Media Aware (Sexual Health Program for Young Adults)

About the program

Media Aware (Sexual Health Program for Young Adults) is a five-lesson, web-based, comprehensive sexual health program that uses an MLE framework and covers a wide range of sexual health topics, including pregnancy and STI prevention, dating violence, relationship health, and communication with sexual partners and medical health professionals.

Throughout the program, students analyse and evaluate popular media messages, and reflect on common themes about sex and relationships, including media representations of gender roles, sexual violence, consent, and sex and substance use. As part of these analyses, students learn to evaluate the accuracy and completeness of information provided in media messages by comparing the information presented media to medically accurate sexual health information.

The program was created through consultation with community college administrators and educators, community college students, psychologists, media researchers, and sexual health experts, as well as via focus group and usability testing with the target user.

Who does it work for?

Media Aware was designed for 18–19-year-old youth. Media Aware has only been evaluated in the USA. A randomized control trial (Scull et al., 2018) was conducted with 184 participants (96 in the intervention group and 88 in the control group). Study participants were recruited from community colleges and mostly identified as heterosexual. Just over half the participants were female and most participants were white.

Media Aware has not been evaluated in Australia or with Aboriginal Australians.

What outcomes does it contribute to?

Positive outcomes:

• Media Aware participants’ self-efficacy about sexual health communication improved
• Female Media Aware participants had increased intentions to use protection during oral sex in the next 6 months
• Media Aware participants were less willing to engage in unprotected sex and had improved attitudes towards use of contraceptives and protection
• Media Aware participants were less accepting of the rape myth “it wasn’t really rape”
• Media Aware participants reported lower estimates of the percentage of peers’ sexual activity, peers having sex with a casual partner and peers’ sexual activity while high or intoxicated.
• Male Media Aware participants were more sceptical of sexually themed media messages

No effect:

• The program had no effect on participants’ intentions towards conducting risky sexual behaviour (i.e., using drugs or alcohol before or during sex) or intentions to use condoms during intercourse
• The program had no effect on participants’ intentions to communicate about sexual health or on participants’ attitudes towards communicating about sexual health
• The program had no effect on participants’ attitudes about risky sexual activity (i.e., using alcohol or drugs before or during a sexual encounter) or beliefs about risky peer sexual activity (e.g., “People my age believe it is okay to use alcohol or drugs before or after a sexual encounter”
• The program had no effect on participants’ acceptance of the rape myths “she asked for it” and “he didn’t mean to”
• The program had no effect on participants’ estimates of peers’ unprotected sexual activity.
• The program had no effect on participants’ perceptions of media realism or of their similarity to media or on participants’ media deconstruction skills.

How effective is it?

Overall, Media Aware had mixed effects on client outcomes.

How strong is the evidence?

Mixed research evidence (with no adverse effects):

• At least one high-quality randomised controlled trial (RCT)/quasi-experimental design (QED) study reports statistically significant positive effects for at least one outcome, AND
• An equal number or more RCT/QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT/QED studies show statistically significant adverse effects.

How is it implemented?

Media Aware is an online program that can be delivered via tablet or mobile phone. All 5 modules can be completed at the participants’ pace over the course of 4 weeks. Media Aware includes a variety of interactive features such as quizzes with immediate feedback, videos of peers discussing a variety of health and media topics, popular media examples (e.g., songs and song lyrics; video clips from TV and film; advertisements), and skill practice with real-time feedback (e.g., practice communicating with virtual medical professionals about sexual health using a branching scenario activity). The interactive nature of the program also allows for program personalization (e.g., students create a personalized profile, including setting specific personal, educational, and health related goals, which they revisit at the end of each lesson) which is designed to increase engagement.

Module 1: Introduction to the program and creation of a personal program profile, selecting personal, educational, and health-related goals. Reflect on personal media use and explore the ways that media and media messages influence sexual decision-making and sexual health.

Module 2: Identify gender stereotypes and unrealistic sexual expectations perpetuated and normalized in media messages and counter those messages with factual information about gender and sexual behaviours. Explore media representations of romantic relationships, and counter portrayals of unhealthy and abusive relationship behaviours with evidence-based information about the realities of unhealthy and abusive romantic relationships.

Module 3: Reflect on the normativity of risky sexual behaviours, including sex and substance use, and the lack of consequences often associated with these behaviours depicted in media messages, and counter this information with medically accurate sexual health information about risky sexual behaviours and their consequences. Identify the ways in which media messages normalize and glamorize sexual violence and counter those messages with accurate information about consent and sexual assault.

Module 4: Discover that media messages often leave out information about contraception and STI protection, giving the perception that unprotected sex is normative and free of consequences, and counter these messages with medically accurate information about unplanned pregnancy, STIs, and contraception/STI protection. Compare information provided in media messages about the effectiveness of contraception, which often underrepresents the effectiveness of condoms and other forms of birth control, with medically accurate information about these methods.

Module 5: Explore the ways in which media messages frequently leave out conversations between partners and with medical professionals about contraception /STI protection and counter those messages with facts about the importance of effective communication related to sexual health. Learn a variety of strategies for effectively communicating with romantic partners about sexual health topics, and practice communicating with a virtual medical professional about sexual health using a branching scenarios activity. Program summary includes revisiting personal goals to expanding on how they will be accomplished.

How much does it cost?

The costs for Media Aware were not reported in the study.

What else should I consider?

Participants require a smart-phone or tablet and web-access to complete this program.

Where does the evidence come from?

1 RCT conducted in the USA with 184 participants (Scull et al., 2018).

Further resources

Scull, TM, Kupersmidt, JB, Malik, CV, & Keefe, EM 2018, ‘Examining the efficacy of an mHealth media literacy education program for sexual health promotion in older adolescents attending community college’, Journal of American College Health, vol. 66, pp. 165-177, DOI 10.1080/07448481.2017.1393822.

The following study is particularly relevant to the program:

Guse, K, Levine, D, Martins, S, Lira,  A, Gaarde, J, Westmorland, W, Gilliam, M 2012, ‘Interventions using new digital media to improve adolescent sexual health: A systematic review’, Journal of Adolescent Health, vol. 51, pp. 535–543. DOI 10.1016/j.jadohealth.2012.03.01.