Blended Learning for Sexual Health Education: Evidence Base, Promising Practices, and Potential Challenges.

BACKGROUND: Blended learning is a combination of online learning and face-to-face instruction, and is increasingly being used in K-12 settings. A meta-analysis conducted for the Department of Education suggests blended learning is more effective than either group-based or online learning alone, particularly in K-12 settings. METHODS: This paper provides a narrative review of the literature from 2000 to 2017 on blended learning as it applies to sexual health education programs, and discusses outcomes, best practices and potential challenges of blended learning that may be important for practitioners and researchers considering this approach. RESULTS: Blended learning approaches are being used successfully in sexual health education programs, including school-based programs, and have yielded positive behavioral and psychosocial changes. Similar to traditional group-based programs, not all outcomes tested in these programs showed positive impact. Designing blended learning programs can be challenging, but there is a large best-practice literature that can inform practitioners interested in using it. CONCLUSIONS: Blended learning approaches are viable for sexual health education and offer numerous advantages to group-based only programs, such as confidential personalization and an instructional approach that is familiar and engaging for participants.

Replication of It's Your Game Keep It Real! in Southeast Texas.

Despite the recent efforts of the Office of Adolescent Health to replicate programs with demonstrated efficacy, there are still few evidence-based HIV, sexually transmitted infection (STI), and teen pregnancy prevention programs that have been replicated in "real-world" settings. To test the effectiveness of It's Your Game…Keep It Real! (IYG), an evidence-based STI and pregnancy prevention program for middle schools, the curriculum was implemented by teachers in urban and suburban middle schools in Southeast Texas from 2012 to 2015. IYG was evaluated using a group-randomized wait-list controlled effectiveness trial design in which 20 middle schools in nine urban and suburban school districts in Southeast Texas were randomized equally, using a multi-attribute randomization protocol, to either the intervention condition (received IYG) (n = 10 schools comprising 1936 eligible seventh graders) or the comparison condition (received usual care) (n = 10 schools comprising 1825 eligible seventh graders). All students were blinded to condition prior to administering the baseline survey. The analytic sample comprised 1543 students (n = 804, intervention; n = 739, comparison) who were followed from baseline (seventh grade) to the 24-month follow-up (ninth grade). Multilevel regression analyses were conducted to assess behavioral and psychosocial outcomes at follow-up. There were no significant differences in initiation of vaginal or oral sex between study conditions at follow-up. However, at 12-month follow-up, compared with students in the comparison condition, students in the intervention condition reported increased knowledge, self-efficacy, and perceived favorable norms related to HIV/STIs, condoms, and/or abstinence; decreased intentions to have sex; and increased intentions to use birth control. Knowledge outcomes were statistically significant at 24-month follow-up. This IYG effectiveness trial did not replicate the behavioral effects of the original IYG efficacy trials. However, it adds to the growing literature on the replication of evidence-based programs, and underscores the need to better understand how variations in implementation, setting, and measurement affect the behavioral impact of such programs.Clinical trial registration clinicaltrials.gov (NCT03533192).

Dual Contraceptive Method Use Among Youth in Alternative Schools.

Dual contraceptive method use, or using a highly effective contraceptive method plus a barrier method like condoms, is gaining attention as a strategy for preventing unplanned pregnancy and sexually transmitted diseases. We investigated rates of dual method use among a sample of youth in urban alternative schools, and explored the relationship between dual method use and sexual partner type. The study analyzed data from 765 students enrolled in 11 district-run continuation high schools in northern California. We explored the association between dual method use and sexual partner type (steady only, a mix of steady and non-steady, and non-steady only) using logistic regression. Differences in dual rates by partner type were statistically significant, with higher rates of dual methods use reported among young people reporting non-steady sexual partners only, as compared to those with steady partners only. The data illustrate that young people in alternative school settings could gain from further intervention on the benefits, skills, and challenges of using two methods of contraception as opposed to one with both steady and non-steady sexual partners.

An exploratory study of adolescent pimping relationships.

In the last decade, public attention to the problem of commercially sexually exploited children (CSEC) has grown. This exploratory qualitative study examines adolescent pimping relationships, including how urban youth perceive these types of relationships. Study data stem from interviews with three young adult informants with first-hand knowledge of adolescent pimping, as well as three gender-specific focus group discussions with a convenience sample of 26 urban high school students who have first- or second-hand knowledge of adolescent pimping. Findings indicate that respondents believe teen pimping exists in their schools and communities, and that those exploited typically do not self-identify as victims. Respondents also believed that younger pimps are more likely to use violence to induce compliance among the girls they exploit, whereas older pimps are more likely to emotionally manipulate young women into exploitation. Further, respondents indicated that some young people agreed to exchange or sell sex for money as a favor to their boyfriends or girlfriends, and some young people believed that selling sex is acceptable under certain circumstances. The growing attention to CSEC provides an important opportunity to expand prevention efforts to reach those most affected and at risk for exploitation. The findings highlight critical areas for augmenting traditional content in school-based HIV/STI and sexuality education classes.

Positive youth development: thriving as the basis of personhood and civil society.

Positive youth development is conceptualized within a developmental systems theoretical model. The role of thriving processes and civic engagement in positive youth development is discussed.

Stability of attributes of positive functioning and of developmental assets among African American adolescent male gang and community-based organization members.

An analysis is presented of the longitudinal stability over the course of a year of characteristics of positive functioning and of individual and ecological developmental assets, among African American male youth involved in gangs or in community-based organizations (CBOs) serving youth. Evidence is provided for the potential of positive youth development among both groups of adolescents.

Individual and ecological assets and positive developmental trajectories among gang and community-based organization youth.

The Search Institute framework for conceptualizing developmental assets was used in a longitudinal study of African American male youth involved in gangs or in community-based organizations (CBOs) serving youth. Analyses of intraindividual change indicated that individual and ecological assets are linked to positive developmental trajectories among these youth.