The effectiveness of digital sexual health interventions for young adults: a systematic literature review (2010-2020).

There has been a proliferation of digital sexual health interventions targeting adolescents; however, limited evaluative reviews have compared the effectiveness of multiple digital tools for sexual health literacy and behaviour change. This study conducted a systematic literature review, screened 9881 records and analysed 61 studies. Findings suggest that websites and mobile phones dominate digital sexual health interventions, with a majority effectively delivering cognitive (e.g. awareness and attitudes about sexual and reproductive health) and behavioural outcomes (e.g. abstinence and use of contraception). The most popular sexual health promotion mechanisms were interactive websites, text messaging and phone calls, and online education programmes, followed by mobile applications-fewer studies in this review utilized social media, games and multimedia. Previous reviews focused on single outcome measures (e.g. sexually transmitted infection testing) to assess interventions' effectiveness. The current review moves beyond single outcome measures to cover a wider range of behavioural and non-behavioural sexual health issues and contexts covered in the literature. Four main categories were analysed as outcomes: cognitive perceptions, promoting sexual health-related behaviours, promoting sexual health-related products and services, and impact (viral load). Seventy-nine per cent of interventions focused on preventive sexual health behaviours and products (e.g. condoms) and services (e.g. HIV testing). Overall, 75% of studies effectively changed sexual health behaviour and cognitive perceptions. However, the digital-only tools did not vary from the blended formats, in influence outcomes, even after categorizing them into behavioural or non-behavioural outcomes. Compared to previous systematic reviews, more studies from the last decade used rigorous research design in the form of randomized controlled trials, non-randomized control trials, and quasi-experiments and lasted longer.

Sexual health literacy among adolescents is essential to avert unwanted pregnancies or abortions and sexually transmitted diseases. Culturally sensitive and age-appropriate interventions are required to educate youth about safe-sex practices and increase their self-efficacy and accessibility to health products and services. Meta-analytical and systematic literature reviews have identified limitations in traditional interventions that rely heavily on classroom-based activities and lectures to educate adolescents about safe sex. In recent years, digital tools have proved productive; however, limited evaluative reviews have compared the effectiveness of multiple digital technologies (such as smartphones, web-based programs, social media, games and multimedia) used within sexual health interventions. This systematic review assessed 9881 articles and synthesized 61 experimental studies on adolescent sexual behaviour conducted in the last decade to identify tools that positively influence cognitive and safe-sex behaviour among youth. Interactive websites, mobile technology and online education programmes were popular promotional tools, but very few studies utilized multimedia alongside games and social media. Findings from this review could facilitate future research and practice in adolescent sexual health.

An Integrative Literature Review of Interventions to Protect People with Disabilities from Domestic and Family Violence.

PURPOSE: While domestic and family violence against people with disabilities is an ongoing and crucial public health concern, and awareness of the extent of violence against people with disabilities is growing, research on the field is still limited. Thus, the present review aims to systematically identify and synthesize evidence and effectiveness from intervention strategies to increase the awareness and skills of those with disabilities to reduce and prevent domestic and family violence against them. METHOD: PRISMA guidelines were followed to perform a systematic search of seven scientific databases to identify the peer-reviewed literature. RESULTS: A total of 17 eligible studies were identified (14 evaluations and 3 descriptive studies), with most taking place in developed countries. Children and women are the most frequent victims, and they were therefore the most common target audience of the included studies. Sexual, physical, and verbal abuse were the most reported types of abuse, while financial abuse and neglect were studied less often. Interventions also focused on a diversity of disabilities, including learning, intellectual, mental, and physical impairments. Overall, the intervention strategies reflected a substantial homogeneity: focus on training and education as well as setting up channels and facilities for victims to seek help. Nine studies yielded significant positive outcomes using various strategies and techniques, while five studies had mixed results, and three studies only reported on the intervention strategies but did not evaluate the results. CONCLUSIONS: This review confirms a significant gap in the literature on domestic and family violence against people with disabilities and how to prevent and address the violence through evidence-based interventions. Several recommendations to improve future research and practice are proposed.

The effectiveness of graphic health warnings on tobacco products: a systematic review on perceived harm and quit intentions.

BACKGROUND: Examination of the format and framing of the graphic health warnings (GHWs) on tobacco products and their impact on tobacco cessation has received increasing attention. This review focused on systematically identifying and synthesizing evidence of longitudinal studies that evaluate different GHW formats and specifically considered GHW influence on perceived risk of tobacco use and quit intentions. METHODS: Ten databases were systematically searched for relevant records in December 2017 and again in September 2019. Thirty-five longitudinal studies were identified and analyzed in terms of the formatting of GHWs and the outcomes of perceived risk and quit intentions. Quality assessment of all studies was conducted. RESULTS: This review found graphics exceeding 50% of packs were the most common ratio for GHWs, and identified an ongoing reliance on negatively framed messages and limited source attribution. Perceived harms and quit intentions were increased by GHWs. However, wear-out effects were observed regardless of GHW format indicating the length of time warnings are present in market warrants ongoing research attention to identify wear out points. Quit intentions and perceived harm were also combined into a cognitive response measure, limiting the evaluation of the effects of each GHW format variables in those cases. In addition, alternative GHW package inserts were found to be a complimentary approach to traditional GHWs. CONCLUSIONS: This review demonstrated the role of GHWs on increasing quit intentions and perceptions of health risks by evaluating quality-assessed longitudinal research designs. The findings of this study recommend testing alternate GHW formats that communicate quit benefits and objective methodologies to extend beyond self-report.