The main aim of this study is to conduct a pretest-posttest RCT with a three-month follow-up to investigate the sustainability of outcomes in students who use the Media Aware program. Media Aware, a web-based media literacy education program for high school students to promote sexual and relationship health. Media Aware is designed to provide high school students with sexual health knowledge, media literacy skills, and the skills to make healthy decisions about sexual activity. This study will examine if behavioral indicators among students in the intervention group sustain, emerge, or diminish over time compared to students in the delayed intervention group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
590
Media Aware is an online media literacy and sexual health education program developed for high school students that addresses the influence of media on sexual behaviors explicitly using established message processing theory. The program consists of 4 self-paced modules each with two to three lessons. Broadly, the modules cover healthy and unhealthy relationships, sexually transmitted infections, consent, substance use, pregnancy, protection and contraception, and communication between adolescents and their partners, parents, or health providers. Users also learn media literacy skills including message deconstruction to help examine the truth behind media messages.
innovation Research and Training
Durham, North Carolina, United States
Willingness to Have Sex
Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to have sex in a relationship context. (Imagine you were with a boyfriend/girlfriend and they say they love you. They want to have sex. In this situation, how willing would you be to have sex?).
Time frame: posttest (approximately one week after pretest)
Willingness to Have Sex
Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to have sex in a relationship context. (Imagine you were with a boyfriend/girlfriend and they say they love you. They want to have sex. In this situation, how willing would you be to have sex?).
Time frame: follow-up (approximately three months after pretest)
Willingness to Engage in Unprotected Sex
Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to engage in unprotected sex (Imagine you were with a boyfriend/girlfriend. They want to have sex, but neither of you have any form of protection. In this situation, how willing would you be to go ahead and have sex anyway?). (adapted from Gibbons, Gerrard, Blanton, \& Russell, 2014)
Time frame: posttest (approximately one week after pretest)
Willingness to Engage in Unprotected Sex
Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to engage in unprotected sex (Imagine you were with a boyfriend/girlfriend. They want to have sex, but neither of you have any form of protection. In this situation, how willing would you be to go ahead and have sex anyway?). (adapted from Gibbons, Gerrard, Blanton, \& Russell, 2014)
Time frame: follow-up (approximately three months after pretest)
Willingness to Hook up
Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to have hook up even if they are not sure that they really want to (Imagine you were with a boyfriend/girlfriend. They want to hook-up, but you are not sure that you want to. In this situation, how willing would you be to go ahead and hook-up anyway?). (adapted from Gibbons, Gerrard, Blanton, \& Russell, 2014)
Time frame: posttest (approximately one week after pretest)
Willingness to Hook up
Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to have hook up even if they are not sure that they really want to (Imagine you were with a boyfriend/girlfriend. They want to hook-up, but you are not sure that you want to. In this situation, how willing would you be to go ahead and hook-up anyway?). (adapted from Gibbons, Gerrard, Blanton, \& Russell, 2014)
Time frame: follow-up (approximately three months after pretest)
Intentions to Engage in Sexual Activity With Another Person
Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to engage in sexual activity in the next year (How likely is that you will have any type of sexual contact with another person (oral sex, anal sex, vaginal sex, or genital-to-genital contact) in the next year?). α = 0.77 (adapted from L'Engle, Brown, and Kenneavy, 2006)
Time frame: posttest (approximately one week after pretest)
Intentions to Engage in Sexual Activity With Another Person
Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to engage in sexual activity in the next year (How likely is that you will have any type of sexual contact with another person (oral sex, anal sex, vaginal sex, or genital-to-genital contact) in the next year?). α = 0.77 (adapted from L'Engle, Brown, and Kenneavy, 2006)
Time frame: follow-up (approximately three months after pretest)
Condom Use Intentions
Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to have vaginal or anal sex, how likely would you be to use a condom?). (adapted from Jemmott and Jemmott, 1991)
Time frame: posttest (approximately one week after pretest)
Condom Use Intentions
Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to have vaginal or anal sex, how likely would you be to use a condom?). (adapted from Jemmott and Jemmott, 1991)
Time frame: follow-up (approximately three months after pretest)
Birth Control Use Intentions (Other Than Condoms)
Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to have vaginal sex, how likely would you be to use birth control other than condoms?). (adapted from Jemmott and Jemmott, 1991)
Time frame: posttest (approximately one week after pretest)
Birth Control Use Intentions (Other Than Condoms)
Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to have vaginal sex, how likely would you be to use birth control other than condoms?). (adapted from Jemmott and Jemmott, 1991)
Time frame: follow-up (approximately three months after pretest)
Protection Intentions During Oral Sex
Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to decide to have oral sex, how likely would you be to use a condom or dental dam?). (adapted from Jemmott and Jemmott, 1991)
Time frame: posttest (approximately one week after pretest)
Protection Intentions During Oral Sex
Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to decide to have oral sex, how likely would you be to use a condom or dental dam?). (adapted from Jemmott and Jemmott, 1991)
Time frame: follow-up (approximately three months after pretest)
Perceived Realism of Media Messages
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) the degree to which they agreed that teens on the media (e.g., Teens in the media do things that average teens do.). (adapted from Austin and Johnson, 1997, α=0.80)
Time frame: posttest (approximately one week after pretest)
Perceived Realism of Media Messages
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) the degree to which they agreed that teens on the media (e.g., Teens in the media do things that average teens do.). (adapted from Austin and Johnson, 1997, α=0.80)
Time frame: follow-up (approximately three months after pretest)
Acceptance of Dating Violence
Participants are asked to indicate on a 4-point Likert scale (1=strongly 2=disagree; 3=disagree; 4=agree; strongly agree) their level of agreement on several items pertaining to dating violence (e.g., It is okay for people to hit their girlfriends/boyfriends if they did something to make them mad.). (adapted from Foshee, Bauman, Ennett, Suchindran, Benefield, and Linder, 2005 α=0.73)
Time frame: posttest (approximately one week after pretest)
Acceptance of Dating Violence
Participants are asked to indicate on a 4-point Likert scale (1=strongly 2=disagree; 3=disagree; 4=agree; strongly agree) their level of agreement on several items pertaining to dating violence (e.g., It is okay for people to hit their girlfriends/boyfriends if they did something to make them mad.). (adapted from Foshee, Bauman, Ennett, Suchindran, Benefield, and Linder, 2005 α=0.73)
Time frame: follow-up (approximately three months after pretest)
Advertisement Deconstruction Skills
Participants are shown an advertisement and asked to describe it in detail including noting marketing strategies and any missing information (e.g., How are advertisers trying to get someone to buy this product?). Qualitative responses to the questions are coded by trained project staff members once inter-coder reliability is established, and scores will be summed to create an overall deconstruction skills composite variable. (adapted from Kupersmidt, Scull, \& Benson, 2012)
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Time frame: posttest (approximately one week after pretest)
Advertisement Deconstruction Skills
Participants are shown an advertisement and asked to describe it in detail including noting marketing strategies and any missing information (e.g., How are advertisers trying to get someone to buy this product?). Qualitative responses to the questions are coded by trained project staff members once inter-coder reliability is established, and scores will be summed to create an overall deconstruction skills composite variable (adapted from Kupersmidt, Scull, \& Benson, 2012).
Time frame: follow-up (approximately three months after pretest)
Media Message Completeness
Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (1=incomplete to 4=complete) how complete the information included in an advertisement is (e.g., How complete is the information in this advertisement?).
Time frame: posttest (approximately one week after pretest)
Media Message Completeness
Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (1=incomplete to 4=complete) how complete the information included in an advertisement is (e.g., How complete is the information in this advertisement?).
Time frame: follow-up (approximately three months after pretest)
Media Skepticism
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) the degree to which they agree with several statements about media (e.g., Media are dishonest about what happens if people have sex.). (adapted from Scull, Malik, and Kupersmidt, 2014, α=0.86)
Time frame: posttest (approximately one week after pretest)
Media Skepticism
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) the degree to which they agree with several statements about media (e.g., Media are dishonest about what happens if people have sex.). (adapted from Scull, Malik, and Kupersmidt, 2014, α=0.86)
Time frame: follow-up (approximately three months after pretest)
Acceptance of Strict Gender Role Stereotypes
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) their level of agreement on several items pertaining to strict gender role stereotypes (e.g., Raising children is primarily a woman's responsibility.). (adapted from Foshee, Bauman, Ennett, Suchindran, Benefield, and Linder, 2005 α=0.87)
Time frame: posttest (approximately one week after pretest)
Acceptance of Strict Gender Role Stereotypes
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) their level of agreement on several items pertaining to strict gender role stereotypes (e.g., Raising children is primarily a woman's responsibility.). (adapted from Foshee, Bauman, Ennett, Suchindran, Benefield, and Linder, 2005 α=0.87)
Time frame: follow-up (approximately three months after pretest)
Acceptance of Rape Myths
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) their level of agreement on several items pertaining to myths about rape (e.g., It shouldn't be considered rape if a guy is drunk and didn't realize what he was doing.). (adapted from Illinois Rape Myth Acceptance-Short Form (IRMA-SF; 7 pt. scale); Payne et al., (1999); McMahon \& Farmer (2011), α=0.88)
Time frame: posttest (approximately one week after pretest)
Acceptance of Rape Myths
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) their level of agreement on several items pertaining to myths about rape (e.g., It shouldn't be considered rape if a guy is drunk and didn't realize what he was doing.). (adapted from Illinois Rape Myth Acceptance-Short Form (IRMA-SF; 7 pt. scale); Payne et al., (1999); McMahon \& Farmer (2011), α=0.88)
Time frame: follow-up (approximately three months after pretest)
Intentions to Intervene as Bystander
Participants are asked to indicate on a 4-point Likert scale (1=not likely at all; 2=Unlikely; 3=Likely; 4=Extremely likely) how likely they would be to intervene as a bystander (e.g., Approach a friend if I thought they were in an abusive relationship and let them know that I am here to help.). (adapted from Banyard, 2005)
Time frame: posttest (approximately one week after pretest)
Intentions to Intervene as Bystander
Participants are asked to indicate on a 4-point Likert scale (1=not likely at all; 2=Unlikely; 3=Likely; 4=Extremely likely) how likely they would be to intervene as a bystander (e.g., Approach a friend if I thought they were in an abusive relationship and let them know that I am here to help.). (adapted from Banyard, 2005)
Time frame: follow-up (approximately three months after pretest)
Efficacy to Intervene as Bystander
Participants are asked to indicate on a scale of 0 (Can't do) to 100 (Very Certain) their degree of confidence in several behaviors (e.g., I could talk to a friend who I suspected is in an abusive relationship.). (adapted from Banyard, 2005)
Time frame: posttest (approximately one week after pretest)
Efficacy to Intervene as Bystander
Participants are asked to indicate on a scale of 0 (Can't do) to 100 (Very Certain) their degree of confidence in several behaviors (e.g., I could talk to a friend who I suspected is in an abusive relationship.). (adapted from Banyard, 2005)
Time frame: follow-up (approximately three months after pretest)
Descriptive Norms Regarding Teen Sexual Activity
Participants are asked to indicate what percentage \[0% = no teens; 100% = all teens\] of teens engage in sexual activity (e.g., oral sex, vaginal sex, anal sex). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)
Time frame: posttest (approximately one week after pretest)
Descriptive Norms Regarding Teen Sexual Activity
Participants are asked to indicate what percentage \[0% = no teens; 100% = all teens\] of teens engage in sexual activity (e.g., oral sex, vaginal sex, anal sex). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)
Time frame: follow-up (approximately three months after pretest)
Descriptive Norms Regarding Teen Risky Sexual Activity
Participants are asked to indicate what percentage \[0% = no teens; 100% = all teens\] of teens engage in risky sexual activities (e.g., What percentage of teens have sex with someone who is much older?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)
Time frame: posttest (approximately one week after pretest)
Descriptive Norms Regarding Teen Risky Sexual Activity
Participants are asked to indicate what percentage \[0% = no teens; 100% = all teens\] of teens engage in risky sexual activities (e.g., What percentage of teens have sex with someone who is much older?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)
Time frame: follow-up (approximately three months after pretest)
Sexual Health Knowledge
Participants are asked several multiple choice and True/False questions about sexual health (e.g., True or false: You can tell someone has an STI by looking at him/her.).
Time frame: posttest (approximately one week after pretest)
Sexual Health Knowledge
Participants are asked several multiple choice and True/False questions about sexual health (e.g., True or false: You can tell someone has an STI by looking at him/her.).
Time frame: follow-up (approximately three months after pretest)
Descriptive Norms Regarding Sexual Health Communication
Participants are asked to indicate what percentage \[0% = no teens; 100% = all teens\] of teens communicate with parents, health providers, or another trusted adult (e.g., Before deciding to have sex, what percentage of teens talk with their boy/girlfriend about sexual health?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)
Time frame: posttest (approximately one week after pretest)
Descriptive Norms Regarding Sexual Health Communication
Participants are asked to indicate what percentage \[0% = no teens; 100% = all teens\] of teens communicate with parents, health providers, or another trusted adult (e.g., Before deciding to have sex, what percentage of teens talk with their boy/girlfriend about sexual health?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)
Time frame: follow-up (approximately three months after pretest)
Efficacy to Negotiate Contraception/Protection Use
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could convince a partner to use contraception (e.g., If I decided to have sex, I could talk to any potential partner to make him/her understand why we should use condoms or other contraception.).
Time frame: posttest (approximately one week after pretest)
Efficacy to Negotiate Contraception/Protection Use
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could convince a partner to use contraception (e.g., If I decided to have sex, I could talk to any potential partner to make him/her understand why we should use condoms or other contraception.).
Time frame: follow-up (approximately three months after pretest)
Efficacy to Use Contraception/Protection
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could get and use contraception (e.g., If I wanted to, I could get condoms or another form of contraception.).
Time frame: posttest (approximately one week after pretest)
Efficacy to Use Contraception/Protection
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could get and use contraception (e.g., If I wanted to, I could get condoms or another form of contraception.).
Time frame: follow-up (approximately three months after pretest)
Descriptive Norms Regarding Teen Birth Control Use
Participants are asked to indicate what percentage \[0% = no teens; 100% = all teens\] of teens use contraception (e.g., What percentage of teens who have oral sex use a condom or a dental dam?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)
Time frame: posttest (approximately one week after pretest)
Descriptive Norms Regarding Teen Birth Control Use
Participants are asked to indicate what percentage \[0% = no teens; 100% = all teens\] of teens use contraception (e.g., What percentage of teens who have oral sex use a condom or a dental dam?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)
Time frame: follow-up (approximately three months after pretest)
Efficacy to Communicate Before Sex
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could communicate with others about sexual health (e.g., I could talk with a boy/girlfriend about using condoms for sexually transmitted infection protection.). (adapted from Scull, Malik, \& Kupersmidt, 2014)
Time frame: posttest (approximately one week after pretest)
Efficacy to Communicate Before Sex
Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could communicate with others about sexual health (e.g., I could talk with a boy/girlfriend about using condoms for sexually transmitted infection protection.). (adapted from Scull, Malik, \& Kupersmidt, 2014)
Time frame: follow-up (approximately three months after pretest)
Intent to Communicate Before Sex
Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to communicate with others before sexual activity (e.g., Before deciding to have sex, how likely would you be to talk with your parents or another trusted adult about sexual health?). (adapted from Scull, Malik, \& Kupersmidt, 2014)
Time frame: posttest (approximately one week after pretest)
Intent to Communicate Before Sex
Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to communicate with others before sexual activity (e.g., Before deciding to have sex, how likely would you be to talk with your parents or another trusted adult about sexual health?). (adapted from Scull, Malik, \& Kupersmidt, 2014)
Time frame: follow-up (approximately three months after pretest)
Cognitive Elaboration While Viewing an Advertisement
Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (1=not much at all; 2=a little; 3=a good amount; 4=a lot) the extent to which they: 1) thought about the ad; 2) spent time thinking about the ad; and 3) paid attention to the ad. (adapted from Shiv, Britton, and Payne, 2004)
Time frame: posttest (approximately one week after pretest)
Cognitive Elaboration While Viewing an Advertisement
Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (1=not much at all; 2=a little; 3=a good amount; 4=a lot) the extent to which they: 1) thought about the ad; 2) spent time thinking about the ad; and 3) paid attention to the ad. (adapted from Shiv, Britton, and Payne, 2004)
Time frame: follow-up (approximately three months after pretest)
Communication With a Doctor or Other Health Professional About Sexual Health
Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a doctor or other health professional (e.g., How often do you talk with a doctor or other health professional about sexual health?).
Time frame: posttest (approximately one week after pretest)
Communication With a Doctor or Other Health Professional About Sexual Health
Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a doctor or other health professional (e.g., How often do you talk with a doctor or other health professional about sexual health?).
Time frame: follow-up (approximately three months after pretest)
Communication With a Parent or Other Trusted Adult About Sexual Health
Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a doctor or trusted adult (e.g., How often do you talk with a parent or other trusted professional about sexual health?).
Time frame: posttest (approximately one week after pretest)
Communication With a Parent or Other Trusted Adult About Sexual Health
Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a doctor or trusted adult (e.g., How often do you talk with a parent or other trusted professional about sexual health?).
Time frame: follow-up (approximately three months after pretest)
Communication With a Boyfriend or Girlfriend About Sexual Health
Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a boyfriend/girlfriend (e.g., How often do you talk with your boyfriend/girlfriend about sexual health?).
Time frame: posttest (approximately one week after pretest)
Communication With a Boyfriend or Girlfriend About Sexual Health
Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a boyfriend/girlfriend (e.g., How often do you talk with your boyfriend/girlfriend about sexual health?).
Time frame: follow-up (approximately three months after pretest)