Evaluation Study of the Online High School Media Aware Program

Sexual Behavior Clinical Trial

Official title:

Web-based High School Media Literacy for Healthy Relationships

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04035694
• Other study ID #: iRT-Media Aware HS-Phase II
• Status: Completed
• Phase: N/A
• Start date: September 10, 2019
• Est. completion date: June 5, 2020

Study information

• Verified date: March 2021
• Source: Innovation Research & Training
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The main aim of this study is to conduct a pretest-posttest RCT with a three-month follow-up to investigate the sustainability of outcomes in students who use the Media Aware program. Media Aware, a web-based media literacy education program for high school students to promote sexual and relationship health. Media Aware is designed to provide high school students with sexual health knowledge, media literacy skills, and the skills to make healthy decisions about sexual activity. This study will examine if behavioral indicators among students in the intervention group sustain, emerge, or diminish over time compared to students in the delayed intervention group.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 590
• Est. completion date: June 5, 2020
• Est. primary completion date: June 5, 2020
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 12 Years to 17 Years

Eligibility

SCHOOL SITES:

Inclusion:

1. Schools must have students in 9th or 10th grade health education as this program is designed for use in these grades during health education classes.

2. Schools must agree to provide the Media Aware program during class periods as their sexual health education which means that an educator will facilitate the students taking the program.

3. Schools must have adequate technology for the students to use the web-based Media Aware program and complete the online questionnaires.

4. It must be feasible for iRT project staff members to travel to the school sites for the three data collection time points.

TEACHER PARTICIPANTS:

Inclusion:

1. Teacher's classrooms must have students in 9th or 10th grade as this program is designed for use in these grades.

2. Teachers must be able to ensure that participating students have computers and internet access during class periods as the program and questionnaires are web-based.

STUDENT PARTICIPANTS:

Inclusion:

1. Students must be in grades 9 or 10.

2. Students must be able to speak and read English because the study materials (e.g., questionnaires) are in English. However, parent permission and youth assent forms for the research study will be available in both English and Spanish.

3. Students must have appropriate parent permission to receive sexual health education per school districts' policy (i.e., opt-in policy or opt-out policy).

Related Conditions & MeSH terms

• Sexual Behavior

Intervention

Other:
• Media Aware Sexual Health - High School
Media Aware is an online media literacy and sexual health education program developed for high school students that addresses the influence of media on sexual behaviors explicitly using established message processing theory. The program consists of 4 self-paced modules each with two to three lessons. Broadly, the modules cover healthy and unhealthy relationships, sexually transmitted infections, consent, substance use, pregnancy, protection and contraception, and communication between adolescents and their partners, parents, or health providers. Users also learn media literacy skills including message deconstruction to help examine the truth behind media messages.

Locations

Country	Name	City	State
United States	innovation Research and Training	Durham	North Carolina

Sponsors (1)

Lead Sponsor	Collaborator
Innovation Research & Training

Country where clinical trial is conducted

United States, 

References & Publications (1)

Scull TM, Malik CV, Morrison A, Keefe EM. Study protocol for a randomized controlled trial to evaluate a web-based comprehensive sexual health and media literacy education program for high school students. Trials. 2020 Jan 8;21(1):50. doi: 10.1186/s13063-019-3992-1. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Counterarguing While Viewing an Advertisement	Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (1=not much at all; 2=a little; 3=a good amount; 4=a lot) the extent to which they: 1) wanted to argue back to what it was saying; 2) thought of ways they disagreed with what was presented; 3) thought of ways that the information being presented was inaccurate or misleading; and 4) found themselves looking for flaws in the way information was presented in the ad. (adapted from Moyer-Gusé and Nabi, 2010)	posttest (approximately one week after pretest)
Other	Counterarguing While Viewing an Advertisement	Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (1=not much at all; 2=a little; 3=a good amount; 4=a lot) the extent to which they: 1) wanted to argue back to what it was saying; 2) thought of ways they disagreed with what was presented; 3) thought of ways that the information being presented was inaccurate or misleading; and 4) found themselves looking for flaws in the way information was presented in the ad. (adapted from Moyer-Gusé and Nabi, 2010)	follow-up (approximately three months after pretest)
Other	Advertisement Credibility	Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (variable) how 1) believable; 2) truthful; 3) trustworthy they find the advertisement. (adapted from MacKenzie, Lutz, and Belch, 1986)	posttest (approximately one week after pretest)
Other	Advertisement Credibility	Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (variable) how 1) believable; 2) truthful; 3) trustworthy they find the advertisement. (adapted from MacKenzie, Lutz, and Belch, 1986)	follow-up (approximately three months after pretest)
Primary	Willingness to Have Sex	Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to have sex in a relationship context. (Imagine you were with a boyfriend/girlfriend and they say they love you. They want to have sex. In this situation, how willing would you be to have sex?).	posttest (approximately one week after pretest)
Primary	Willingness to Have Sex	Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to have sex in a relationship context. (Imagine you were with a boyfriend/girlfriend and they say they love you. They want to have sex. In this situation, how willing would you be to have sex?).	follow-up (approximately three months after pretest)
Primary	Willingness to Engage in Unprotected Sex	Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to engage in unprotected sex (Imagine you were with a boyfriend/girlfriend. They want to have sex, but neither of you have any form of protection. In this situation, how willing would you be to go ahead and have sex anyway?). (adapted from Gibbons, Gerrard, Blanton, & Russell, 2014)	posttest (approximately one week after pretest)
Primary	Willingness to Engage in Unprotected Sex	Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to engage in unprotected sex (Imagine you were with a boyfriend/girlfriend. They want to have sex, but neither of you have any form of protection. In this situation, how willing would you be to go ahead and have sex anyway?). (adapted from Gibbons, Gerrard, Blanton, & Russell, 2014)	follow-up (approximately three months after pretest)
Primary	Willingness to Hook up	Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to have hook up even if they are not sure that they really want to (Imagine you were with a boyfriend/girlfriend. They want to hook-up, but you are not sure that you want to. In this situation, how willing would you be to go ahead and hook-up anyway?). (adapted from Gibbons, Gerrard, Blanton, & Russell, 2014)	posttest (approximately one week after pretest)
Primary	Willingness to Hook up	Participants are asked to indicate on a 4-point Likert scale (1=very unwilling; 2=unwilling; 3=willing; 4=very willing) how willing they are to have hook up even if they are not sure that they really want to (Imagine you were with a boyfriend/girlfriend. They want to hook-up, but you are not sure that you want to. In this situation, how willing would you be to go ahead and hook-up anyway?). (adapted from Gibbons, Gerrard, Blanton, & Russell, 2014)	follow-up (approximately three months after pretest)
Primary	Intentions to Engage in Sexual Activity With Another Person	Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to engage in sexual activity in the next year (How likely is that you will have any type of sexual contact with another person (oral sex, anal sex, vaginal sex, or genital-to-genital contact) in the next year?). a = 0.77 (adapted from L'Engle, Brown, and Kenneavy, 2006)	posttest (approximately one week after pretest)
Primary	Intentions to Engage in Sexual Activity With Another Person	Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to engage in sexual activity in the next year (How likely is that you will have any type of sexual contact with another person (oral sex, anal sex, vaginal sex, or genital-to-genital contact) in the next year?). a = 0.77 (adapted from L'Engle, Brown, and Kenneavy, 2006)	follow-up (approximately three months after pretest)
Primary	Condom Use Intentions	Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to have vaginal or anal sex, how likely would you be to use a condom?). (adapted from Jemmott and Jemmott, 1991)	posttest (approximately one week after pretest)
Primary	Condom Use Intentions	Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to have vaginal or anal sex, how likely would you be to use a condom?). (adapted from Jemmott and Jemmott, 1991)	follow-up (approximately three months after pretest)
Primary	Birth Control Use Intentions (Other Than Condoms)	Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to have vaginal sex, how likely would you be to use birth control other than condoms?). (adapted from Jemmott and Jemmott, 1991)	posttest (approximately one week after pretest)
Primary	Birth Control Use Intentions (Other Than Condoms)	Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to have vaginal sex, how likely would you be to use birth control other than condoms?). (adapted from Jemmott and Jemmott, 1991)	follow-up (approximately three months after pretest)
Primary	Protection Intentions During Oral Sex	Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to decide to have oral sex, how likely would you be to use a condom or dental dam?). (adapted from Jemmott and Jemmott, 1991)	posttest (approximately one week after pretest)
Primary	Protection Intentions During Oral Sex	Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to use protection (if you were to decide to have oral sex, how likely would you be to use a condom or dental dam?). (adapted from Jemmott and Jemmott, 1991)	follow-up (approximately three months after pretest)
Secondary	Perceived Realism of Media Messages	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) the degree to which they agreed that teens on the media (e.g., Teens in the media do things that average teens do.). (adapted from Austin and Johnson, 1997, a=0.80)	posttest (approximately one week after pretest)
Secondary	Perceived Realism of Media Messages	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) the degree to which they agreed that teens on the media (e.g., Teens in the media do things that average teens do.). (adapted from Austin and Johnson, 1997, a=0.80)	follow-up (approximately three months after pretest)
Secondary	Acceptance of Dating Violence	Participants are asked to indicate on a 4-point Likert scale (1=strongly 2=disagree; 3=disagree; 4=agree; strongly agree) their level of agreement on several items pertaining to dating violence (e.g., It is okay for people to hit their girlfriends/boyfriends if they did something to make them mad.). (adapted from Foshee, Bauman, Ennett, Suchindran, Benefield, and Linder, 2005 a=0.73)	posttest (approximately one week after pretest)
Secondary	Acceptance of Dating Violence	Participants are asked to indicate on a 4-point Likert scale (1=strongly 2=disagree; 3=disagree; 4=agree; strongly agree) their level of agreement on several items pertaining to dating violence (e.g., It is okay for people to hit their girlfriends/boyfriends if they did something to make them mad.). (adapted from Foshee, Bauman, Ennett, Suchindran, Benefield, and Linder, 2005 a=0.73)	follow-up (approximately three months after pretest)
Secondary	Advertisement Deconstruction Skills	Participants are shown an advertisement and asked to describe it in detail including noting marketing strategies and any missing information (e.g., How are advertisers trying to get someone to buy this product?). Qualitative responses to the questions are coded by trained project staff members once inter-coder reliability is established, and scores will be summed to create an overall deconstruction skills composite variable. (adapted from Kupersmidt, Scull, & Benson, 2012)	posttest (approximately one week after pretest)
Secondary	Advertisement Deconstruction Skills	Participants are shown an advertisement and asked to describe it in detail including noting marketing strategies and any missing information (e.g., How are advertisers trying to get someone to buy this product?). Qualitative responses to the questions are coded by trained project staff members once inter-coder reliability is established, and scores will be summed to create an overall deconstruction skills composite variable (adapted from Kupersmidt, Scull, & Benson, 2012).	follow-up (approximately three months after pretest)
Secondary	Media Message Completeness	Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (1=incomplete to 4=complete) how complete the information included in an advertisement is (e.g., How complete is the information in this advertisement?).	posttest (approximately one week after pretest)
Secondary	Media Message Completeness	Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (1=incomplete to 4=complete) how complete the information included in an advertisement is (e.g., How complete is the information in this advertisement?).	follow-up (approximately three months after pretest)
Secondary	Media Skepticism	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) the degree to which they agree with several statements about media (e.g., Media are dishonest about what happens if people have sex.). (adapted from Scull, Malik, and Kupersmidt, 2014, a=0.86)	posttest (approximately one week after pretest)
Secondary	Media Skepticism	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) the degree to which they agree with several statements about media (e.g., Media are dishonest about what happens if people have sex.). (adapted from Scull, Malik, and Kupersmidt, 2014, a=0.86)	follow-up (approximately three months after pretest)
Secondary	Acceptance of Strict Gender Role Stereotypes	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) their level of agreement on several items pertaining to strict gender role stereotypes (e.g., Raising children is primarily a woman's responsibility.). (adapted from Foshee, Bauman, Ennett, Suchindran, Benefield, and Linder, 2005 a=0.87)	posttest (approximately one week after pretest)
Secondary	Acceptance of Strict Gender Role Stereotypes	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) their level of agreement on several items pertaining to strict gender role stereotypes (e.g., Raising children is primarily a woman's responsibility.). (adapted from Foshee, Bauman, Ennett, Suchindran, Benefield, and Linder, 2005 a=0.87)	follow-up (approximately three months after pretest)
Secondary	Acceptance of Rape Myths	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) their level of agreement on several items pertaining to myths about rape (e.g., It shouldn't be considered rape if a guy is drunk and didn't realize what he was doing.). (adapted from Illinois Rape Myth Acceptance-Short Form (IRMA-SF; 7 pt. scale); Payne et al., (1999); McMahon & Farmer (2011), a=0.88)	posttest (approximately one week after pretest)
Secondary	Acceptance of Rape Myths	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) their level of agreement on several items pertaining to myths about rape (e.g., It shouldn't be considered rape if a guy is drunk and didn't realize what he was doing.). (adapted from Illinois Rape Myth Acceptance-Short Form (IRMA-SF; 7 pt. scale); Payne et al., (1999); McMahon & Farmer (2011), a=0.88)	follow-up (approximately three months after pretest)
Secondary	Intentions to Intervene as Bystander	Participants are asked to indicate on a 4-point Likert scale (1=not likely at all; 2=Unlikely; 3=Likely; 4=Extremely likely) how likely they would be to intervene as a bystander (e.g., Approach a friend if I thought they were in an abusive relationship and let them know that I am here to help.). (adapted from Banyard, 2005)	posttest (approximately one week after pretest)
Secondary	Intentions to Intervene as Bystander	Participants are asked to indicate on a 4-point Likert scale (1=not likely at all; 2=Unlikely; 3=Likely; 4=Extremely likely) how likely they would be to intervene as a bystander (e.g., Approach a friend if I thought they were in an abusive relationship and let them know that I am here to help.). (adapted from Banyard, 2005)	follow-up (approximately three months after pretest)
Secondary	Efficacy to Intervene as Bystander	Participants are asked to indicate on a scale of 0 (Can't do) to 100 (Very Certain) their degree of confidence in several behaviors (e.g., I could talk to a friend who I suspected is in an abusive relationship.). (adapted from Banyard, 2005)	posttest (approximately one week after pretest)
Secondary	Efficacy to Intervene as Bystander	Participants are asked to indicate on a scale of 0 (Can't do) to 100 (Very Certain) their degree of confidence in several behaviors (e.g., I could talk to a friend who I suspected is in an abusive relationship.). (adapted from Banyard, 2005)	follow-up (approximately three months after pretest)
Secondary	Descriptive Norms Regarding Teen Sexual Activity	Participants are asked to indicate what percentage [0% = no teens; 100% = all teens] of teens engage in sexual activity (e.g., oral sex, vaginal sex, anal sex). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)	posttest (approximately one week after pretest)
Secondary	Descriptive Norms Regarding Teen Sexual Activity	Participants are asked to indicate what percentage [0% = no teens; 100% = all teens] of teens engage in sexual activity (e.g., oral sex, vaginal sex, anal sex). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)	follow-up (approximately three months after pretest)
Secondary	Descriptive Norms Regarding Teen Risky Sexual Activity	Participants are asked to indicate what percentage [0% = no teens; 100% = all teens] of teens engage in risky sexual activities (e.g., What percentage of teens have sex with someone who is much older?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)	posttest (approximately one week after pretest)
Secondary	Descriptive Norms Regarding Teen Risky Sexual Activity	Participants are asked to indicate what percentage [0% = no teens; 100% = all teens] of teens engage in risky sexual activities (e.g., What percentage of teens have sex with someone who is much older?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)	follow-up (approximately three months after pretest)
Secondary	Sexual Health Knowledge	Participants are asked several multiple choice and True/False questions about sexual health (e.g., True or false: You can tell someone has an STI by looking at him/her.).	posttest (approximately one week after pretest)
Secondary	Sexual Health Knowledge	Participants are asked several multiple choice and True/False questions about sexual health (e.g., True or false: You can tell someone has an STI by looking at him/her.).	follow-up (approximately three months after pretest)
Secondary	Descriptive Norms Regarding Sexual Health Communication	Participants are asked to indicate what percentage [0% = no teens; 100% = all teens] of teens communicate with parents, health providers, or another trusted adult (e.g., Before deciding to have sex, what percentage of teens talk with their boy/girlfriend about sexual health?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)	posttest (approximately one week after pretest)
Secondary	Descriptive Norms Regarding Sexual Health Communication	Participants are asked to indicate what percentage [0% = no teens; 100% = all teens] of teens communicate with parents, health providers, or another trusted adult (e.g., Before deciding to have sex, what percentage of teens talk with their boy/girlfriend about sexual health?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)	follow-up (approximately three months after pretest)
Secondary	Efficacy to Negotiate Contraception/Protection Use	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could convince a partner to use contraception (e.g., If I decided to have sex, I could talk to any potential partner to make him/her understand why we should use condoms or other contraception.).	posttest (approximately one week after pretest)
Secondary	Efficacy to Negotiate Contraception/Protection Use	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could convince a partner to use contraception (e.g., If I decided to have sex, I could talk to any potential partner to make him/her understand why we should use condoms or other contraception.).	follow-up (approximately three months after pretest)
Secondary	Efficacy to Use Contraception/Protection	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could get and use contraception (e.g., If I wanted to, I could get condoms or another form of contraception.).	posttest (approximately one week after pretest)
Secondary	Efficacy to Use Contraception/Protection	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could get and use contraception (e.g., If I wanted to, I could get condoms or another form of contraception.).	follow-up (approximately three months after pretest)
Secondary	Descriptive Norms Regarding Teen Birth Control Use	Participants are asked to indicate what percentage [0% = no teens; 100% = all teens] of teens use contraception (e.g., What percentage of teens who have oral sex use a condom or a dental dam?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)	posttest (approximately one week after pretest)
Secondary	Descriptive Norms Regarding Teen Birth Control Use	Participants are asked to indicate what percentage [0% = no teens; 100% = all teens] of teens use contraception (e.g., What percentage of teens who have oral sex use a condom or a dental dam?). (adapted from Scull, Kupersmidt, Malik, and Keefe, 2018)	follow-up (approximately three months after pretest)
Secondary	Efficacy to Communicate Before Sex	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could communicate with others about sexual health (e.g., I could talk with a boy/girlfriend about using condoms for sexually transmitted infection protection.). (adapted from Scull, Malik, & Kupersmidt, 2014)	posttest (approximately one week after pretest)
Secondary	Efficacy to Communicate Before Sex	Participants are asked to indicate on a 4-point Likert scale (1=strongly disagree; 2=disagree; 3=agree; 4=strongly agree) how effectively they could communicate with others about sexual health (e.g., I could talk with a boy/girlfriend about using condoms for sexually transmitted infection protection.). (adapted from Scull, Malik, & Kupersmidt, 2014)	follow-up (approximately three months after pretest)
Secondary	Intent to Communicate Before Sex	Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to communicate with others before sexual activity (e.g., Before deciding to have sex, how likely would you be to talk with your parents or another trusted adult about sexual health?). (adapted from Scull, Malik, & Kupersmidt, 2014)	posttest (approximately one week after pretest)
Secondary	Intent to Communicate Before Sex	Participants are asked to indicate on a 4-point Likert scale (1=not at all likely; 2=unlikely; 3=likely; 4=extremely likely) how likely they are to communicate with others before sexual activity (e.g., Before deciding to have sex, how likely would you be to talk with your parents or another trusted adult about sexual health?). (adapted from Scull, Malik, & Kupersmidt, 2014)	follow-up (approximately three months after pretest)
Secondary	Cognitive Elaboration While Viewing an Advertisement	Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (1=not much at all; 2=a little; 3=a good amount; 4=a lot) the extent to which they: 1) thought about the ad; 2) spent time thinking about the ad; and 3) paid attention to the ad. (adapted from Shiv, Britton, and Payne, 2004)	posttest (approximately one week after pretest)
Secondary	Cognitive Elaboration While Viewing an Advertisement	Participants are shown an advertisement and asked to indicate on a 4-point Likert scale (1=not much at all; 2=a little; 3=a good amount; 4=a lot) the extent to which they: 1) thought about the ad; 2) spent time thinking about the ad; and 3) paid attention to the ad. (adapted from Shiv, Britton, and Payne, 2004)	follow-up (approximately three months after pretest)
Secondary	Communication With a Doctor or Other Health Professional About Sexual Health	Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a doctor or other health professional (e.g., How often do you talk with a doctor or other health professional about sexual health?).	posttest (approximately one week after pretest)
Secondary	Communication With a Doctor or Other Health Professional About Sexual Health	Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a doctor or other health professional (e.g., How often do you talk with a doctor or other health professional about sexual health?).	follow-up (approximately three months after pretest)
Secondary	Communication With a Parent or Other Trusted Adult About Sexual Health	Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a doctor or trusted adult (e.g., How often do you talk with a parent or other trusted professional about sexual health?).	posttest (approximately one week after pretest)
Secondary	Communication With a Parent or Other Trusted Adult About Sexual Health	Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a doctor or trusted adult (e.g., How often do you talk with a parent or other trusted professional about sexual health?).	follow-up (approximately three months after pretest)
Secondary	Communication With a Boyfriend or Girlfriend About Sexual Health	Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a boyfriend/girlfriend (e.g., How often do you talk with your boyfriend/girlfriend about sexual health?).	posttest (approximately one week after pretest)
Secondary	Communication With a Boyfriend or Girlfriend About Sexual Health	Participants are asked on a 4-point Likert scale (1never; 2=rarely; 3=sometimes; 4=often) about their frequency of sexual health communication with a boyfriend/girlfriend (e.g., How often do you talk with your boyfriend/girlfriend about sexual health?).	follow-up (approximately three months after pretest)