An Implementation Pilot of Web-Based Self-Training Programs on Sexual Dysfunctions in the Dutch Public Sexual Health Setting: Mixed Methods Study.

BACKGROUND: Web-based sexual health interventions may be more acceptable to people compared with face-to-face support, given the stigma and embarrassment often associated with sexual problems. The Dutch public sexual health clinics (SHCs) conducted an implementation pilot with 4 web-based self-training programs on sexual dysfunctions (WSTPs) for young people. In addition to a basic sexuality program, the WSTPs focused on the following complaints: pain during intercourse, premature ejaculation, and no sex drive. OBJECTIVE: This study aims to gain insight into the potential reach of the freely offered WSTPs; use, acceptance, evaluation, and perceived impact of the WSTPs by young people; and evaluation and acceptance of the WSTPs by nurses of the SHCs. METHODS: A quantitative baseline measurement (BM) and a follow-up measurement (FM) were conducted among the users. In addition, qualitative data were gathered through video interviews with a sample of respondents of the FM and nurses of the SHCs to gain more in-depth insights into their assessment of the WSTPs. Participants were recruited via social media, posters, and referrals by nurses of the SHCs. Quantitative data were analyzed using descriptive statistics. Independent 2-tailed t tests and one-way independent ANOVAs were used to compare the scores between subgroups based on background characteristics. Dependent 2-tailed t tests were used to assess the possible changes between BM and FM. The interviews were analyzed using a thematic analysis. RESULTS: A total of 1028 young people (aged 16-24 y) completed the BM, 666 started with 1 of the WSTPs, and 104 participants completed the FM. In addition, 8 users and 8 nurses were interviewed. Of the participants who completed the BM, 87.74% (902/1028) experienced moderate (411/1028, 39.98%) to high (491/1028, 47.76%) severity of complaints, of which 20.43% (210/1028) had had them for >1 year and 27.82% (286/1028) even for ≥2 years, and 38.91% (400/1028) were dissatisfied with their sex lives. Only 8.75% (90/1028) had sought professional help in the past 2 years. At FM, users rated satisfaction with their sex life more positively than they did at BM, and they experienced less discomfort from their complaints. The overall rating was positive, with a mean report grade of 7.3 (SD 1.45; on a 10-point scale). Anonymity, clear information and explanation, and practical exercises are indicated as strengths of the WSTPs, leading to more understanding and normalization. Nurses appreciate the high quality of information and accessibility of the WSTPs. They consider them as a valuable addition to the consultation hours. CONCLUSIONS: WSTPs can reach a large number of young people with sexual problems who are less likely to seek professional help. This can result in an improved understanding of their issues, a decrease in complaints, and reduced barriers to communicating with a partner or professional.

Introducing video consultations at public sexual health clinics in the Netherlands: a mixed-methods study.

Video consultations (in combination with remote STI testing) can benefit both public sexual health clinics (SHCs) and their clients. The Dutch public SHCs explored the extent to which video consultations are accepted and appreciated-compared to face-to-face consultations-by both young clients (under 25 years) and nurses who normally carry out consultations. A mixed-methods study, using online questionnaires and telephone interviews with both young clients (aged under 25 years) and nurses (focus groups), was conducted to evaluate acceptance and appreciation of video and face-to-face consultations of the SHCs. Young clients evaluated 333 video consultations and 100 face-to-face consultations. Clients rated the VCs and F2F consultations as being of equal high level on five evaluation criteria (e.g. how it feels to talk about sex with a nurse, contact with the nurse). These positive results were confirmed in the interviews. Most important perceived advantages of VCs were time saving, ease, and feelings of comfort and safety. The nurses evaluated 422 VCs and 120 F2F consultations, rating the VCs and F2F consultations on an equal high level on three evaluation criteria (e.g., contact with the client, possibility to continue asking questions). Increasing accessibility of SHC consultations, getting faster to the point and saving time were mentioned as advantages of VCs during the focus group sessions with nurses. Video consultations are accepted and appreciated by young clients and nurses. They can be used for standard STI consultations that do not require a physical examination.

Traditionally, public health consultations for sexually transmitted infections (STIs) and other sexual health problems that young people in the Netherlands have, are offered on a face-to-face (F2F) basis. For some clients, who, for example, live further away from a clinic or are afraid of meeting acquaintances at the clinic, this can create barriers. By offering video consultations (VCs) these barriers can be removed. For clinics, VCs may cut costs and may reach high-risk clients via online services who do not make sufficient use of F2F consultations. Using a mixed-methods study, we investigated to what extent young clients and nurses accepted and rated VCs compared to face-to-face consultations. 433 young clients evaluated 333 VCs and 100 F2F consultations. Nurses evaluated 422 VCs and 120 F2F consultations. The young clients of Sexual Health Clinics (SHCs) appreciated and accepted a VC on a similar level to that of a F2F consultation. According to nurses, VCs can be an attractive addition to the services of SHCs. VCs can be used for standard STI consultations that do not require a physical examination. The advantages of VCs can contribute to reaching target groups that make less use of the current services of SHCs.

Justify your love: testing an online STI-risk communication intervention designed to promote condom use and STI-testing.

The efficacy of a tailored, web-based intervention communicating the risks of sexually transmitted infections (STI) for heterosexual young adults was examined in a randomised, controlled trial. The main aims of the relationship-oriented intervention were to influence risk perceptions and to promote (maintenance of) condom use and STI-testing among young adults who reported being recently engaged in a heterosexual relationship. The intervention addressed risk perceptions, attitudes, normative beliefs, self-efficacy and skills related to condom use and STI-testing. Outcomes were compared immediately after the intervention (N = 171) and 3 months later (N = 115) to a non-tailored intervention group and to a control group. Cognitive and behavioural outcomes showed that the tailored intervention was efficacious in influencing perceived susceptibility to STI and STI-testing intentions immediately after the intervention, and in reducing rates of unprotected sex at 3 months.

Experimental pretesting of public health campaigns: a case study.

The aim of the present study is to demonstrate the merits of evaluating new public health campaign materials in the developmental phase using an experimental design. This is referred to as experimental pretesting. In practice, most new materials are tested only after they have been distributed using nonexperimental or quasiexperimental designs. In cases where materials are pretested prior to distribution, pretesting is usually done using qualitative research methods such as focus groups. Although these methods are useful, they cannot reliably predict the effectiveness of new campaign materials in a developmental phase. Therefore, we suggest when pretesting new materials, not only qualitative research methods but also experimental research methods must be used. The present study discusses an experimental pretest study of new campaign materials intended for distribution in a national sexually transmitted infection (STI) AIDS prevention campaign in the Netherlands. The campaign material tested was the storyline of a planned television commercial on safe sex. A storyboard that consisted of drawings and text was presented to members of the target population, namely, students between the ages of 14 and 16 enrolled in vocational schools. Results showed positive effects on targeted determinants of safe sexual behavior. The advantages, practical implications, and limitations of experimental pretesting are discussed.