The increasing popularity and widespread use of the Internet has made it an emerging venue for delivering health-related messages and interventions. The current study explored the potential for using social networking sites (SNS), specifically MySpace, to connect youth to sexual health services. Surveys and focus groups with youth aged 14-19 living in low-income communities in California revealed high levels of overall Internet access, frequent use of SNS, and experience in searching for health information online. However, disparities in frequency and location of Internet access by race/ethnicity, and hesitancy among some youth to join a clinic's online social network, may affect the success of this new strategy in some populations. Interviews with clinic staff highlighted the successes and challenges of using MySpace as part of their outreach efforts. Staff described balancing the benefits of web-based outreach, including its low cost, wide reach, and teen friendliness, with its challenges, including overcoming technological barriers, ensuring teens' safety from inappropriate contact, and remaining timely and relevant given the dynamic nature of the Internet. This study indicates that SNS and other technologies have strong potential for reaching diverse youth with critical health information when implemented as part of a comprehensive outreach strategy.

While questions remain to be answered regarding the implementation and impact of rights-based sexuality education, the proposed conceptual definition suggests multiple avenues for advocates, researchers, program developers and funders to enhance adolescent sexual health.

BackgroundAn emerging model for sexuality education is the rights-based approach, which unifies discussions of sexuality, gender norms, and sexual rights to promote the healthy sexual development of adolescents. A rigorous evaluation of a rights-based intervention for a broad population of adolescents in the U.S. has not previously been published. This paper evaluates the immediate effects of the Sexuality Education Initiative (SEI) on hypothesized psychosocial determinants of sexual behavior.MethodsA cluster-randomized trial was conducted with ninth-grade students at 10 high schools in Los Angeles. Classrooms at each school were randomized to receive either a rights-based curriculum or basic sex education (control) curriculum. Surveys were completed by 1,750 students (N = 934 intervention, N = 816 control) at pretest and immediate posttest. Multilevel regression models examined the short-term effects of the intervention on nine psychosocial outcomes, which were hypothesized to be mediators of students’ sexual behaviors.ResultsCompared with students who received the control curriculum, students receiving the rights-based curriculum demonstrated significantly greater knowledge about sexual health and sexual health services, more positive attitudes about sexual relationship rights, greater communication about sex and relationships with parents, and greater self-efficacy to manage risky situations at immediate posttest. There were no significant differences between the two groups for two outcomes, communication with sexual partners and intentions to use condoms.ConclusionsParticipation in the rights-based classroom curriculum resulted in positive, statistically significant effects on seven of nine psychosocial outcomes, relative to a basic sex education curriculum. Longer-term effects on students’ sexual behaviors will be tested in subsequent analyses.Trial registrationClinicalTrials.gov NCT02009046 [http://www.advocatesforyouth.org/the-3rs].

As U.S. states legalize marijuana and as governmental attention is paid to the "opioid crisis," state policies pertaining to drug use during pregnancy are increasingly important. Little is known about the scope of state policies targeting drug use during pregnancy, how they have evolved, and how they compare to alcohol use during pregnancy policies. Method: Our 46-year original data set of statutes and regulations in U.S. states covers the entirety of state-level legislation in this policy domain. Data were obtained through original legal research and from the National Institute on Alcohol Abuse and Alcoholism's Alcohol Policy Information System. Policies were analyzed individually as well as by classification as punitive toward or supportive of women. Results: The number of states with drug use during pregnancy policies has increased from 1 in 1974 to 43 in 2016. Policies started as punitive. By the mid-to late 1980s, supportive policies emerged, and mixed policy environments dominated in the 2000s. Overall, drug/pregnancy policy environments have become less supportive over time. Comparisons of drug laws to alcohol laws show that the policy trajectories started in opposite directions, but by 2016, the results were the same: Punitive policies were more prevalent than supportive policies across states. Moreover, there is a great deal of overlap between drug use during pregnancy policies and alcohol/pregnancy policies. Conclusion: This study breaks new ground. More studies are needed that explore the effects of these policies on alcohol and other drug use by pregnant women and on birth outcomes.

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