DESCRIPTION: In order to prevent sexually transmitted infections STIsthe World Health Organization recommends educating people on sexual health. With more than 2 billion active users worldwide, online social media potentially represent powerful channels for health promotion, including sexual health. To review the scientific literature on the use of online social media for sexual health promotion.Expand Dong: Just if you want to know the Swedish woman said something about the weather
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To analyze the use of online social media for sexual health. education or . three were part of the Get Yourself Tested campaign. (19, 37, 50);. Engaging young people with sexual health through social and . We campaign for a world where people with HIV live healthy lives, free from prejudice and discrimination, and we promote good sexual health as a right and reality for all. accessible online tools and services - Tailored adverts and targeted. While not all of the health-related campaigns remain online, outlined This pilot intervention trialled the delivery of sexual health promotion via.
In order to sexually transmitted infections STIsthe World Health Organization recommends educating people on sexual health. With more than 2 billion active users worldwide, online social media potentially represent powerful channels for health promotion, including sexual health.
To review the scientific literature on the use of online social media for sexual health promotion. A search was conducted of scientific and medical databases, and grey literature was also included. The selected publications were classified according to their study designs, sexual health promotion main subject, target audience age, and social media use.
Fifty-one publications were included; 4 publications presenting randomized intervention studies, 39 non-randomized intervention studies, and 8 observational studies. In 29 publications Although billions of people worldwide actively use social media, we identified only 51 publications on the use of social media for promoting sexual health. About a quarter of the publications have identified promising results, and the evidence for positive effects of social media interventions for promoting sexual health is increasing.
There is a need for more studies that explicitly discuss their theoretical framework, and that have strong research designs, in order to increase the evidence base of the field.
It is estimated that about a million people globally acquire a sexually transmitted infection STI every day, including many who are infected with the human immunodeficiency virus HIV 12.
Individuals who have STIs may experience acute or chronic symptoms. Women with STIs Sexual health promotion campaigns online particular are at risk for pelvic inflammatory disease, cervical cancer, infertility, ectopic pregnancy, and transmitting STIs to their children during birth 12.
In order to prevent STIs, minimize the effects among infected people, and to reduce the enormous burden that STIs represent for developed and developing countries, the World Health Organization WHO Sexual health promotion campaigns online published the Global Strategy for the Prevention and Control of Sexually Transmitted Infectionswhere the need for educating people on sexual health is emphasized 12. In order to achieve this educational goal, the WHO points to the importance of choosing the communication channels that most effectively reach the target population 12.
Online social media, such as Facebook or Twitter, have become extremely popular worldwide and might therefore be powerful channels for reaching many people. Since their launch, the adoption of these technologies has been steeply increasing, surpassing 2 billion active users worldwide in Facebook is the most used social media channel, with more than 1. Because social media are popular and frequently used by many people of various ages worldwide, there is potential for the media to be used for health promotion 4 — 7including for potentially sensitive and stigmatizing subjects such as those related to sexual health 8 — Previous reviews have addressed the use of computer-based technologies in general for sexual health promotion but not specifically the social media 11 — And some reviews have analyzed the use of social media for health promotion in general, including sexual health 8 We have identified prior reviews that addressed the use of online media specifically sexual health education or sexual health promotion.
A more recent review focused specifically on the impact of social media interventions targeting adolescents and young adults. The study reported that online social media can increase knowledge regarding STI prevention in this population, Sexual health promotion campaigns online the evidence was weaker regarding the effects on behavior change Another review studied the viability of social media as tools that health care professionals can provide to adolescents The authors highlighted the need for further studies on how to use these technologies to educate adolescents about STIs The number of publications and programs describing social media as a means for promoting sexual health is rapidly increasing.
There is a need for an updated review of the literature that is not restricted to youth or to peer-reviewed publications, specific uses of social media, or to specific types of outcomes or study designs, that examines the literature regarding the use of social media for STI prevention and health promotion. The objective of this scoping review is to describe the scientific literature on the use of online social media for sexual health education and sexual health promotion.
The search was performed in the following multidisciplinary databases: To capture grey literature, additional publications, conference proceedings, and research reports were searched in additional databases e. We also searched manually for program evaluation reports referring to the use of social media for sexual health promotion or sexual health education Sexual health promotion campaigns online available on websites of the following non-governmental organizations NGOs: The full search strategy is summarized in the Supplementary file.
Publications were included in the review if they: Papers that did not meet all three criteria were excluded. Following the search, duplicates were removed. Subsequently, full-text articles of the selected studies were retrieved and rigorously examined to sort out any remaining papers that did not meet the criteria. The
Sexual health promotion campaigns online selected for full review were classified according to
Sexual health promotion campaigns online study designs i.
Data were extracted by one reviewer EG and verified by a second reviewer RW. A total of 9, publications were identified; the search strategy and its results are summarized in the Supplementary file. Fifty-one of these publications met
Sexual health promotion campaigns online inclusion criteria 19 — 69 see Fig. Forty-one of these 51 publications corresponded to unique studies; in addition, three publications belonged to Project HOPE 264043 ; three were part of the Get Yourself Tested campaign 193750 ; two papers referred to the FaceSpace Project 2333 ; and two studies reported on an HIV self-test campaign on Grindr.
All the included studies were carried out between and Among the 51 included publications, 4
Sexual health promotion campaigns online on randomized intervention studies, 39 reported on non-randomized interventions, and 8 reported on observational studies.
A summary of the publications included in this review is presented in Table 1. Only four of the included papers had a design that involved a randomization procedure 222638 Two of these publications, belonging to the Project HOPE study, described an intervention in which participants were randomized to receive either peer-delivered HIV-related information or general health information through Facebook for 12 weeks, framed within a social network intervention Sexual health promotion campaigns online, specifically, a peer-delivered intervention 26 The study reported that peer leaders felt more comfortable discussing sexual health on social media Another study randomized the participants to an intervention through a Facebook page on youth health information or to a News page on Facebook for 2 months Another study randomized health centers to offer a reminder service to increase HPV vaccination completion including messages sent through Facebook or to schedule routine follow-up The intervention group did not increase vaccine completion rates All the randomized studies were carried out in the US.
It is difficult to compare the effects of these randomized studies because they measure outcomes as different as feeling comfortable discussing sexual health on social media and rates of HIV testing 2640condom use 22and HPV vaccination completion rates Two of the three studies did report some type of positive statistically significant outcome from social media interventions. Thirty-nine of the selected publications had a non-randomized design. Eighteen of them only showed data regarding project reach and engagement number of users, time spent, etc.
The designs in 12 of the publications combined quantitative data on technology use and also questionnaires or opinions of project users regarding their satisfaction, knowledge, engagement, or behavior change intention to test 2930333439414246505863 The remaining study had an observational approach and analyzed the strategies for successful user engagement in some Facebook and Twitter profiles undertaking sexual health promotion As a result of the intervention, 34 and program users, respectively, attended health services 5263 and asked for a self-test Only five of these non-randomized intervention studies or programs referred to the theoretical models they used as a framework for behavior change intervention 24304158 The chosen approaches were Kelly's popular opinion leader model; game-based learning with participatory approach; Pender's health promotion model; peer education models; and a community engagement model.
Two projects referring to the Kelly's popular opinion leader model and Pender's health promotion model, respectively, reported positive results regarding an increase in intention to test Eight studies were observational—where the subjects participated in focus groups or answered questionnaires or surveys 20212527313544 Sexual health promotion campaigns online, In all the studies with young people, social media were reported to be pervasive, and the study participants reacted positively to using new technologies for sexual health promotion or education 20212527 In the observational studies with adults, the importance of considering privacy, stigma, and social norms was emphasized 4457and in this sense, links to social media profiles were not considered to be appealing No theoretical framework was reported in any of the observational studies included in this review.
In 29 of the 51 publications Among the 51 included publications, 30 The 10 remaining publications These studies involved Facebook, either used separately 222430363940 Sexual health promotion campaigns online, 4356 or in addition to other social media channels such as Twitter, Flickr, YouTube, etc. Three studies used the geosocial networking app Grindr 51 — 53 ; one was carried out on YouTube 62 ; and one publication referred to two purpose-developed online social networks Eight publications that used social media as unique channels for sexual health promotion interventions reported an effect on behavior three randomized trials and five non-randomized interventions.
The reported effects were: Twenty of these 28 publications considered more than one social media channel as a supporting resource for the promotion i. Twitter, Instagram, YouTube, Whatsapp, Vkontakte or did not specify a unique resource 192125282931353742 Sexual health promotion campaigns online, 47495459 — 61636567 — Only one of these studies did not refer specifically to Facebook.
In this latter study, the sexual health promotion was carried out on YouTube, and the comments on the study were tracked though Twitter When a unique social media channel to support the promotion was chosen, Facebook was the medium of choice in seven publications 32384146485058 and Twitter in one study Six publications using online social media as a tool supporting sexual health promotion reported an effect on behavior, all of them non-randomized interventions.
The use of the Internet for health purposes has been increasing for a long time 7071and many health services around the world now offer Internet-based services 16 The development of online social media is more recent, but these media have become very popular 3offering a strong potential for health-related use and also within the field of sexual health The present review shows that although online social media have been used in the sexual health promotion research field, the number of scientific studies is still relatively modest; we were able to identify 51 publications that fit the inclusion criteria.
The use of social media for sexual health promotion is a rapidly emerging field. Although some reviews have previously been published dealing with the topic 10 — 17these are either several years old, or they only report on selected target groups i.
The four RCTs Randomized Controlled Trials reported on in the present review are relatively new and therefore were not included in several of the prior reviews.
Our updated review includes recent publications covering all target groups. It also covers relevant sexual health promotion projects that have been carried out by NGOs, many of which have not been included in previous review papers. However, only three of these publications were randomized studies 222640that is, studies with a design that allowed for controlled measurements of the effects of the interventions.
Two of these quality studies three publications reported important results linked to the use of social media with regard to users feeling comfortable with sexual health topics on these channels 26 40a short-term increase in condom use, and increased HIV testing rates Another randomized trial did not find any benefit in sending reminders to complete a HPV vaccination schedule with the use of several channels, including social media
Sexual health promotion campaigns online Although the four studies had a strong RCT design, they all reported on various limitations that might have impacted the findings, including a reliance on self-reporting 17small sample sizes 2135and low completion rates The different outcome measures used in the randomized studies make it difficult to compare the outcomes of the different social media interventions in these studies.
However, we find it promising that two of the three studies did report positive statistically significant differences between the intervention and control groups. Only 4 of the 14 studies reporting behavior effects have been contextualized within a theoretical framework or model or have referred explicitly to a model. More studies that systematically evaluate interventions with a randomized control condition and that refer to a theoretical framework clearly are needed to increase the evidence and move the field forward.
A further 39 studies were non-randomized intervention studies or programs, a design that allowed for the testing out of various interventions, but where it would be somewhat more difficult to make strong claims about the effects of the interventions themselves because there was Sexual health promotion campaigns online randomization.
The non-randomized intervention studies seemed to have had positive results in terms of increases in rates of STI testing, higher condom use, and intention to test, better sexual health knowledge, and a potential to change behavior linked to the intervention 19243037475253 Sexual health promotion campaigns online, 556367and even a change in curable STIs rates 2447 Many of the studies reported that large numbers of people had visited educational sites or utilized the online interventions 23282932 — 343943454850545659 — Eight studies were observational and, although these designs may provide important insights—for instance, relating to willingness to use or obstacles to use online social media for sexual health 2021252731354457they do not allow for strong claims about the effects of social media on STI prevention and sexual health promotion.
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To analyze the use of online social media for sexual health. education or . three were part of the Get Yourself Tested campaign. (19, 37, 50);. Our DCHS sexual health promotion team deliver sexual health campaigns throughout the year. The aim of these campaigns is to raise awareness and provide. While not all of the health-related campaigns remain online, outlined This pilot intervention trialled the delivery of sexual health promotion via.