An effective single-session online sexual-health training for youth and their sexual network
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Abstract
Background & objectives: this study presents the development and evaluation of an online intervention to counteract barriers to safe sex and STI screening among youth aged 16 to 24.
Methods: the intervention -www.vrijlekker.nl- was based on over 200 qualitative interviews with youth investigating barriers to safe sex and STI screening. Based on these interviews, training modules were developed which participants could follow online. These modules aimed at counteracting cognitive and behavioural barriers for safe sex and STI screening as well as addressing barriers within their sexual network. The training was designed to inflict cognitive change during a single session online. The Information-, Motivation and Behavioural Skills (IMB) model was used as the theoretical basis to the intervention. The training included filmed coaches that guided users throughout the intervention, thematic films, interactive text with personal feedback and sexual network tools. The modules were offered on a tailored basis to match each user’s own cognitive & behavioural risk profile that was established via an automated online intake. An evaluation was conducted comparing the behavioural outcomes of the control versus the intervention group at 6 month follow-up.
Results: the evaluation included 2944 participants of whom 1553 completed the follow-up (mean age 19, SD 2.4). The intervention group used condoms significantly more often with their most recent casual partner [OR=1.82 95% CI 1.08 - 3.04] and/or with their steady partner [OR=2.17 95%CI 1.48 - 3.18] than the control group at 6 months follow-up. Over 170,000 unique persons used the intervention already during its first year, and today more than 200 new users continue to do so every week. Some schools in the Netherlands have adopted the site as part of their routine sexual education program.
Conclusions: This study has shown than offering youth a single session intervention that is empirically and theoretically sound, that is aimed at the individual needs of each user and its sexual network, resulted in the desired behavioural change and high uptake. Online tailored interventions can provide effective and cost-effective counselling to the mass.
Methods: the intervention -www.vrijlekker.nl- was based on over 200 qualitative interviews with youth investigating barriers to safe sex and STI screening. Based on these interviews, training modules were developed which participants could follow online. These modules aimed at counteracting cognitive and behavioural barriers for safe sex and STI screening as well as addressing barriers within their sexual network. The training was designed to inflict cognitive change during a single session online. The Information-, Motivation and Behavioural Skills (IMB) model was used as the theoretical basis to the intervention. The training included filmed coaches that guided users throughout the intervention, thematic films, interactive text with personal feedback and sexual network tools. The modules were offered on a tailored basis to match each user’s own cognitive & behavioural risk profile that was established via an automated online intake. An evaluation was conducted comparing the behavioural outcomes of the control versus the intervention group at 6 month follow-up.
Results: the evaluation included 2944 participants of whom 1553 completed the follow-up (mean age 19, SD 2.4). The intervention group used condoms significantly more often with their most recent casual partner [OR=1.82 95% CI 1.08 - 3.04] and/or with their steady partner [OR=2.17 95%CI 1.48 - 3.18] than the control group at 6 months follow-up. Over 170,000 unique persons used the intervention already during its first year, and today more than 200 new users continue to do so every week. Some schools in the Netherlands have adopted the site as part of their routine sexual education program.
Conclusions: This study has shown than offering youth a single session intervention that is empirically and theoretically sound, that is aimed at the individual needs of each user and its sexual network, resulted in the desired behavioural change and high uptake. Online tailored interventions can provide effective and cost-effective counselling to the mass.
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