchindran C, Benefield T, Linder GF. Assessing the effects of the dating violence prevention program "Safe Dates" using random coefficient regression modeling. Prev Sci. 2005;6(3):245–58.PubMedCrossRef Foshee VA, Bauman KE, Ennett ST, Suchindran C, Benefield T, Linder GF. Assessing the effects of the dating violence prevention program "Safe Dates" using random coefficient regression modeling. Prev Sci. 2005;6(3):245–58.PubMedCrossRef
45.
go back to reference Payne DL, Lonsway KA, Fitzgerald LF. Rape myth acceptance: exploration of its structure and its measurement using the Illinois Rape Myth Acceptance Scale. J Res Pers. 1999;33:27–68.CrossRef Payne DL, Lonsway KA, Fitzgerald LF. Rape myth acceptance: exploration of its structure and its measurement using the Illinois Rape Myth Acceptance Scale. J Res Pers. 1999;33:27–68.CrossRef
46.
go back to reference McMahon S, Farmer L. An updated measure for assessing subtle rape myths. Natl Assoc Soc Workers. 2011;35(2):71–81. McMahon S, Farmer L. An updated measure for assessing subtle rape myths. Natl Assoc Soc Workers. 2011;35(2):71–81.
47.
go back to reference Banyard VL, Plante EG, Moynihan MM. Rape prevention through bystander education: bringing a broader community perspective to sexual violence prevention. Washington, DC: US Department of Justice; 2005. Banyard VL, Plante EG, Moynihan MM. Rape prevention through bystander education: bringing a broader community perspective to sexual violence prevention. Washington, DC: US Department of Justice; 2005.
48.
go back to reference Soet JE, Dudley WN, Dilorio C. The effects of ethnicity and perceived power on women's sexual behavior. Psychol Women Q. 1999;23:707–23.PubMedCrossRef Soet JE, Dudley WN, Dilorio C. The effects of ethnicity and perceived power on women's sexual behavior. Psychol Women Q. 1999;23:707–23.PubMedCrossRef
49.
go back to reference Shiv B, Britton JAE, Payne JW. Does elaboration increase or decrease the effectiveness of negatively versus positively framed messages? J Consum Res. 2004;31(1):199–208.CrossRef Shiv B, Britton JAE, Payne JW. Does elaboration increase or decrease the effectiveness of negatively versus positively framed messages? J Consum Res. 2004;31(1):199–208.CrossRef
50.
go back to reference Moyer-Gusé E, Nabi RL. Explaining the effects of narrative in an entertainment television program: overcoming resistance to persuasion. Hum Commun Res. 2010;36(1):26–52.CrossRef Moyer-Gusé E, Nabi RL. Explaining the effects of narrative in an entertainment television program: overcoming resistance to persuasion. Hum Commun Res. 2010;36(1):26–52.CrossRef
51.
go back to reference MacKenzie SB, Lutz RJ, Belch GE. The role of attitude toward the ad as a mediator of advertising effectiveness: a test of competing explanations. J Mark Res. 1986;23(2):130–43.CrossRef MacKenzie SB, Lutz RJ, Belch GE. The role of attitude toward the ad as a mediator of advertising effectiveness: a test of competing explanations. J Mark Res. 1986;23(2):130–43.CrossRef
52.
go back to reference Myklestad I, Rise J. Predicting willingness to engage in unsafe sex and intention to perform sexual protective behaviors among adolescents. Health Educ Behav. 2007;34(4):686–99.PubMedCrossRef Myklestad I, Rise J. Predicting willingness to engage in unsafe sex and intention to perform sexual protective behaviors among adolescents. Health Educ Behav. 2007;34(4):686–99.PubMedCrossRef
53.
go back to reference Schafer JL. The analysis of incomplete multivariate data. London: Chapman & Hall; 1997.CrossRef Schafer JL. The analysis of incomplete multivariate data. London: Chapman & Hall; 1997.CrossRef
Metadata
Title
Study protocol for a randomized controlled trial to evaluate a web-based comprehensive sexual health and media literacy education program for high school students
Authors
Tracy M. Scull
Christina V. Malik
Abigail Morrison
Elyse M. Keefe
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Trials / Issue 1/2020
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3992-1

Other articles of this Issue 1/2020

Trials 1/2020 Go to the issue