Teenagers, Sexual Health Information and the Digital Age

Kerry Mckellar, Elizabeth Sillence

• Publisher: Academic Press
• Year: 2020
• ISBN:
  9780128169704
• Topic: Psychology
• Subtopic: Developmental Psychology
• Index: Psychology

Teenagers, Sexual Health Information and the Digital Age examines the online resources available on teenagers, including games and digital interventions. In addition, it highlights current issues such as sexting and pornography. Information needs and provisions are examined, and existing sexual health interventions and digital interventions are discussed, gathering both teenagers' and sexual health professionals' views on these services. In addition to a review of the current literature on sexual health and teenagers, the book examines groups of teenagers, particularly those vulnerable to risky sex and asks what are the predictors of these behaviors and what can be done to address the behaviors.

Finally, the book will also provide reflections and practical advice on the ethical issues associated with research in this context.

• Provides guidance on the ethical issues with research associated with this topic
• Covers both teenagers' information needs as well as their existing levels of knowledge
• Assesses how teenagers engage with, and evaluate, sexual health information
• Addresses the challenges inherent in the online environment, such as unreliable and misleading information

Chapter 1

Introduction

Abstract

This chapter provides an overview of the contributions of this book. In this book, we aim to highlight current research on teenagers, sexual health, and the digital age. Teenagers are surrounded by information about sexual health, and access to digital technology has made it possible to envisage exciting opportunities for innovative and creative ways of providing teenagers with reliable information in a confidential manner. However, the online environment also poses challenges for teenagers, parents, and health practitioners with access to unreliable, misleading and potentially dangerous information. This book examines the current information landscape for teenagers. It examines the online resources available including games and digital interventions and highlights current issues such as sexting and pornography. Information needs and provision will be examined, and existing sexual health interventions and digital interventions will be discussed, gathering both teenagers’ and sexual health professionals’ views on these services. In addition to a review of the current literature on sexual health and teenagers, the book examines groups of teenagers particularly vulnerable to risky sex and asks what are the predictors of these behaviours and what can be done to address the behaviours. This book will also provide reflections and practical advice on the ethical issues associated with research in this context. This chapter provides an overview of the contributions of each of the following chapters.

Keywords

Digital sexual health interventions; Teenagers; Sexual health; Sexual health intervention programs

1. Introduction
2. Contributions of this Book
   1. Current Research on Sexual Health and Teenagers (Chapter 2)
   2. Sexual Health Education in Schools and Digital Interventions (Chapter 3)
   3. Sexual Health Professional Views of Sexual Health Education (Chapter 4)
   4. Ethical Issues When Researching Teenagers and Sexual Health (Chapter 5)
   5. Teenagers' Views of Sexual Health Education (Chapter 6)
   6. Predictors of Risky Sexual Behaviors for Female Teenagers (Chapter 7)
   7. Teenagers' Views of Sexual Health Education Websites and Apps (Chapter 8)
   8. Students' Views of Sexual Health Apps (Chapter 9)
   9. A Brief Online Self-affirmation Intervention to Promote Safe sex Intentions (Chapter 10)
   10. Reflections and Conclusions (Chapter 11)

Introduction

First sexual initiation is a normal and expected aspect of adolescent development (Heywood, Patrick, Smith, & Pitts, 2015). However, risky sexual behaviors are also prevalent among teenagers. In the UK, teenagers are becoming sexually active at an earlier age (Mercer et al., 2010). A large survey in Britain found that although the average age of first heterosexual intercourse was 16, nearly a quarter of girls had sex before they were 16. Furthermore, half of the girls said they wish they had waited longer to have sex, and were twice as likely to say this if they were under age 15 at first sexual initiation (FPA, 2016).

It is important to reduce teenage risk taking, as the consequences of teenage sexual risk taking are unplanned pregnancies and sexually transmitted infections (STIs). Teenage pregnancy rates in the UK have shown a downward trend in the last decade and are currently at the lowest level since records began. Despite this, the UK continues to have one of the highest rates of teenage conceptions in Western Europe (ONS, 2014). One of the reasons for the reduction in teenage pregnancy is that contraception use is improving in this age group. A recent survey found a small reduction in the overall number of new STIs in the teenage population; however, overall levels remained very high (Health Protection Report, 2017). Teenage abortion rates have not decreased, although the rise is only slight, 0.6% since 2014 (FPA, 2016).

There are many teenage sexual health intervention programs in the UK. General practitioners and school nurses offer free and confidential services for teenagers across the country (Baxter, 2010), and teenagers have widespread access to free contraceptives. However, teenagers generally do not report using these services and often report reluctance to use these because of worries about confidentiality and feeling judged (Iyer & Baxter-MacGregor, 2010). In addition, teenagers believe it is embarrassing to discuss sexual health with sexual health professionals and parents (Buhi, 2013). Therefore, despite the confidential and free sexual health services available, teenagers are still reluctant to use them. This may be one of the reasons that there is still a high number of unplanned pregnancies and STIs in the teenage population.

Teenagers are known for their early adoption of the Internet, and teenagers report that the Internet is their primary source when seeking health information (Gray & Klein, 2006), likely because of the anonymity it affords. Discussing sex with teachers, parents, or even friends is considered embarrassing in a society that problematizes teenage sexuality (Kendall & Funk, 2012; Moran, 2000). The Internet is an appealing source of sexual health information because teens can access the information without the embarrassment of anyone finding out (Kanuga & Rosenfeld, 2004). Therefore, it is worthwhile to consider current digital interventions and whether technology is contributing to teenage sexual health knowledge.

Contributions of this Book

In this book, we aim to highlight current research on teenagers, sexual health, and the digital age. Teenagers are surrounded by information about sexual health, and access to digital technology has made it possible to envisage exciting opportunities for innovative and creative ways of providing teenagers with reliable information in a confidential manner. However, the online environment also poses challenges for teenagers, parents, and health practitioners with access to unreliable, misleading, and potentially dangerous information. Examining our teenagers' information needs and existing levels of knowledge is important, but we also need to understand how they engage with and evaluate sexual health information both offline and in a digital context so that we can improve the provision of useful information.

This book examines the current information landscape for teenagers. It examines the online resources available including digital interventions and highlights current issues such as sexting and pornography. Information needs and provision are examined, and existing sexual health interventions and digital interventions are discussed, gathering both teenagers' and sexual health professionals' views on these services. In addition to a review of the current literature on sexual health and teenagers, this book examines groups of teenagers particularly vulnerable to risky sex and asks what are the predictors of these behaviors and what can be done to address the behaviors. Our own research studies presented throughout this book are conducted within the North East England in the UK, with low socioeconomic status (SES) female teenagers, as we identified that these were a high-risk group for unplanned teenage pregnancies and STIs. However, teenage sexual risk taking, unplanned pregnancies, and STIs are issues facing many countries. The background literature explores teenage sexual risk taking from a worldwide perspective, and the ideas discussed within this book are generalizable beyond the UK and to non-SES populations. This book also provides reflections and practical advice on the ethical issues associated with research in this context.

Overall, the book comprises 11 chapters, with Chapters 2–11 outlined below.

Current Research on Sexual Health and Teenagers (Chapter 2)

Chapter 2 provides current literature around teenager's sexual health. The chapter is split into five sections: (1) an overview of teenage sexual health and consideration of risky sexual behaviors; (2) an overview of the main theoretical models in the literature; (3) an examination of the predictors of risky sexual behaviors; (4) an overview of sexual health issues in the digital world; and finally (5) the particular issues associated with females from low SES areas. Taken together, these sections provide an overview of current research on sexual health and teenagers.

Sexual Health Education in Schools and Digital Interventions (Chapter 3)

Chapter 3 presents an overview of the research on commonly cited sexual health intervention programs. This chapter is in three sections to provide greater clarity of the research literature. The first section provides an overview of sexual health education within schools, the second section provides an overview of external sexual health intervention programs, and the final section considers digital sexual interventions.

Sexual Health Professional Views of Sexual Health Education (Chapter 4)

Chapter 4 presents a qualitative study exploring sexual health professionals' views of female teenagers' sexual health information seeking practices and barriers and reexamines the sexual health predictors suggested by previous literature. The focus on sexual health professionals is important given their position as key stakeholders in implementing sexual health interventions, yet their views are largely absent from the literature. The barriers identified were “environment and family,” “society and media,” “peer influences,” “self-esteem,” and “moving forward with intervention programs.” In terms of the sexual health predictors, sexual health professionals ranked 33 of the 57 identified as key predictors in the extant literature as highly important, thus supporting previous research. Some of the barriers identified were consistent with previous research, while others were particularly novel. Interestingly, sexual health professionals identified self-esteem as a highly important factor influencing teenagers' likelihood to seek sexual health information, while also being an important predictor of risky sexual behaviors. Yet, limited evidence for self-esteem has been found in previous quantitative studies. This suggests that going forward, sexual health interventions that build self-esteem and address socioeconomic stigma may encourage adolescents to feel confident to make their own informed sexual health decisions.

Ethical Issues When Researching Teenagers and Sexual Health (Chapter 5)

Chapter 5 considers the importance of ethical issues when conducting sexual health research with teenagers. The chapter is divided into four sections. Section 1 discusses the importance and background of ethics. Section 2 considers existing ethical guidelines and Section 3 provides a consideration of our own personal experiences of the ethical issues encountered in sexual health research. The final section draws together the key issues and provides guidance on how to implement ethical procedures when researching sexual health with teenagers.

Teenagers' Views of Sexual Health Education (Chapter 6)

Chapter 6 discusses a qualitative study designed to explore low SES female teenagers' sexual health knowledge and information sources. The study utilized a 4-week diary produced three themes: (1) Can I ask you a question? (2) The social consequences of sex; (3) Information ...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Acknowledgments
• Chapter 1. Introduction
• Chapter 2. Current Research on Sexual Health and Teenagers
• Chapter 3. Sexual Health Education in and Outside of Schools and Digital Sexual Health Interventions
• Chapter 4. Sexual Health Professional Views of Sexual Health Education
• Chapter 5. Ethical Issues When Researching Sexual Health With Teenagers
• Chapter 6. Teenagers' Views of Sexual Health Education
• Chapter 7. Predictors of Risky Behaviors for Female Teenagers
• Chapter 8. Teenagers' Views of Sexual Health Education Websites and Apps
• Chapter 9. Students' Views of Sexual Health Apps
• Chapter 10. A Brief Online Self-affirmation Intervention to Promote Safe sex Intentions
• Chapter 11. Reflections
• Index