The risky sexual behaviors of older adolescents (18- to 19-year-olds), like having sex without a condom, having multiple or casual partners, or having intoxicated sexual encounters, are a major U.S. public health issue. Older adolescents consistently report a lack of information and access to necessary resources regarding pregnancy prevention and/or healthy relationships. Our long-range goal is to advance the state of sexual health promotion in for older adolescents, an underserved population in sexual risk behavior prevention efforts. Consumption of unhealthy media messages that normalize or glorify risky sex is related to early and risky sexual behaviors in adolescents. Critical analysis of these media messages and the creation of medically accurate health messages promote healthy perspective taking about relationships and sexual behaviors. We hypothesize that critical thinking about media messages impacts norms, cognitions, and attitudes about risky sex and ultimately reduces risky sexual behaviors.
The aims of this R21 proposal from an early stage investigator are to 1) create a brief web-based media literacy intervention to reduce risky sexual practices in community college students, 2) conduct a feasibility study for the intervention and investigate moderators of the program's effectiveness, and 3) develop procedures and measures for a future randomized control trial. The proposed study applies a media literacy framework (e.g., Message Interpretation Process Model) to explore if a media literacy intervention can be a compelling sexual education program for the target age group. In Year 1, focus groups and one-to-one evaluations will be used to develop the web-based media literacy education program, Media World Relationships (MWR). The intervention is intended to be self-paced, brief, and highly interactive. In Year 2, a feasibility study will be conducted in which community colleges (N=8) are randomly assigned to the intervention group, where participating students (N = 200) will either complete the web-based program or participate as part of the control group and complete pre-post assessments. Student outcome assessments (pretest, immediate posttest) will provide a preliminary test of program effectiveness for positively affecting sexual health outcomes. Program assessment by college administrators and health educators (N=16) will also be used to evaluate feasibility. Results from the study will serve as a foundation for a larger randomized clinical trial. One of the added benefits of this innovative program is that while potentially enhancing the sexual health of community college campuses, it also emphasizes the development and refinement of critical thinking skills valued in higher education which should foster dissemination.

Public Health Relevance

Risky sexual behaviors of older adolescents are a significant public health concern and media literacy-based interventions appear to be a promising approach to addressing this issue and should be evaluated rigorously. This study provides a feasibility test of a media literacy intervention and an initial examination of the moderators of te intervention's effectiveness. The long-term objective of this project is to test the developed web-based media literacy program to reduce risky sexual behaviors in older adolescents in a randomized clinical trial.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Exploratory/Developmental Grants (R21)
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Community-Level Health Promotion Study Section (CLHP)
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Diana, Augusto
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Innovation Research and Training, Inc.
United States
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Scull, Tracy Marie; Kupersmidt, Janis Beth; Malik, Christina Valerie et al. (2017) Examining the efficacy of an mHealth media literacy education program for sexual health promotion in older adolescents attending community college. J Am Coll Health :1-13