Introduction: A growing body of research has addressed adolescent use of mobile devices to exchange sexually explicit images and messages (sexting). While there are legal consequences in some states for sexting among adolescents, research findings have also demonstrated associations between sexting and sexual activity. The purpose of this systematic review was to synthesize research examining the association between adolescent sexting and sexual activity. Methods: Five databases (The Cumulative Index to Nursing and Allied Health Literature, Embase, Ovid, MEDLINE, PsychINFO, and Scopus) were searched for studies measuring adolescent sexting and sexual behaviors. Studies were appraised for quality using a modified Downs and Black scale. Studies reporting frequencies or odds ratios were eligible for inclusion in random effects meta-analytic models. Results: Of 669 articles retrieved, 9 studies met inclusion for systematic review; of these, 6 were included in meta-analysis. Pooling data from 9,676 adolescents, the odds of reporting sexual activity was 6.3 times higher (95% confidence interval 4.9–8.1; Q=14.3,I2= 65.1) for adolescents who sent sexts compared to those who did not. Discussion: These data suggest that adolescents who send sexually explicit text messages are more likely to report sexual activity than adolescents who do not. Midwives are well-poised to integrate a discussion of sexting into sexual and reproductive health counseling with adolescent and young adult patients.

Background and purposeThe purpose of this systematic review was to evaluate parental monitoring instruments and the theoretical perspectives informing their development.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, seven databases were searched for original studies using a monitoring instrument. The psychometric properties of each identified instrument were assessed using the “COnsensus-based Standards for the selection of health status Measurement INstruments” (COSMIN) methodology.ResultsOf 2,245 articles identified, 72 studies representing six parental monitoring instruments met inclusion criteria. Quality of reporting on psychometric properties varied widely across instruments with only three including content validation studies.ConclusionsFindings of this review reveal inattention to the psychometric quality of child self-reported monitoring instruments. Future research must focus on the psychometric quality of instruments used to measure the parent–child relationship.

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Background: Behavioral health interventions conducted by peers – individuals who share common characteristics, circumstances, or experiences with research participants – have shown promising results. The Adherence Connection for Counseling, Education, and Support (ACCESS) I proof-of-concept study is a peer-led intervention to improve HIV medication adherence in youth living with HIV who are in treatment but have detectable viral loads. Participants received five online sessions with peer health coaches who followed a structured intervention manual. Although peer health coaches maintained intervention fidelity, they also engaged in dialogue not directly related to intervention content during the sessions. We believe that these casual interactions develop social capital, which can then be used to encourage positive health outcomes. Methods: Sessions were transcribed and coded for intervention content as well as content that was not directly covered in the intervention manual. Sections of session transcripts that included this non-intervention content, labeled peer-to-peer (P2P), were then sub-coded to document the focus of these interactions. Results: Ten P2P sub-codes were identified, and sessions were divided into beginning, middle, and end to allow for the “small talk” that was expected at the start of each session and the scheduling that occurred at the end of each session. “Activities” was the most common code in the beginning sections, commonly reflecting a review of participant activities since the prior session. “Personal Experiences” was the most common code during the middle of the sessions, as peers built social capital by sharing their own stories and providing additional support to participants. At the end of sessions, “Activities” was again the most common code, as peers and participants discussed upcoming plans and scheduled their next session. Conclusions: Narrative content not directly included in the intervention manual reflected interactions that strengthened the peer-participant relationship, building social capital for the peer educators who could then use this social capital to encourage positive behavior change. Although social capital was not directly measured, these analyses illustrate the value of attending to seemingly casual interactions in peer-led interventions. Future research can focus on the measurement of social capital and the ways in which it is deployed to encourage behavior change.

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