Feasibility Study of the Online High School Media Aware Program

Study Overview
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Brief Summary
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This is a pretest-posttest feasibility study of Media Aware Sexual Health - High School, an interactive web-based comprehensive sexual health media literacy education program for high school students. The program is designed to develop students' critical thinking skills and promote sexual health. It is hypothesized that this program will enhance adolescents' media literacy skills, sexual health knowledge, cognitions (i.e., attitudes, self-efficacy, and norms), and behaviors regarding healthy sexual decision-making.

Official Title
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Web-based High School Media Literacy for Healthy Relationships,

Conditions
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Sexual Behavior

Intervention / Treatment
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* Behavioral: Media Aware Sexual Health - High School


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Students must be in grades 9 or 10 in participating classrooms at participating schools. Students must be able to speak and read English because the study materials (e.g., questionnaires) and the program are in English. Students must have appropriate permissions to receive sex education per school districts' policy (i.e., opt-in policy or opt-out policy).

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Media Aware Sexual Health - High School<br>Students received the web-based Media Aware Sexual Health - High School program. | Behavioral: Media Aware Sexual Health - High School<br>* Media Aware Sexual Health is a web-based comprehensive sexual health education program for high school students that uses a media literacy approach.<br>* Other names: Media Aware;|
| No Intervention: Typical Health Education Programming<br>Students received their regular health education programming not related to sexual health education. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in willingness to engage in unprotected sex | 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) assessing the degree to which one is willing to engage in unprotected sex (Suppose you were with a boyfriend/girlfriend. 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 hook-up anyway?). | pretest and posttest (approximately one week after pretest) | 
| Change in willingness to hook up against own wishes | 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) assessing the degree to which one is willing to hook up with someone even if they are not sure that they really want to. (Suppose you were with a boyfriend/girlfriend. He/she wants to hook-up, but you are not sure that you want to. In this situation, how willing would you be to go ahead and hook-up anyway?). | pretest and posttest (approximately one week after pretest) | 
| Change in intentions to use contraception/protection | 4-point Likert scale (not at all likely; unlikely; likely; extremely likely) assessing intentions to use contraception (e.g., if you were to have vaginal or anal sex, how likely would you be to use a condom?). | pretest and posttest (approximately one week after pretest) | 
| Change in intentions to engage in sexual activity | 4-point Likert scale (not at all likely; unlikely; likely; extremely likely) assessing participants intentions to engage in sex in the next year (How likely is that you will have any type of sexual contact with another person (oral sex, anal sex, vaginal sex, or genital-to-genital contact) in the next year?). | pretest and posttest (approximately one week after pretest) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Efficacy to refuse sexual activity | 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) assessing participants efficacy to refuse sex (e.g., I could say no to someone who is pressuring me to have sex). | pretest and posttest (approximately one week after pretest) | 
| Efficacy to communicate before sex | 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) assessing participants efficacy to communicate about sexual health (e.g., I could talk with a boy/girlfriend about using condoms for sexually transmitted infection protection). | pretest and posttest (approximately one week after pretest) | 
| Efficacy to use contraception/protection | 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) assessing participants efficacy to get and use contraception (e.g., If I wanted to, I could get condoms or another form of contraception). | pretest and posttest (approximately one week after pretest) | 
| Intentions to communicate before sex | 4-point Likert scale (not at all likely; unlikely; likely; extremely likely) assessing intentions to communicate about sexual health before sex (e.g., Before deciding to have sex, how likely would you be to talk to a boy/girlfriend about HIV/AIDS or other sexually transmitted infections?). | pretest and posttest (approximately one week after pretest) | 
| Sexual health knowledge | Participants are asked several multiple choice and T/F questions about sexual health. | pretest and posttest (approximately one week after pretest) | 
| Norms - Frequency of teen risky sexual activity (%) | Participants are asked to indicate what percentage [0% = no teens; 100% = all teens] are engage in risky sexual activities (e.g., have sex with someone who is much older). | pretest and posttest (approximately one week after pretest) | 
| Norms - teen sexual activity (%) | Participants are asked to indicate what percentage [0% = no teens; 100% = all teens] are engage in sexual activity. | pretest and posttest (approximately one week after pretest) | 
| Perceived realism of media messages | Participants are asked on a 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) the degree to which they agreed that teens on the media: 1) do things that average teens do; 2) act like average teens; 3) are as sexually experienced as average teens; 3) get pregnant as often as average teens; 4) get STIs as often as average teens. | pretest and posttest (approximately one week after pretest) | 
| Perceived similarity to media messages | Participants are asked on a 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) the degree to which they agreed that: 1) The things I do in my life are similar to what I see teens do in the media; 2) I look like teens I see in the media; 3) I like the kinds of things that teens in the media like. | pretest and posttest (approximately one week after pretest) | 
| Cognitive elaboration of advertisement | Participants are shown an advertisement and responded on a 4-point Likert scale (not much at all; a little; a good amount; a lot) the extent to which they: 1) thought about the ad; 2) spent time thinking about the ad; and 3) paid attention to the ad. | pretest and posttest (approximately one week after pretest) | 
| Media Skepticism | Participants are asked on a 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) the degree to which they agree with several statements about media (e.g., Media are dishonest about what happens when people drink alcohol). | pretest and posttest (approximately one week after pretest) | 
| Teen Sex Attitudes | Participants are asked on a 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) the degree to which they agree with several statements about teen sex (e.g., it is ok for teens to be sexually active). | pretest and posttest (approximately one week after pretest) | 
| Risky Teen Sex Attitudes | Participants are asked on a 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) the degree to which they agree with several statements about teens engaging in risky sexually behaviors (e.g., I believe it is ok for teens to do use alcohol or drugs before or during a sexual encounter.) | pretest and posttest (approximately one week after pretest) | 
| Teen Contraception Use Attitudes | Participants are asked on a 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) the degree to which they agree with several statements about teen contraception use (e.g., I believe if a teen is going to have sex, they should always use a condom.) | pretest and posttest (approximately one week after pretest) | 
| Teen Sexual Communication Attitudes | Participants are asked on a 4-point Likert scale (strongly disagree; disagree; agree; strongly agree) the degree to which they agree with several statements about teen sexual communication (e.g., Before deciding to have sex, I believe teens should talk with their parents or another trusted adult). | pretest and posttest (approximately one week after pretest) |