Research suggests up to 77% of harmful sexual experiences during childhood are caused by other youth. Sometimes called peer-peer abuse or youth-perpetrated child sexual abuse, problematic and harmful sexual behavior among youth (PHSBY) involves sexual behaviors that are not developmentally appropriate and have potential to cause harm to the child or children involved. Compared to adults, children and adolescents who engage in sexual exploration are at greater risk of making mistakes or causing harm, in large part because they have insufficient information about healthy sexual behavior and development, consent, and related concepts. However, the available support, information, and resources for youth who have engaged in or are at risk of engaging in PSHB are limited. To address these unmet needs, Stop it Now! (stopitnow.org) created the first youth-focused website and helpline services (WhatsOK) for young people with concerns about their sexual thoughts, interests, and behaviors. WhatsOK.org is a microsite developed specifically for youth aged 14-21 years. If a child or young person has concerns about their sexual thoughts or behaviors, the WhatsOK Online Help Center and Helpline can provide support and resources to support healthy behavior and prevent problematic or harmful behavior. If someone has already engaged in PHSBY or if they are unsure about whether what has been done is illegal, they can still reach out for confidential help to learn about taking steps to stop. Preliminary findings from a longitudinal, observational study of the WhatsOK helpline suggest that youth are willing to seek out help for their (and others') sexual interests and behaviors, highlighting the critical need for prevention strategies targeting youth with potentially concerning sexual behaviors. We examined the characteristics of contacts to the WhatsOK helpline via data collected from pre-set questions on age, primary reason for contact, timing of inquiry relative to other help-seeking, and timing relative to harm caused. Most inquiries came from youth aged 14 to 21 (57.7%) via email (54.4%). Over half (54.6%) had already engaged in harmful or illegal behaviors or were potentially at risk to do so. The majority of contacts sought help prior to seeking out other external professional resources (54%). The current study is a randomized control trial evaluating the impact of the WhatsOK helpline in reducing PHSBY and improving help-seeking attitudes and behavior in a sample of participants ages 14-17 with concerns about their sexual thoughts and behaviors.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
920
Participants will be directed to contact the WhatsOK helpline, where they can confidentially discuss their concerns about sexual thoughts or behaviors with a trained counselor
Help-seeking behaviors
Investigators will measure whether participants have sought support (beyond their assigned treatment condition) for concerns about their sexual thoughts and behaviors. Help-seeking behaviors will be measured using two items. 1.) \[In the past time\], have you tried to find information related to concerns about your sexual thoughts, feelings, or behaviors? and 2.) \[In the past time\], have you reached out for support about concerns related to your sexual thoughts, feelings, or behaviors? Response options are binary "yes/no". Participants can also select "prefer not to answer".
Time frame: Participants' behaviors will be measured at baseline, t2 (baseline + 3 days), T3 (baseline + 14 days), T4 (baseline + 45 days), and T5 (baseline + 90 days)
Sexual behaviors
Investigators will measure a variety of sexual behaviors, such as engaging in sexual contact with someone who does not consent (e.g, Have you ever made someone do sexual things when they didn't want to?); engaging in sexual contact with a young child; viewing or sharing sexual images of/with someone who does not consent; viewing, sharing, or creating sexual images of someone under the age of 18. Researcher created measure.
Time frame: Participants' behaviors will be measured at baseline, t2 (baseline + 3 days), T3 (baseline + 14 days), T4 (baseline + 45 days), and T5 (baseline + 90 days)
Safety Planning
Participants will be asked two questions about safety planning behaviors that ask if participants have ever thought about specific ways or taken specific steps to make sure they don't engage in sexual behaviors that are illegal or could harm someone else. Participants are asked to choose the statement that best describes them. Options include: "yes, I have thought of specific ways/taken specific steps to avoid these behaviors", "no -I know I won't engage in these behaviors", "no - I need more information to come up with specific ways" or "no - I have ideas but haven't been able to put them into action yet", "no - avoiding these behaviors is not a priority for me". "something else" and "prefer not to answer".
Time frame: Participants' mental health will be measured at baseline, t2 (baseline + 3 days), T3 (baseline + 14 days), T4 (baseline + 45 days), and T5 (baseline + 90 days)
Well-being
Well-being will be assessed using the 7-item Students' Life Satisfaction Scale. A 7-point Likert scale (from very strongly disagree to very strongly agree) will be used to measure participants' responses. Participants are also able to select "prefer not to answer".
Time frame: Participants' mental health will be measured at baseline, t2 (baseline + 3 days), T3 (baseline + 14 days), T4 (baseline + 45 days), and T5 (baseline + 90 days)
Internal shame
Investigators will measure internal shame using the 4-item Internal Shame Subscale of the External and Internal Shame Scale. Responses are measures using a 7-point Likert scale ranging from "very strongly disagree" to "very strongly agree". Participants can also select "prefer not to answer".
Time frame: Participants' behaviors will be measured at baseline, t2 (baseline + 3 days), T3 (baseline + 14 days), T4 (baseline + 45 days), and T5 (baseline + 90 days)
Perceived resources
Investigators will measure participants perceptions of resources in their lives for concerns about sexual thoughts and behaviors through a 4-item researcher-created scale (e.g., "There are safe resources available to help people my age with similar concerns about their sexual thoughts, feelings, or behaviors"). Responses are measured through a 7-point Likert scale that ranges from "very strongly disagree" to "very strongly agree". Participants are also able to select "prefer not to answer".
Time frame: Participants' behaviors will be measured at baseline, t2 (baseline + 3 days), T3 (baseline + 14 days), T4 (baseline + 45 days), and T5 (baseline + 90 days)
Perceived self-efficacy
This is a researcher-created scale. This scale consists of 4 items to measure participants' perceived ability to avoid engaging in harmful or illegal behaviors (e.g., "If I have sexual thoughts that make me feel worried or concerned, I can take steps to address them."). Items are scored on a 7-point Likert Scale which ranges from "very strongly disagree" to "very strongly agree"). Participants are also able to select "prefer not to answer".
Time frame: Participants' perceived self-efficacy will be measured at baseline, t2 (baseline + 3 days), T3 (baseline + 14 days), T4 (baseline + 45 days), and T5 (baseline + 90 days)
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