Developing a brief online sexual health intervention for low socio economic status female teenagers

McKellar, Kerry (2017) Developing a brief online sexual health intervention for low socio economic status female teenagers. Doctoral thesis, Northumbria University.

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Abstract

Risky sexual behaviours are prevalent among low Socio Economic Status (SES) female teenagers, and earlier sexual initiation is associated with unplanned pregnancies and sexually transmitted infections. Large systematic reviews have found an extensive list of predictors of risky sexual behaviours, but it is not clear which of these are highly important to low SES female teenagers and if sexual health intervention programs are currently meeting teenagers’ sexual health needs. This thesis sets out specifically to address this issue, by investigating the predictors and developing a brief online sexual health intervention program for low SES female teenagers.

Two research questions were explored using a mixed-methods approach across five studies. The research aimed to gain sexual health professionals and teenagers qualitative views on the predictors of risky sexual behaviours, and then confirm these predictors quantitatively with a large number of female teenagers. Teenagers views of existing online sexual health intervention programs were then explored leading to the development of a brief online self-affirmation and sexual health intervention program.

Self-esteem was found to be an important predictor of risky sexual behaviours both by sexual health professionals and low SES female teenagers. It was also clear that teenagers did not currently have access to reliable sexual health information. Therefore, a brief online self-affirmation intervention, aimed at increasing self-esteem, paired with reliable sexual health information was developed. It was found that the self-affirmation intervention significantly increased self-esteem for the self-affirmed group compared to the non-affirmed group. In addition, the self-affirmed group had significantly higher intentions to have safe sex post intervention and at a one week follow up, compared to the non-affirmed group. Therefore, low-cost brief online self-esteem and sexual health interventions can be effective in increasing intentions to have safe sex for low SES female teenagers.

The theoretical and practical implications of these results are discussed together with suggestions for future research.

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