The effects of the ‘Our Love, Our Control’ online program on sexual health literacy (SHL) and behaviors in preventing unintended pregnancy and sexually transmitted diseases (STDs) among adolescents in agricultural areas during&nbsp;&nbsp;<br />
COVID-19 outbreak in Thailand

Saowanee Thongnopakun; Mereerat Manwong; Yuvadee Rodjarkpai; Aimutcha Wattanaburanon; Sawitree Visanuyothin

doi:10.12688/f1000research.121767.1

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Research Article

The effects of the ‘Our Love, Our Control’ online program on sexual health literacy (SHL) and behaviors in preventing unintended pregnancy and sexually transmitted diseases (STDs) among adolescents in agricultural areas during
COVID-19 outbreak in Thailand

[version 1; peer review: 1 approved, 1 approved with reservations]

Saowanee Thongnopakun¹, Mereerat Manwong ², Yuvadee Rodjarkpai¹, Aimutcha Wattanaburanon¹, Sawitree Visanuyothin³

Saowanee Thongnopakun¹, Mereerat Manwong ², [...] Yuvadee Rodjarkpai¹, Aimutcha Wattanaburanon¹, Sawitree Visanuyothin³

PUBLISHED 12 Aug 2022

Author details Author details

¹ Faculty of Public Health, Burapha University, Muaeng, Chon Buri, 20131, Thailand
² College of Medicine and Public Health, Ubon Ratchathani University, Warin Chamrap, Ubon Ratchathani, 34190, Thailand
³ National Health Security Office, Region 9, National Health Security Office (NHSO), Muaeng, Nakhon Ratchasima, 30000, Thailand

Saowanee Thongnopakun
Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Writing – Original Draft Preparation, Writing – Review & Editing

Mereerat Manwong
Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Yuvadee Rodjarkpai
Roles: Supervision, Writing – Original Draft Preparation, Writing – Review & Editing

Aimutcha Wattanaburanon
Roles: Supervision, Writing – Original Draft Preparation, Writing – Review & Editing

Sawitree Visanuyothin
Roles: Conceptualization, Methodology, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

This article is included in the Global Public Health gateway.

Abstract

Background: This quasi-experimental study aimed to determine the effects of the ‘Our Love, Our Control’ online program on sexual health literacy and behaviors during the COVID-19 situation in Thailand from February 2020 to September 2021.
Methods: Multistage sampling resulted in 37 and 34 participants in the experimental and control groups, respectively. Data were collected by a self-administered questionnaire. Descriptive statistics, Fisher’s exact test/Chi-square test, and independent t-test/Mann-Whitney test were used to determine differences in sociodemographic variables between the experimental and control groups. Repeated measures of ANCOVA were used to compare the mean and 95% confidence intervals of the adjusted variables.
Results: From the results, adolescents who had sexual intercourse experience had statistically significant differences at the eighth week of score for behaviors (23.92; 95% CI: 16.56; 31.29), and at the eighth and at the twentieth week of score for sexual health literacy (43.55; 95% CI: 28.10; 59.00; and 19.35; 95% CI: 0.23; 38.48, respectively). However, adolescents who had no sexual intercourse experience had statistically significant differences only at the eighth week of score for sexual health literacy. (11.20; 95% CI: 3.79; 18.61).
Conclusions: These findings present a useful practical program to prevent unintended pregnancy and sexually transmitted diseases, especially in sexually active adolescents.

Keywords

Sexual health literacy, pregnancy, sexually transmitted disease, student, health, COVID-19

Corresponding author: Mereerat Manwong

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2022 Thongnopakun S et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Thongnopakun S, Manwong M, Rodjarkpai Y et al. The effects of the ‘Our Love, Our Control’ online program on sexual health literacy (SHL) and behaviors in preventing unintended pregnancy and sexually transmitted diseases (STDs) among adolescents in agricultural areas during
COVID-19 outbreak in Thailand [version 1; peer review: 1 approved, 1 approved with reservations]. F1000Research 2022, 11:929 (https://doi.org/10.12688/f1000research.121767.1) First published: 12 Aug 2022, 11:929 (https://doi.org/10.12688/f1000research.121767.1) Latest published: 12 Aug 2022, 11:929 (https://doi.org/10.12688/f1000research.121767.1)

Introduction

The World Health Organization (WHO) defines ‘sexual health as a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity’ (World Health Organization, 2006). Sexual health is an important concept to globally prevent sexually transmitted disease (STDs) and unintended pregnancy, which are worldwide challenges among adolescents (Douglas and Fenton, 2013; Forsyth and Rogstad, 2015; World Health Organization, 2018, 2021a; Centers for Disease control and Prevention, 2021).

In developing countries, unintended pregnancies among adolescents aged 15–19 years are estimated to be more than 10 million pregnancies per year (World Health Organization, 2020). The unintended pregnancy rate in Southeast Asia has been increasing, with the top three rates in Lao People’s Democratic Republic (PDR), Cambodia and Thailand (UNESCO, 2018). The unintended pregnancy rate in adolescents aged 15–19 years is 28.7 cases per 1,000 (Bureau of Reproductive Health, 2018), which leads not only to health complications, but also to socioeconomic consequences (World Health Organization, 2015). STDs directly impact sexual and reproductive health (World Health Organization, 2021b). Unintended pregnancies and STDs are caused by low contraception use rates and other factors (UNICEF, 2015), and sex education is a major approach to solving these problems (Kay, Jones, and Jantaraweragul, 2010; Aragão et al., 2018; Briñez, Panqueva, and Hinojos, 2019). Currently, the COVID-19 pandemic is a barrier to adolescents’ access to those services. Consequently, UNESCO suggests that digital health sources that provide easy accessibility, privacy protection, comfort and entertaining content should be used to improve sexual health in adolescents (UNESCO, 2021).

A study in Thailand demonstrated that online media education is an effective method for preventing pregnancy in adolescents (Narkarat et al., 2021). Health literacy plays an essential role in promoting sexual health (Vamos et al., 2020; Massey et al., 2012; Fortenberry et al., 2001). Sexual health literacy is ‘the ability to understand preventive sexual health information to make informed choices, increase safe sex practices, and reduce sexual transmitted infection risk’ (Vamos et al., 2020). Another study in Thailand that applied health literacy and self-efficacy concepts in the intervention increased the intention and practice for pregnancy prevention (Thongnopakun, Pumpaibool, and Somrongthong, 2018b). There has been little research on online sexual health literacy interventions against pregnancy and STDs in adolescents during the COVID-19 pandemic. Adolescents seem to have good health and are likely to neglect sexual health, especially after exposure to sexually risky behaviors (Massey et al., 2012). Also, there was a province in the East region of Thailand which has the highest number of STDs (Department of Disease Control, 2019) including a high rate of unintended pregnancies. Therefore, the ‘Our Love, Our Control’ online program was conducted in this province, for edutainment, sexual health literacy (accessing, understanding, appraising and applying health-related information in healthcare) (Sørensen et al., 2012), and self-efficacy concepts. This study aims to determine the effects of the ‘Our Love, Our Control’ online program on sexual health literacy and behaviors among adolescents who had sexual intercourse experience and those who had none during the COVID-19 situation in Thailand.

Methods

Study design

This quasi-experimental research was conducted in a province of the East region, Thailand during February 2020 to September 2021. The intervention took place from 12 February 2021 – 25 June 2021. The study aimed to determine the effects of the ‘Our Love, Our Control’ online program on sexual health literacy and behaviors among adolescents who had sexual intercourse experience and those who had none during the COVID-19 situation in Thailand. Edutainment, sexual health literacy and self-efficacy were principal concepts of the online program. The experimental group attended the online program; whereas the control group lived their usual lifestyle. Nonetheless, the control group received a manual for unintended pregnancy and sexually transmitted disease prevention at the end of the research.

Population sample

The Ministry of Public Health disclosed that this province had a childbearing rate of 30.63 per 1,000 among 15–19-year-old teenagers. The top three rates per 1,000 were 48.45, 36.83, and 36.74 in the districts of this province. Epidemiologic reports revealed that this province had the highest rate of STDs in Thailand, with 107.8 per 100,000 among 15–24 year-olds (Department of Disease Control, 2019).

The population of this study was 4,653 adolescent eighth graders from 71 public schools in this province. Two districts with the highest rate of teenage pregnancy/STDs were purposively selected as the experiment and comparison areas. The distance between both districts was 94 kilometres, and they were similar in terms of population size, number of students in school, agricultural land, and rurality. The classrooms in those schools from which the study population was drawn were randomly selected. The participating students received prior permission from their parents.

Lemeshow’s model was used to formulate the sample sizes (Lemeshow and Stroh 1988) with a confidence interval (CI) of 95%. The significant level (α) was taken as 0.05 and the power was 0.80. The mean difference was 3.46. (Krinara, Ketvatimart, and Maneechot, 2013). The sample size had a 20% attrition rate (Thongnopakun, Pumpaibool, and Somrongthong, 2018b). In the experimental group, there were 37 adolescents. The inclusion criteria were as follows: 1) Thai nationality; 2) live in the area for at least three months; 3) receive parental allowance. The exclusion criteria were as follows: 1) unable to access a smartphone; 2) being pregnant (self-reported).

Study tools

A self-administered 30-minute questionnaire was given to both groups at baseline, eighth week, and twentieth week. The questionnaire consisted of four categories with 70 items as follows: 1). Sociodemographic characteristics (10 closed-ended questions, including sex, grade point average, religion, average income per day, daily sufficient income, parents’ marital status, co-living with others, and occupation of parent); 2). Attribute and pattern of sexual behaviors (15 closed-ended questions, including sexual orientation, having a boy or girl friend, sexual intercourse experiences, preventive pregnancy and STD history, consultation history about preventive pregnancy and STDs, and consequences of sexual intercourse); 3). Sexual health literacy (30 Likert’s scale questions with a total of 120 point, including accessibility of sexual health information and services, sufficient understanding of sexual health and services for practice, sexual health assessment, and decision making of sexual practice), which were mainly adapted from two studies (Sørensen et al., 2012; Ministry of Public Health, 2014); 4). Behaviors for preventing unintended pregnancy and STDs (15 Likert’s scale questions with a total of 60 point, including night life, watching pornographic media, self-management of sex drive, preventing unintended pregnancy and STDs, parental consultation about sexual health, which were mainly adapted from one study (Health Education Division Ministry of Public Health, 2014). A copy of the questionnaire can be found under Extended data (Manwong, 2022).

Intervention (12 February 2021 – 25 June 2021)

In order to increase sexual health literacy, behaviors for preventing unintended pregnancy and STDs, the ‘Our Love, Our Control’ online program was created by the researcher team and stakeholders with approval from five experts of adolescent health and behavior based on edutainment, sexual health literacy and self-efficacy concepts. There were seven main activities: ‘clear by doctor’ (accessibility of sexual health information and services), ‘sex must know’ (sufficient understanding of sexual health and services for practice), ‘help!!! I am not ready’ (sufficient understanding of sexual health and services for practice, and decision making of sexual practice), ‘condom matter’ (sufficient understanding of sexual health and services for practice), ‘believable’ (sexual health assessment), ‘my value’ (decision making of sexual practice), and ‘my choice’ (decision making of sexual practice). There were two research assistants (RAs) who were public health graduates and have worked with adolescents for at least three years. They were trained in sexual health literacy, behaviors for preventing unintended pregnancy and STDs, research methodology, data collection skills and Facebook management by a main researcher during 28 January – 11 February 2021, two weeks before the recruitment process. The edutainment media was composed of animation, infographic, live modelling techniques, short movies, and an interview with a health expert. All edutainment media were implemented via Facebook using the following methods: independent online learning, group discussion, pair discussion, group assignment, game playing, independent practice, rewarding and recognizing. The activities were held once weekly for eight weeks, for an average of 50 minutes per activity. After that, seven main activities were repeated from the ninth to the twentieth week. A copy of the program guide can be found under Extended data (Manwong, 2022).

Data collection

Five experts in adolescent health and behavior from the Ministry of Education, Ministry of Public Health, and Ministry of Higher Education, Science, Research and Innovation validated the questionnaire via Google Forms and the online program. The questionnaire’s index of item objective congruence (IOC) was 0.94 and that of the online program was 0.80 (Rovinelli and Hambleton, 1976). After testing the questionnaire on 30 adolescents with similar characteristics to the participants, the Cronbach’s alpha coefficient (DeVellis, 2016) for each part was as follows: comfortable communication with parents about sexual issues was 0.90; social and environmental factors was 0.76; sexual health literacy was 0.89; and behaviors for preventing unintended pregnancy and STDs was 0.76. The online program was tested on 30 adolescents. They evaluated the program in seven activities by five-scale ratings as follows: 1) corrected content; 2) appropriate content; 3) understandable content; 4) updated content; 5) appropriate duration; 6) interest; 7) easily applying. The results showed that 95.6% strongly agreed and agreed with all seven activities. The online questionnaires were collected at baseline, eighth week, and twentieth week by sending QR code via ‘Our Love, Our Control’, closed Facebook group.

Data analysis

After each participants entered their data via Google Forms, all individual data were exported into a CSV file. This CSV file was imported into SPSS. The data was validated, coded and analysed using SPSS (IBM SPSS version 23×86, Burapha University license). Sexual intercourse experience was coded as 1 for who had experience, and 0 who had no experience. In part three of the questionnaires, there were five levels of ‘sexual health literacy’ scores as follows; 0=strongly disagree , 1=disagree, 2=not sure, 3=agree, 4=strongly agree. In part 4 of the questionnaires, there were five levels of ‘behaviors for preventing unintended pregnancy and STDs’ scores as follows; 0=never, 1=rarely, 2=sometimes, 3=very often, 4=always. The total scores of two dependent variables as sexual health literacy and behaviors for preventing unintended pregnancy and STDs were analyzed for comparison. The frequency distributions, mean (SD), median (IQR), minimum and maximum for continuous variables, and numbers and percentages for categorical variables were used to examine the sociodemographic characteristics for each group. Fisher’s exact test or Chi-square test was used for categorical data. Independent t-tests or Mann-Whitney tests for continuous data were used to determine differences in sociodemographic variables between the experiment and control groups. A literature review indicated that sexual intercourse experience was associated with behaviors for preventing unintended pregnancy and sexual health literacy (Thongnopakun, Pumpaibool, and Somrongthong, 2018a). Therefore, the data were sub-grouped and analysed by sexual intercourse experiences. Repeated measures of ANCOVA were used to compare the mean with 95% CIs of the adjusted variables of marital status and co-living with others, adjusted at baseline, eighth week and twentieth week. Statistical significance was considered when the p-value was <0.05.

Ethical considerations

Ethical approval was granted by Burapha University with code number: IRB1-003/2021. The approval was made in accordance with the Helsinki Declaration on studies involving human subjects. The researcher informed the participants of the research procedure in a classroom. Each participant brought the consent form back home. The parents and participants signed the informed consent form of this research if they had a mutual agreement to participate. To protect their privacy, code names were utilized, and data was kept confidential.

Results

A total of 37 adolescents from the experimental group and 34 adolescents from the control group completed this study. Three adolescents in the control group quit the study due to the COVID-19 situation. A total of 71 adolescents participated in the final per protocol analysis.

The experimental demographic characteristics (sex, grade point average, religion, average income per day, daily sufficient income, and occupation of parent) was nearly similar to that of the control group. More than half were female. The average grade point was at least 3.00. All of them were Buddhist. The average daily income was 60 baths. Forty-seven to fifty-seven percent had sufficient daily income. More than half of the parents were agriculturists. Their sexual orientation was heterosexual, at more than 70%. There were differences in demographic variables between the experimental and control groups. In the experimental group, 40.5% of them had married parents, and 59.4% had divorced or separated parents. Conversely, in the control group 70.6% were married. Among those co-living with parents, 43.2% of the experimental group lived with parents and 37.8% lived with either mother/father. In the control group, 70.6% lived with their parents. The experimental group had higher experience of sexual intercourse than the control group. (Table 1). The full dataset can be found under Underlying data (Manwong, 2022).

Table 1. Demographic characteristics of the intervention and control groups (n=71).

Demographic characteristics	Experimental group (n=37)		Control group (n=34)		p-value
Demographic characteristics	Number	Percent	Number	Percent	p-value
Sex					0.999
Male	17	45.9	16	47.1
Female	20	54.1	18	52.9
Grade point average Mean (S.D.)	3.00 (1.32)		3.24 (1.10)		0.136^b
Buddhist	37	100.0	34	100.0
Daily income (baht) Median (IQR)	60 (35)		60 (50)		0.749^b
Daily sufficiently income					0.216^a
Sufficient income and saving	16	43.2	15	44.1
Sufficient income	21	56.8	16	47.1
Insufficient income	0	0.0	3	8.8
Parent marital status					0.046^a
Married	15	40.5	24	70.6
Separated	6	16.2	4	11.8
Divorced	15	40.5	6	17.6
Widowed	1	2.7	0	0.0
Co-living with others					0.020^a
Co-living with parents	16	43.2	24	70.6
Co-living with father/mother	14	37.8	4	11.8
Co-living with friend	0	0.0	2	5.9
Co-living with relative	7	18.9	4	11.8
Occupation of parents					0.212^a
Agricultural	19	51.4	19	55.9
Civil servant	0	0.0	3	8.8
Self-employ	14	37.8	11	32.4
Merchant	4	10.8	1	2.9
Sexual orientation					0.095^a
Heterosexual	33	89.2	24	70.6
Homosexual	0	0.0	3	8.8
Bisexual	4	10.8	7	20.6
Have boy/girl friend					0.066
Yes	20	54.1	11	32.4
No	17	45.9	23	67.6
Sexual intercourse experience					0.015
Yes	12	32.4	3	8.8
No	25	67.6	31	91.2

a Fisher’s exact test.

b Mann-Whitney test.

Comparing the experimental group and the control group of adolescents who had sexual intercourse experience

There was no difference in behaviors for preventing unintended pregnancy and STDs at baseline between the experimental group and the control group. After adjusting the variables of marital status and co-living with others at the eighth week of the program, the score of behaviors for preventing unintended pregnancy and STDs showed a significant statistical difference between the experimental group and the control group (mean difference: 23.92; 95% CI: 16.56; 31.29). However, there was no difference in these scores at the twentieth week (Table 2, and Figure 1) Sexual health literacy showed no statistically significant difference between the experimental group and the control group at baseline. The score for sexual health literacy was statistically significantly different between the experimental group and the control group at the eighth week of the program (mean difference: 43.55; 95% CI: 28.10; 59.00) and at the twentieth week of the program (mean difference: 19.35; 95% CI: 0.23; 38.48) after adjusting for marital status and co-living with others (Table 2, and Figure 3).

Table 2. Comparison between the results of the experimental group and the control group, at baseline, 8 week, and 20 week of sexual intercourse behaviour.

Results	Experimental group (n=12)	Control group (n=3)	Unadjusted mean difference	Adjusted mean difference
Adolescents who had sexual intercourse experience
Behaviours to prevent unintended pregnancies and STDs: Mean (S.D.)			p-value <0.001	p-value <0.001
Baseline	41.08 (6.23)	41.67 (4.16)	- 0.58 (-8.88, 7.71)	1.06 (-8.13, 10.24)
8^th week	54.92 (4.56)	30.67 (4.04)	24.25 (18.00, 30.51)*	23.92 (16.56, 31.29)*
20^th week	50.50 (4.95)	43.33 (1.16)	7.17 (0.79, 13.54)*	7.04 (-0.51, 14.59)
Sexual health literacy to prevent unintended pregnancy and STDs: Mean (S.D.)			p-value <0.001	p-value <0.001
Baseline	78.75 (11.86)	69.33 (1.16)	9.42 (-5.81, 24.64)	14.40 (-0.76, 29.55)
8^th week	101.42 (9.64)	60.67 (12.66)	40.75 (26.57, 54.93)*	43.55 (28.10, 59.00)*
20^th week	82.58 (12.78)	65.33 (5.03)	17.25 (0.63, 33.88)*	19.35 (0.23, 38.48)*
Adolescents who had no sexual intercourse experience
Behaviours to prevent unintended pregnancies and STDs: Mean (S.D.)			p-value = 0.972	p-value = 0.967
Baseline	37.56 (7.46)	36.71 (6.81)	0.85 (-2.98, 4.68)	0.25 (-3.85, 4.35)
8^th week	37.76 (7.79)	36.45 (7.12)	1.31 (-2.69, 5.31)	0.68 (-3.54, 4.89)
20^th week	37.68 (7.27)	36.52 (7.43)	1.16 (-2.80, 5.13)	0.76 (-3.46, 4.98)
Sexual health literacy to prevent unintended pregnancies and STDs: Mean (S.D.)			p-value = 0.065	p-value = 0.095
Baseline	76.84 (11.47)	73.42 (15.45)	3.42 (-4.03, 10.87)	4.34 (-3.66, 12.33)
8^th week	79.08 (11.08)	67.55 (14.12)	11.53 (4.60, 18.46)*	11.20 (3.79, 18.61)*
20^th week	72.68 (15.09)	70.52 (15.04)	2.16 (-5.95, 10.28)	0.13 (-8.32, 8.57)

* Statistically significant.

Figure 1. Adjusted mean of behaviors for preventing unintended pregnancy and STDs (Adolescents who had sexual intercourse experience).

Figure 2. Adjusted mean behaviors for preventing unintended pregnancy and STDs (Adolescents who had no sexual intercourse experience).

Figure 3. Adjusted mean of sexual health literacy to prevent unintended pregnancy and STDs (Adolescents who had sexual intercourse experience).

Comparing the experimental group and the control group of adolescents who had no sexual intercourse experience

There were no differences in behaviors for preventing unintended pregnancy and STDs at baseline between the experimental group and the control group. After adjusting the variables of marital status and co-living with others at the eighth and twentieth week, the score of behaviors for preventing unintended pregnancy and STDs was not statistically significantly different between the experimental group and the control group (Table 2, and Figure 2). There was no statistically significant difference in sexual health literacy between the experimental group and the control group at baseline. The score for sexual health literacy was statistically significantly different between the experimental group and the control group at the eighth week of the program (mean difference: 11.20; 95% CI: 3.79; 18.61) after adjusting for marital status and co-living with others. However, there was no difference in these scores at the twentieth week between the groups (Table 2, and Figure 4).

Figure 4. Adjusted mean of sexual health literacy to prevent unintended pregnancy and STDs (Adolescents who had no sexual intercourse experience).

Discussion

Comparison among adolescents who had sexual intercourse experience

The results in adolescents who had sexual intercourse experience show that there are statistically significant differences at the eighth week of score for behaviors, and at the eighth week and the twentieth week of score for sexual health literacy. These findings demonstrate that the online program was effective and appropriate in improving behaviors and sexual health literacy for preventing unintended pregnancies and STDs. The online program involved adolescents and teachers using edutainment, media, self-efficacy concepts and various designed methods for the study. Therefore, this program may be appropriate for adolescents to prevent unintended pregnancies and STDs. The intervention in this study was consistent with the two studies that used visual media, watching a discussion between medical experts, infographic and animations (Graf and Patrick 2015; Narkarat et al., 2021). A study in Thailand also disclosed that applying different methods to modify behaviors was effective for pregnancy prevention (Thongnopakun, Pumpaibool, and Somrongthong, 2018b). During the follow up period, from the ninth to the twentieth week, the activities for increasing self-efficacy were not implemented in this study, such as brainstorming and group discussion. Moreover, communication was mostly in one direction (Feldman and Rosenthal, 2000; Koesten, 2004). Without activities for increasing self-efficacy, an insignificant difference in behavior scores was observed at the twentieth week between the experimental and the control groups. Although the average behavior score at the twentieth week in the experimental group was lower than that at the eighth week, the score was still higher than that of the baseline. During the COVID-19 lockdown, the score at the twentieth week of behaviors and sexual health literacy in the control group was higher than that at the eighth week. An increase in the score in the control group may be explained by 70.6% of the control group living with their parents. Living with parents gave them the opportunity to discuss sexual information with their parents and friends, which is supported by a post hoc analytic study that revealed that friends and family were common sources of sexual information (Graf and Patrick, 2015).

Comparison among adolescents who had no sexual intercourse experience

There was no difference in behaviors and sexual health literacy for preventing unintended pregnancy and STDs between the experimental group and the control group. Except for the experimental adolescents who had no sexual intercourse experience, there was a statistically significant difference in sexual health literacy scores at the eighth week compared to the control group. A study by Valois et al. (1999) observed that the number of sexual intercourse partners is associated with sexually risky behaviors. Therefore, adolescents who had sexual intercourse experience were aware that they had high sexual risk behaviors. Therefore, they may focus on improving their preventive behavior and sexual health literacy. In contrast, adolescents who have no sexual intercourse experience may not be aware of sexually risky behaviors or even gain sexual health literacy improvement.

Conclusion and recommendations

The ‘Our Love, Our Control’ online program on sexual health literacy and behaviors during the COVID-19 situation in Thailand was effective, especially among adolescents who had sexual intercourse experience. There were statistically significant improvements in behaviors and sexual health literacy to prevent unintended pregnancies and STDs. Therefore, this program behavior is novel and practical in the COVID-19 era to prevent unintended pregnancies and STDs, particularly in adolescents who have sexual intercourse experience living in rural areas. Policy makers should focus on the promotion of sexual health among adolescents using online programs during the COVID-19 pandemic. This study was a quasi-experiment that represents real-life research during the COVID-19 outbreak; however, this design may not fully control all enrolments. To generate the results of this study, context needs to be considered.

Data availability

Underlying data

Zenodo: The Effects of the ‘Our Love, Our Control’ Online Programe on Sexual Health Literacy (SHL) and Behaviors in Preventing Unintended Pregnancy and Sexually Transmitted Diseases (STDs) among Adolescents in Agricultural Areas during Coronavirus Disease 2019 (COVID-19) Situation in Thailand. https://doi.org/10.5281/zenodo.6646350 (Manwong, 2022).

This project contains the following underlying data:

- 000 Data set our love our control F1000 030665.xlsx [Data set]

Extended data

This project contains the following extended data:

- 000 Program table our love our control 030665.pdf
- 000 Questionnaire our love our control F1000 030665.pdf

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

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Manwong M: The Effects of the ‘Our Love, Our Control’ Online Program on Sexual Health Literacy (SHL) and Behaviors in Preventing Unintended Pregnancy and Sexually Transmitted Diseases (STDs) among Adolescents in Agricultural Areas during Coronavirus Disease 2019 (COVID-19) Situation in Thailand.2022. Publisher Full Text
Ministry of Public Health: Health Literacy Scale for Unwanted Pregnancy Prevention of Thai Female Adolescents. Nonthaburi:2014.
Narkarat P, Taneepanichskul S, Kumar R, et al.: Effects of mobile health education on sexual and reproductive health information among female school-going adolescents of rural Thailand [version 1; peer review: 2 approved]. F1000Res. 2021; 10(452). Publisher Full Text
Rovinelli RJ, Hambleton RK: On the use of content specialists in the assessment of criterion-referenced test item validity.1976.
Thongnopakun S, Pumpaibool T, Somrongthong R: The association of sociodemographic characteristics and sexual risk behaviors with health literacy toward behaviors for preventing unintended pregnancy among university students. J. Multidiscip. Healthc. 2018a; Volume 11: 149–156. PubMed Abstract | Publisher Full Text
Thongnopakun S, Pumpaibool T, Somrongthong R: The effects of an educational program on knowledge, attitudes and intentions regarding condom and emergency contraceptive pill use among Thai female university students. J. Health Res. 2018b; 32(4): 270–278. Publisher Full Text
Sørensen K, Van den Broucke S, Fullam J, et al.: Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012; 12(1): 80. PubMed Abstract | Publisher Full Text
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UNESCO: Addressing the patterns of child marriage, early union and teen pregnancy in Southeast Asia: A matter of urgency. Bangkok:UNESCO;2018. Accessed January 3.Reference Source
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Valois RF, Oeltmann JE, Waller J, et al.: Relationship between number of sexual intercourse partners and selected health risk behaviors among public high school adolescents. J. Adolesc. Health. 1999; 25(5): 328–335. Publisher Full Text
Vamos CA, Thompson EL, Logan RG, et al.: Exploring college students’ sexual and reproductive health literacy. J. Am. Coll. Heal. 2020; 68(1): 79–88. PubMed Abstract | Publisher Full Text
World Health Organization: Defining sexual health: report of a technical consultation on sexual health, 28-31 January 2002. World Health Organization;2006.Reference Source
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Author details Author details

Mereerat Manwong
Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Yuvadee Rodjarkpai
Roles: Supervision, Writing – Original Draft Preparation, Writing – Review & Editing

Aimutcha Wattanaburanon
Roles: Supervision, Writing – Original Draft Preparation, Writing – Review & Editing

Sawitree Visanuyothin
Roles: Conceptualization, Methodology, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

The author(s) declared that no grants were involved in supporting this work.

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https://doi.org/10.12688/f1000research.121767.1

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Thongnopakun S, Manwong M, Rodjarkpai Y et al. The effects of the ‘Our Love, Our Control’ online program on sexual health literacy (SHL) and behaviors in preventing unintended pregnancy and sexually transmitted diseases (STDs) among adolescents in agricultural areas during
COVID-19 outbreak in Thailand [version 1; peer review: 1 approved, 1 approved with reservations]. F1000Research 2022, 11:929 (https://doi.org/10.12688/f1000research.121767.1)

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Reviewer Report 11 May 2024

Ratana Somrongthongh, Chulalongkorn University, Bangkok, Bangkok, Thailand

Approved

https://doi.org/10.5256/f1000research.133666.r256747

Intervention: edutainment media were implemented via Facebook , how to ensure whether the participants were exposed to all packages of the intervention, how many pecentage of them did not completed the intervention pacakage.
Discussion: need more discussion why there ... Continue reading

Intervention: Please describe more a bit on how to ensure the participants complied with the packages of the intervention
Add more the limitation: such ass small sample size

The article is scientific valid, the research methodology the results presented is clear.

Is the work clearly and accurately presented and does it cite the current literature?

Yes
Is the study design appropriate and is the work technically sound?

Yes
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

Yes
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Yes

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Public health and reproductive health

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

CITE

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Reviewer Report 06 Oct 2022

Bayu Anggileo Pramesona, Department of Public Health, Faculty of Medicine, Lampung University (Universitas Lampung), Bandar Lampung, Indonesia

Approved with Reservations

https://doi.org/10.5256/f1000research.133666.r147524

Overall, this study has successfully presented the whole aspect of a well written article by providing adequate information in background, methods, results, and conclusion. However, I have the following responses to this manuscript:

In the abstract,

In the abstract, in the methods section, if applicable, the authors may add the intervention which provided in both groups.
Since one of the outcomes of this study was preventing unintended pregnancy, why the authors thought that they need to assess the respondents' sexual orientation? You have 3 homosexual respondents and 11 bisexuals as their sexual orientation. Why do you think it's necessary to include them as your respondents? Because homosexuals may only be interested in the same gender. Those who have bisexual orientation maybe still ok to be recruited as your sample, but, for those who have a homosexual orientation, is it still relevant to your "preventing unintended pregnancy" outcome?
Your edutainment media was mostly using Facebook as a tool. How do you convince us that the outcomes revealed due to your intervention, because the information on this sexual related issue may not only be obtained from FB, the respondents may receive some information from outside? How do you control the samples in the intervention group to follow your intervention and convince us that your samples followed your intervention until the end of study?
In the discussion, the authors need to explain why there was no difference between the experimental group and the control group in scores at the twentieth week, and why in the 20th week, there was an increase in adjusted mean of behaviors for preventing unintended pregnancy and STDs (among adolescents who had sexual intercourse experience) for the control group, while the intervention group mean score was decreased.

Is the work clearly and accurately presented and does it cite the current literature?

Yes
Is the study design appropriate and is the work technically sound?

Yes
Are sufficient details of methods and analysis provided to allow replication by others?

Yes
If applicable, is the statistical analysis and its interpretation appropriate?

Yes
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Yes

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: public health policy

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

CITE

Report a concern

Author Response 22 Dec 2022

Mereerat Manwong, College of Medicine and Public Health, Ubon Ratchathani University, Warin Chamrap, 34190, Thailand

22 Dec 2022

Author Response

1. "In the abstract, in the methods section, if applicable, the authors may add the intervention which provided in both groups."

Answer: Due to the limitation of word count ... Continue reading 1. "In the abstract, in the methods section, if applicable, the authors may add the intervention which provided in both groups."

Answer: Due to the limitation of word count in the abstract of this journal, the details of the intervention were in the manuscript.

2. "Since one of the outcomes of this study was preventing unintended pregnancy, why the authors thought that they need to assess the respondents' sexual orientation? You have 3 homosexual respondents and 11 bisexuals as their sexual orientation. Why do you think it's necessary to include them as your respondents? Because homosexuals may only be interested in the same gender. Those who have bisexual orientation maybe still ok to be recruited as your sample, but, for those who have a homosexual orientation, is it still relevant to your "preventing unintended pregnancy" outcome?"

Answer: Based-on literature review of “Can Some Gay Men and Lesbians Change Their Sexual Orientation? 200 Participants Reporting a Change from Homosexual to Heterosexual Orientation” (Spitzer, 2003), there were 200 participants (143 males, 57 females) who reported at least some minimal change from homosexual to heterosexual orientation that lasted at least 5 years. Therefore, this study should not avoid to recruit homosexual.

3. "Your edutainment media was mostly using Facebook as a tool. How do you convince us that the outcomes revealed due to your intervention, because the information on this sexual related issue may not only be obtained from FB, the respondents may receive some information from outside? How do you control the samples in the intervention group to follow your intervention and convince us that your samples followed your intervention until the end of study?"

Answer: That is why there was the control group to be compared with an experimental group in order to reduce the other effects. More than that, repeated measures of ANCOVA were used to analyze aiming to decrease effects of time and other variables, except the effect of the intervention in this study.

4. "In the discussion, the authors need to explain why there was no difference between the experimental group and the control group in scores at the twentieth week, and why in the 20th week, there was an increase in adjusted mean of behaviors for preventing unintended pregnancy and STDs (among adolescents who had sexual intercourse experience) for the control group, while the intervention group mean score was decreased."

Answer: Actually, there the discussion about that between line 6 to 11 in page 9, as following.
“Although the average behavior score at the twentieth week in the experimental group was lower than that at the eighth week, the score was still higher than that of the baseline. During the COVID-19 lockdown, the score at the twentieth week of behaviors and sexual health literacy in the control group was higher than that at the eighth week. An increase in the score in the control group may be explained by 70.6% of the control group living with their parents. Living with parents gave them the opportunity to discuss sexual information with their parents and friends, which is supported by a post hoc analytic study that revealed that friends and family were common sources of sexual information (Graf & Patrick, 2015)”
1. "In the abstract, in the methods section, if applicable, the authors may add the intervention which provided in both groups."

Answer: Due to the limitation of word count in the abstract of this journal, the details of the intervention were in the manuscript.

2. "Since one of the outcomes of this study was preventing unintended pregnancy, why the authors thought that they need to assess the respondents' sexual orientation? You have 3 homosexual respondents and 11 bisexuals as their sexual orientation. Why do you think it's necessary to include them as your respondents? Because homosexuals may only be interested in the same gender. Those who have bisexual orientation maybe still ok to be recruited as your sample, but, for those who have a homosexual orientation, is it still relevant to your "preventing unintended pregnancy" outcome?"

Answer: Based-on literature review of “Can Some Gay Men and Lesbians Change Their Sexual Orientation? 200 Participants Reporting a Change from Homosexual to Heterosexual Orientation” (Spitzer, 2003), there were 200 participants (143 males, 57 females) who reported at least some minimal change from homosexual to heterosexual orientation that lasted at least 5 years. Therefore, this study should not avoid to recruit homosexual.

3. "Your edutainment media was mostly using Facebook as a tool. How do you convince us that the outcomes revealed due to your intervention, because the information on this sexual related issue may not only be obtained from FB, the respondents may receive some information from outside? How do you control the samples in the intervention group to follow your intervention and convince us that your samples followed your intervention until the end of study?"

Answer: That is why there was the control group to be compared with an experimental group in order to reduce the other effects. More than that, repeated measures of ANCOVA were used to analyze aiming to decrease effects of time and other variables, except the effect of the intervention in this study.

4. "In the discussion, the authors need to explain why there was no difference between the experimental group and the control group in scores at the twentieth week, and why in the 20th week, there was an increase in adjusted mean of behaviors for preventing unintended pregnancy and STDs (among adolescents who had sexual intercourse experience) for the control group, while the intervention group mean score was decreased."

Answer: Actually, there the discussion about that between line 6 to 11 in page 9, as following.
“Although the average behavior score at the twentieth week in the experimental group was lower than that at the eighth week, the score was still higher than that of the baseline. During the COVID-19 lockdown, the score at the twentieth week of behaviors and sexual health literacy in the control group was higher than that at the eighth week. An increase in the score in the control group may be explained by 70.6% of the control group living with their parents. Living with parents gave them the opportunity to discuss sexual information with their parents and friends, which is supported by a post hoc analytic study that revealed that friends and family were common sources of sexual information (Graf & Patrick, 2015)”
Competing Interests: No competing interests were disclosed. Close
Report a concern
Respond or Comment

COMMENTS ON THIS REPORT

Author Response 22 Dec 2022

Mereerat Manwong, College of Medicine and Public Health, Ubon Ratchathani University, Warin Chamrap, 34190, Thailand

22 Dec 2022

Author Response

1. "In the abstract, in the methods section, if applicable, the authors may add the intervention which provided in both groups."

Answer: Due to the limitation of word count ... Continue reading 1. "In the abstract, in the methods section, if applicable, the authors may add the intervention which provided in both groups."

Answer: Due to the limitation of word count in the abstract of this journal, the details of the intervention were in the manuscript.

2. "Since one of the outcomes of this study was preventing unintended pregnancy, why the authors thought that they need to assess the respondents' sexual orientation? You have 3 homosexual respondents and 11 bisexuals as their sexual orientation. Why do you think it's necessary to include them as your respondents? Because homosexuals may only be interested in the same gender. Those who have bisexual orientation maybe still ok to be recruited as your sample, but, for those who have a homosexual orientation, is it still relevant to your "preventing unintended pregnancy" outcome?"

Answer: Based-on literature review of “Can Some Gay Men and Lesbians Change Their Sexual Orientation? 200 Participants Reporting a Change from Homosexual to Heterosexual Orientation” (Spitzer, 2003), there were 200 participants (143 males, 57 females) who reported at least some minimal change from homosexual to heterosexual orientation that lasted at least 5 years. Therefore, this study should not avoid to recruit homosexual.

3. "Your edutainment media was mostly using Facebook as a tool. How do you convince us that the outcomes revealed due to your intervention, because the information on this sexual related issue may not only be obtained from FB, the respondents may receive some information from outside? How do you control the samples in the intervention group to follow your intervention and convince us that your samples followed your intervention until the end of study?"

Answer: That is why there was the control group to be compared with an experimental group in order to reduce the other effects. More than that, repeated measures of ANCOVA were used to analyze aiming to decrease effects of time and other variables, except the effect of the intervention in this study.

4. "In the discussion, the authors need to explain why there was no difference between the experimental group and the control group in scores at the twentieth week, and why in the 20th week, there was an increase in adjusted mean of behaviors for preventing unintended pregnancy and STDs (among adolescents who had sexual intercourse experience) for the control group, while the intervention group mean score was decreased."

Answer: Actually, there the discussion about that between line 6 to 11 in page 9, as following.
“Although the average behavior score at the twentieth week in the experimental group was lower than that at the eighth week, the score was still higher than that of the baseline. During the COVID-19 lockdown, the score at the twentieth week of behaviors and sexual health literacy in the control group was higher than that at the eighth week. An increase in the score in the control group may be explained by 70.6% of the control group living with their parents. Living with parents gave them the opportunity to discuss sexual information with their parents and friends, which is supported by a post hoc analytic study that revealed that friends and family were common sources of sexual information (Graf & Patrick, 2015)”
1. "In the abstract, in the methods section, if applicable, the authors may add the intervention which provided in both groups."

Answer: Due to the limitation of word count in the abstract of this journal, the details of the intervention were in the manuscript.

2. "Since one of the outcomes of this study was preventing unintended pregnancy, why the authors thought that they need to assess the respondents' sexual orientation? You have 3 homosexual respondents and 11 bisexuals as their sexual orientation. Why do you think it's necessary to include them as your respondents? Because homosexuals may only be interested in the same gender. Those who have bisexual orientation maybe still ok to be recruited as your sample, but, for those who have a homosexual orientation, is it still relevant to your "preventing unintended pregnancy" outcome?"

Answer: Based-on literature review of “Can Some Gay Men and Lesbians Change Their Sexual Orientation? 200 Participants Reporting a Change from Homosexual to Heterosexual Orientation” (Spitzer, 2003), there were 200 participants (143 males, 57 females) who reported at least some minimal change from homosexual to heterosexual orientation that lasted at least 5 years. Therefore, this study should not avoid to recruit homosexual.

3. "Your edutainment media was mostly using Facebook as a tool. How do you convince us that the outcomes revealed due to your intervention, because the information on this sexual related issue may not only be obtained from FB, the respondents may receive some information from outside? How do you control the samples in the intervention group to follow your intervention and convince us that your samples followed your intervention until the end of study?"

Answer: That is why there was the control group to be compared with an experimental group in order to reduce the other effects. More than that, repeated measures of ANCOVA were used to analyze aiming to decrease effects of time and other variables, except the effect of the intervention in this study.

4. "In the discussion, the authors need to explain why there was no difference between the experimental group and the control group in scores at the twentieth week, and why in the 20th week, there was an increase in adjusted mean of behaviors for preventing unintended pregnancy and STDs (among adolescents who had sexual intercourse experience) for the control group, while the intervention group mean score was decreased."

Answer: Actually, there the discussion about that between line 6 to 11 in page 9, as following.
“Although the average behavior score at the twentieth week in the experimental group was lower than that at the eighth week, the score was still higher than that of the baseline. During the COVID-19 lockdown, the score at the twentieth week of behaviors and sexual health literacy in the control group was higher than that at the eighth week. An increase in the score in the control group may be explained by 70.6% of the control group living with their parents. Living with parents gave them the opportunity to discuss sexual information with their parents and friends, which is supported by a post hoc analytic study that revealed that friends and family were common sources of sexual information (Graf & Patrick, 2015)”
Competing Interests: No competing interests were disclosed. Close
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Version 1 12 Aug 22	read	read

Bayu Anggileo Pramesona, Lampung University (Universitas Lampung), Bandar Lampung, Indonesia
Ratana Somrongthongh, Chulalongkorn University, Bangkok, Thailand

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Reviewer Report

6 Views

11 May 2024 | for Version 1

Ratana Somrongthongh, Chulalongkorn University, Bangkok, Bangkok, Thailand

6 Views Cite this report Responses(0)

Approved

Intervention: Please describe more a bit on how to ensure the participants complied with the packages of the intervention
Add more the limitation: such ass small sample size

The article is scientific valid, the research methodology the results presented is clear.

Is the work clearly and accurately presented and does it cite the current literature?

Yes
Is the study design appropriate and is the work technically sound?

Yes
Are sufficient details of methods and analysis provided to allow replication by others?

Partly
If applicable, is the statistical analysis and its interpretation appropriate?

Yes
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Yes

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Public health and reproductive health

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

Respond to this report

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Reviewer Report

54 Views

06 Oct 2022 | for Version 1

Bayu Anggileo Pramesona, Department of Public Health, Faculty of Medicine, Lampung University (Universitas Lampung), Bandar Lampung, Indonesia

54 Views Cite this report Responses(1)

Approved With Reservations

In the abstract, in the methods section, if applicable, the authors may add the intervention which provided in both groups.
Since one of the outcomes of this study was preventing unintended pregnancy, why the authors thought that they need to assess the respondents' sexual orientation? You have 3 homosexual respondents and 11 bisexuals as their sexual orientation. Why do you think it's necessary to include them as your respondents? Because homosexuals may only be interested in the same gender. Those who have bisexual orientation maybe still ok to be recruited as your sample, but, for those who have a homosexual orientation, is it still relevant to your "preventing unintended pregnancy" outcome?
Your edutainment media was mostly using Facebook as a tool. How do you convince us that the outcomes revealed due to your intervention, because the information on this sexual related issue may not only be obtained from FB, the respondents may receive some information from outside? How do you control the samples in the intervention group to follow your intervention and convince us that your samples followed your intervention until the end of study?
In the discussion, the authors need to explain why there was no difference between the experimental group and the control group in scores at the twentieth week, and why in the 20th week, there was an increase in adjusted mean of behaviors for preventing unintended pregnancy and STDs (among adolescents who had sexual intercourse experience) for the control group, while the intervention group mean score was decreased.

Is the work clearly and accurately presented and does it cite the current literature?

Yes
Is the study design appropriate and is the work technically sound?

Yes
Are sufficient details of methods and analysis provided to allow replication by others?

Yes
If applicable, is the statistical analysis and its interpretation appropriate?

Yes
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Yes

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

public health policy

Respond to this report

Responses (1)

Author Response

22 Dec 2022

Mereerat Manwong, College of Medicine and Public Health, Ubon Ratchathani University, Warin Chamrap, 34190, Thailand

1. "In the abstract, in the methods section, if applicable, the authors may add the intervention which provided in both groups."

Answer: Due to the limitation of word count in the abstract of this journal, the details of the intervention were in the manuscript.

2. "Since one of the outcomes of this study was preventing unintended pregnancy, why the authors thought that they need to assess the respondents' sexual orientation? You have 3 homosexual respondents and 11 bisexuals as their sexual orientation. Why do you think it's necessary to include them as your respondents? Because homosexuals may only be interested in the same gender. Those who have bisexual orientation maybe still ok to be recruited as your sample, but, for those who have a homosexual orientation, is it still relevant to your "preventing unintended pregnancy" outcome?"

Answer: Based-on literature review of “Can Some Gay Men and Lesbians Change Their Sexual Orientation? 200 Participants Reporting a Change from Homosexual to Heterosexual Orientation” (Spitzer, 2003), there were 200 participants (143 males, 57 females) who reported at least some minimal change from homosexual to heterosexual orientation that lasted at least 5 years. Therefore, this study should not avoid to recruit homosexual.

3. "Your edutainment media was mostly using Facebook as a tool. How do you convince us that the outcomes revealed due to your intervention, because the information on this sexual related issue may not only be obtained from FB, the respondents may receive some information from outside? How do you control the samples in the intervention group to follow your intervention and convince us that your samples followed your intervention until the end of study?"

Answer: That is why there was the control group to be compared with an experimental group in order to reduce the other effects. More than that, repeated measures of ANCOVA were used to analyze aiming to decrease effects of time and other variables, except the effect of the intervention in this study.

4. "In the discussion, the authors need to explain why there was no difference between the experimental group and the control group in scores at the twentieth week, and why in the 20th week, there was an increase in adjusted mean of behaviors for preventing unintended pregnancy and STDs (among adolescents who had sexual intercourse experience) for the control group, while the intervention group mean score was decreased."

Answer: Actually, there the discussion about that between line 6 to 11 in page 9, as following.
“Although the average behavior score at the twentieth week in the experimental group was lower than that at the eighth week, the score was still higher than that of the baseline. During the COVID-19 lockdown, the score at the twentieth week of behaviors and sexual health literacy in the control group was higher than that at the eighth week. An increase in the score in the control group may be explained by 70.6% of the control group living with their parents. Living with parents gave them the opportunity to discuss sexual information with their parents and friends, which is supported by a post hoc analytic study that revealed that friends and family were common sources of sexual information (Graf & Patrick, 2015)”

View more View less

Competing Interests

No competing interests were disclosed.

Alongside their report, reviewers assign a status to the article:

Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested

Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.

Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions

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[17] Lemeshow S, Stroh G: Sampling techniques for evaluating health parameters in developing countries. National Academies;1988.

[18] Massey PM, Prelip M, Calimlim BM, et al.: Contextualizing an expanded definition of health literacy among adolescents in the health care setting. Health Educ. Res. 2012; 27(6): 961–974. Publisher Full Text

[19] Manwong M: The Effects of the ‘Our Love, Our Control’ Online Program on Sexual Health Literacy (SHL) and Behaviors in Preventing Unintended Pregnancy and Sexually Transmitted Diseases (STDs) among Adolescents in Agricultural Areas during Coronavirus Disease 2019 (COVID-19) Situation in Thailand.2022. Publisher Full Text

[20] Ministry of Public Health: Health Literacy Scale for Unwanted Pregnancy Prevention of Thai Female Adolescents. Nonthaburi:2014.

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The effects of the ‘Our Love, Our Control’ online program on sexual health literacy (SHL) and behaviors in preventing unintended pregnancy and sexually transmitted diseases (STDs) among adolescents in agricultural areas during COVID-19 outbreak in Thailand

Abstract

Keywords

Introduction

Methods

Study design

Population sample

Study tools

Data collection

Data analysis

Ethical considerations

Results

Table 1. Demographic characteristics of the intervention and control groups (n=71).

Comparing the experimental group and the control group of adolescents who had sexual intercourse experience

Table 2. Comparison between the results of the experimental group and the control group, at baseline, 8 week, and 20 week of sexual intercourse behaviour.

Figure 1. Adjusted mean of behaviors for preventing unintended pregnancy and STDs (Adolescents who had sexual intercourse experience).

Figure 2. Adjusted mean behaviors for preventing unintended pregnancy and STDs (Adolescents who had no sexual intercourse experience).

Figure 3. Adjusted mean of sexual health literacy to prevent unintended pregnancy and STDs (Adolescents who had sexual intercourse experience).

Comparing the experimental group and the control group of adolescents who had no sexual intercourse experience

Figure 4. Adjusted mean of sexual health literacy to prevent unintended pregnancy and STDs (Adolescents who had no sexual intercourse experience).

Discussion

Comparison among adolescents who had sexual intercourse experience

Comparison among adolescents who had no sexual intercourse experience

Conclusion and recommendations

Data availability

Underlying data

Extended data

References

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The effects of the ‘Our Love, Our Control’ online program on sexual health literacy (SHL) and behaviors in preventing unintended pregnancy and sexually transmitted diseases (STDs) among adolescents in agricultural areas during
COVID-19 outbreak in Thailand