Sexual Assertiveness Skills and Sexual Decision-Making in Adolescent Girls: Randomized Controlled Trial of an Online Program

• Published in: American journal of public health (1971) 2018-01, Vol.108 (1), p.96-102
• Main Authors: Widman, Laura, Golin, Carol E, Kamke, Kristyn, Burnette, Jeni L, Prinstein, Mitchell J
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adolescent Health; Adolescents; African Americans; AIDS; AJPH Research; Assertiveness; Attitudes; Clinical trials; Communication; Condoms; Condoms - statistics & numerical data; Consent; Decision Making; Demographics; Disease transmission; Educational technology; Effectiveness; Efficacy; Female; Girls; Health care policy; Health Education; Health Knowledge, Attitudes, Practice; Health Promotion; Heart; HIV; HIV/AIDS; Human immunodeficiency virus; Humans; Intention; Internet; Intervention; Mental health; Motivation; Norms; Pregnancy; Prevention; Public health; Randomization; Self Efficacy; Sex Education - methods; Sexual behavior; Sexual Behavior - psychology; Sexual Health; Sexually transmitted diseases; Sexually Transmitted Diseases - prevention & control; Skills; Smartphones; Social Norms; Socioeconomic Factors; Southeastern United States; STD; Teenagers; Training
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2017.304106

To evaluate the efficacy of an interactive, Web-based sexual health program (Health Education and Relationship Training [HEART]) for developing sexual assertiveness skills and enhancing sexual decision-making in adolescent girls. Participants were 222 tenth-grade girls (mean age = 15.2; 38% White, 29% Hispanic, 25% Black) in the Southeastern United States who were randomized in fall 2015 to the HEART intervention or an attention-matched control. We assessed participants at pretest, immediate posttest, and 4-month follow-up. Both groups had similar demographic and sexual behavior characteristics at pretest. At immediate posttest, girls who completed the HEART program demonstrated better sexual assertiveness skills measured with a behavioral task, higher self-reported assertiveness, intentions to communicate about sexual health, knowledge regarding HIV and other sexually transmitted diseases (STDs), safer sex norms and attitudes, and condom self-efficacy compared with the control condition. At 4-month follow-up, group differences remained in knowledge regarding HIV and other STDs, condom attitudes, and condom self-efficacy. This brief online sexual health program can improve short-term outcomes among adolescent girls and offers an exciting new option in the growing array of digital health interventions available to youths. NCT02579135.