Study of Long-term Efficacy and Mechanisms Underlying the Impact of a Web-based Sexual and Relationship Health Promotion Program With Young Adult Community College Students

The Community College Health Study: A Study of Long-term Efficacy and Mechanisms Underlying the Impact of a Web-based Sexual and Relationship Health Promotion Program With Young Adult Community College Students

Community college students are an underserved and at-risk population in terms of their sexual and relationship health. This is a three-arm randomized control trial to evaluate the long-term efficacy of a web-based sexual and relationship health promotion program among U.S. community college students (expected N = 2010) and explore the mechanisms underlying the program efficacy.

Study Overview

• Status: Completed
• Conditions: Sexual Behavior; Violence, Domestic; Sexual Assault
• Intervention / Treatment: Behavioral: Media Aware for Young Adults; Behavioral: Health Aware for Young Adults

Detailed Description

Community college students are an underserved and at-risk population in terms of their sexual and relationship health. One promising avenue for improving sexual decision making among this population is media literacy education (MLE). Though studies show MLE is an effective approach to sexual health promotion there is a need to better understand the mechanisms by which MLE programs impact health outcomes. The ultimate goals of this study are to 1) advance theoretical frameworks of media literacy to better understand the underlying mechanisms that lead to sexual health behavior change and 2) enhance the sexual and relationship health of community college students by identifying successful methods of health promotion and strategies to implement health programs at community colleges. This study is a three-arm randomized control trial (RCT) with 2010 community college students (ages 18-19) from 30 colleges across the U.S. All components of this study (i.e., interventions, surveys) are web-based.

Participating students will be randomized to one of three conditions: 1) students who receive a sexual health program grounded in MLE (Media Aware); 2) students who receive a sexual health program with no MLE; and 3) a wait-list control group. Participants will complete pretest, posttest, 6-month follow-up, and 12-month follow-up surveys to examine changes across the three groups in our primary outcomes (e.g., risky sexual behavior) and secondary outcomes (e.g., sexual health knowledge, rape myth acceptance, perceived realism of media messages).

• Study Type: Interventional
• Enrollment (Actual): 2184
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • North Carolina
    • Durham, North Carolina, United States, 27713
      • innovation Research and Training

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 19 years (Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Students must be 18 or 19 years of age.
• Students must attend one of the community colleges from which this study is recruiting participants.
• Students must have an email address to receive study communication.
• Students must have access to a computer, tablet, or phone device with internet access as the questionnaires and programs are web-based.
• Students must be able to speak and read English because the study materials (e.g., questionnaires, programs) are in English.

Exclusion Criteria:

-

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention - Media Aware for Young Adults; This arm will receive Media Aware for Young Adults between the pretest and posttest questionnaire. Media Aware for Young Adults is a web-based sexual and relationship health promotion program that uses a media literacy education (MLE) approach. The program is self-paced and includes four modules.	Behavioral: Media Aware for Young Adults; Media Aware for Young Adults is a web-based sexual and relationship health promotion program designed for young adults that uses a media literacy education (MLE) approach.
Active Comparator: Active Control - Health Aware for Young Adults; This arm will receive Health Aware for Young Adults in between the pretest and posttest questionnaire. Health Aware for Young Adults is a web-based sexual and relationship health promotion program. The program contains the same health content as Media Aware for Young Adults but without the media literacy education components. The program is self-paced and includes four modules.	Behavioral: Health Aware for Young Adults; Media Aware for Young Adults is a web-based sexual and relationship health promotion program designed for young adults.
No Intervention: Delayed Intervention Control; Participants in this condition will not receive a sexual or relationship health promotion program until after the 12-month follow-up survey. After that survey is complete, they will receive access to the Media Aware for Young Adults program.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Relationship Satisfaction	Relationship satisfaction will be assessed using 7-items (e.g., "How well does your partner meet your needs?") rated on a 5-point Likert-type scale from 1 (poorly) to 5 (extremely well); higher scores indicate greater relationship satisfaction; range = 1-5; higher scores indicate a more favorable outcome. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Relationship Satisfaction	Relationship satisfaction will be assessed using 7-items (e.g., "How well does your partner meet your needs?") rated on a 5-point Likert-type scale from 1 (poorly) to 5 (extremely well); higher scores indicate greater relationship satisfaction; range = 1-5; higher scores indicate a more favorable outcome. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Relationship Satisfaction	Relationship satisfaction will be assessed using 7-items (e.g., "How well does your partner meet your needs?") rated on a 5-point Likert-type scale from 1 (poorly) to 5 (extremely well); higher scores indicate greater relationship satisfaction; range = 1-5; higher scores indicate a more favorable outcome. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Percentage of Participants With Relationship Violence Perpetration	10-items (e.g., "I spoke to my partner in a hostile or mean tone of voice."); Participants were asked to rate how often these things happened with their current or ex-dating partner on a 4-point Likert-type scale from 1 (never) to 4 (often); higher scores indicate more frequent relationship violence; range = 1-4. [Given lack of variability, this measure was dichotomized so 0 equals no violence and 1 equals any violence.]	posttest (4-weeks after pretest)
Percentage of Participants With Relationship Violence Perpetration	10-items (e.g., "I spoke to my partner in a hostile or mean tone of voice."); Participants were asked to rate how often these things happened with their current or ex-dating partner on a 4-point Likert-type scale from 1 (never) to 4 (often); higher scores indicate more frequent relationship violence; range = 1-4. [Given lack of variability, this measure was dichotomized so 0 equals no violence and 1 equals any violence.]	6-month follow-up
Percentage of Participants With Relationship Violence Perpetration	10-items (e.g., "I spoke to my partner in a hostile or mean tone of voice."); Participants were asked to rate how often these things happened with their current or ex-dating partner on a 4-point Likert-type scale from 1 (never) to 4 (often); higher scores indicate more frequent relationship violence; range = 1-4. [Given lack of variability, this measure was dichotomized so 0 equals no violence and 1 equals any violence.]	12-month follow-up
Percentage of Participants With Relationship Violence Victimization	10-items (e.g., "My partner spoke to me in a hostile or mean tone of voice"); Participants were asked to rate how often these things happened with their current or ex-dating partner on a 4-point Likert-type scale from 1 (never) to 4 (often); higher scores indicate more frequent relationship violence; range = 1-4; [Given lack of variability, this measure was dichotomized so 0 equals no violence and 1 equals any violence.]	posttest (4-weeks after pretest)
Percentage of Participants With Relationship Violence Victimization	10-items (e.g., "My partner spoke to me in a hostile or mean tone of voice"); Participants were asked to rate how often these things happened with their current or ex-dating partner on a 4-point Likert-type scale from 1 (never) to 4 (often); higher scores indicate more frequent relationship violence; range = 1-4; [Given lack of variability, this measure was dichotomized so 0 equals no violence and 1 equals any violence.]	6-month follow-up
Percentage of Participants With Relationship Violence Victimization	10-items (e.g., "My partner spoke to me in a hostile or mean tone of voice"); Participants were asked to rate how often these things happened with their current or ex-dating partner on a 4-point Likert-type scale from 1 (never) to 4 (often); higher scores indicate more frequent relationship violence; range = 1-4; [Given lack of variability, this measure was dichotomized so 0 equals no violence and 1 equals any violence.]	12-month follow-up
Risky Sexual Behaviors	4-items (e.g., How many times have you had oral, vaginal, or anal sex with a casual partner?); Participants were asked to report how many times each behavior happened; higher scores indicate greater sexual risk taking. Responses were open-ended so while the lower limit of the range was assumed to be zero, there was no upper limit imposed on participants.	posttest (4-weeks after pretest)
Risky Sexual Behaviors	4-items (e.g., How many times have you had oral, vaginal, or anal sex with a casual partner?); Participants were asked to report how many times each behavior happened; higher scores indicate greater sexual risk taking. Responses were open-ended so while the lower limit of the range was assumed to be zero, there was no upper limit imposed on participants.	6-month follow-up
Risky Sexual Behaviors	4-items (e.g., How many times have you had oral, vaginal, or anal sex with a casual partner?); Participants were asked to report how many times each behavior happened; higher scores indicate greater sexual risk taking. Responses were open-ended so while the lower limit of the range was assumed to be zero, there was no upper limit imposed on participants.	12-month follow-up
Percentage of Participants That Used Protection at Last Oral Sex	1-item ("Did you use a condom and/or dental dam the last time you had oral sex?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had oral sex responded to this item	posttest (4-weeks after pretest)
Percentage of Participants That Used Protection at Last Oral Sex	1-item ("Did you use a condom and/or dental dam the last time you had oral sex?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had oral sex responded to this item	6-month follow-up
Percentage of Participants That Used Protection at Last Oral Sex	1-item ("Did you use a condom and/or dental dam the last time you had oral sex?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had oral sex responded to this item	12-month follow-up
Frequency of Use of Protection During Oral Sex	3-items used to calculate change in frequency of use of protection during oral sex [e.g., "In the past month, how often did you or your partner(s) use a condom or dental dam when having oral sex?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent use of protection; Only participants who indicated they had had oral sex responded to these items.	posttest (4-weeks after pretest)
Frequency of Use of Protection During Oral Sex	3-items used to calculate change in frequency of use of protection during oral sex [e.g., "In the past month, how often did you or your partner(s) use a condom or dental dam when having oral sex?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent use of protection; Only participants who indicated they had had oral sex responded to these items.	6-month follow-up
Frequency of Use of Protection During Oral Sex	3-items used to calculate change in frequency of use of protection during oral sex [e.g., "In the past month, how often did you or your partner(s) use a condom or dental dam when having oral sex?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent use of protection; Only participants who indicated they had had oral sex responded to these items.	12-month follow-up
Frequency of Condom Use During Vaginal Sex	3-items used to calculate change in frequency of condom use during vaginal sex [e.g., "In the past month, how often did you or your partner(s) use a condom when having vaginal sex?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent condom use; Only participants who indicated they had had vaginal sex responded to these items.	posttest (4-weeks after pretest)
Frequency of Condom Use During Vaginal Sex	3-items used to calculate change in frequency of condom use during vaginal sex [e.g., "In the past month, how often did you or your partner(s) use a condom when having vaginal sex?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent condom use; Only participants who indicated they had had vaginal sex responded to these items.	6-month follow-up
Frequency of Condom Use During Vaginal Sex	3-items used to calculate change in frequency of condom use during vaginal sex [e.g., "In the past month, how often did you or your partner(s) use a condom when having vaginal sex?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent condom use; Only participants who indicated they had had vaginal sex responded to these items.	12-month follow-up
Frequency of Birth Control Use	3-items used to calculate change in frequency of birth control use [e.g., "In the past month, how often did you or your partner(s) use one of the following forms of birth control? Birth control pills, The Shot (DepoProvera), The Patch, The Ring (Nuvaring), IUD (Mirena, Paragard, Skyla), The Implant (Implanon, Nexplanon), or other FDA approved methods."]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent birth control use; Only participants who indicated they had had vaginal sex responded to these items.	posttest (4-weeks after pretest)
Frequency of Birth Control Use	3-items used to calculate change in frequency of birth control use [e.g., "In the past month, how often did you or your partner(s) use one of the following forms of birth control? Birth control pills, The Shot (DepoProvera), The Patch, The Ring (Nuvaring), IUD (Mirena, Paragard, Skyla), The Implant (Implanon, Nexplanon), or other FDA approved methods."]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent birth control use; Only participants who indicated they had had vaginal sex responded to these items.	6-month follow-up
Frequency of Birth Control Use	3-items used to calculate change in frequency of birth control use [e.g., "In the past month, how often did you or your partner(s) use one of the following forms of birth control? Birth control pills, The Shot (DepoProvera), The Patch, The Ring (Nuvaring), IUD (Mirena, Paragard, Skyla), The Implant (Implanon, Nexplanon), or other FDA approved methods."]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent birth control use; Only participants who indicated they had had vaginal sex responded to these items.	12-month follow-up
Percentage of Participants That Used Contraceptive at Last Vaginal Sex	1-item ("Did you use any contraceptive method the last time you had vaginal sex?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had vaginal sex responded to this item	posttest (4-weeks after pretest)
Percentage of Participants That Used Contraceptives at Last Vaginal Sex	1-item ("Did you use any contraceptive method the last time you had vaginal sex?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had vaginal sex responded to this item	6-month follow-up
Percentage of Participants That Used Contraceptives at Last Vaginal Sex	1-item ("Did you use any contraceptive method the last time you had vaginal sex?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had vaginal sex responded to this item	12-month follow-up
Frequency of Condom Use During Anal Sex	3-items used to calculate change in frequency of condom use during anal sex [e.g., "In the past month, how often did you or your partner(s) use a condom when having anal sex?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent condom use; Only participants who indicated they had had anal sex responded to these items.	posttest (4-weeks after pretest)
Frequency of Condom Use During Anal Sex	3-items used to calculate change in frequency of condom use during anal sex [e.g., "In the past month, how often did you or your partner(s) use a condom when having anal sex?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent condom use; Only participants who indicated they had had anal sex responded to these items.	6-month follow-up
Frequency of Condom Use During Anal Sex	3-items used to calculate change in frequency of condom use during anal sex [e.g., "In the past month, how often did you or your partner(s) use a condom when having anal sex?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always) and averaged for analyses; higher scores indicate more frequent condom use; Only participants who indicated they had had anal sex responded to these items.	12-month follow-up
Percentage of Participants That Used a Condom at Last Anal Sex	1-item ("Did you use a condom during your last anal intercourse?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had anal sex responded to this item	posttest (4-weeks after pretest)
Percentage of Participants That Used a Condom at Last Anal Sex	1-item ("Did you use a condom during your last anal intercourse?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had anal sex responded to this item	6-month follow-up
Percentage of Participants That Used a Condom at Last Anal Sex	1-item ("Did you use a condom during your last anal intercourse?"); participants answered "yes" (1) or "no" (0); Only participants who indicated they had had anal sex responded to this item	12-month follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived Realism of Media Messages	6-items (e.g., "People my age in the media…have sexual contact as often as average people my age"; rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants think media is more realistic, indicating a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Perceived Realism of Media Messages	6-items (e.g., "People my age in the media…have sexual contact as often as average people my age"; rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants think media is more realistic, indicating a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Perceived Realism of Media Messages	6-items (e.g., "People my age in the media…have sexual contact as often as average people my age"; rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants think media is more realistic, indicating a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Perceived Similarity to Media Messages	7-items (e.g., "The things I do in my life are similar to what I see in the media"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater perceived similarity, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Perceived Similarity to Media Messages	7-items (e.g., "The things I do in my life are similar to what I see in the media"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater perceived similarity, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Perceived Similarity to Media Messages	7-items (e.g., "The things I do in my life are similar to what I see in the media"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater perceived similarity, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Identification With Media	3-items (e.g., "I want to do the things that people my age in the media do"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants identify more with media, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Identification With Media	3-items (e.g., "I want to do the things that people my age in the media do"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants identify more with media, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Identification With Media	3-items (e.g., "I want to do the things that people my age in the media do"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants identify more with media, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Media Skepticism	6-items (e.g., "The media are dishonest about what happens when people drink alcohol"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants have more media skepticism, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Media Skepticism	6-items (e.g., "The media are dishonest about what happens when people drink alcohol"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants have more media skepticism, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Media Skepticism	6-items (e.g., "The media are dishonest about what happens when people drink alcohol"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate participants have more media skepticism, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Gender Role Norms	6-items (e.g., "Raising children is primarily a woman's responsibility"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate more traditional gender role norms, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Gender Role Norms	6-items (e.g., "Raising children is primarily a woman's responsibility"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate more traditional gender role norms, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Gender Role Norms	6-items (e.g., "Raising children is primarily a woman's responsibility"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate more traditional gender role norms, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Rape Myth Acceptance	13-items (e.g., "If a girl is raped while she is drunk, she is at least somewhat responsible for letting things get out of hand"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater rape myth acceptance, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Rape Myth Acceptance	13-items (e.g., "If a girl is raped while she is drunk, she is at least somewhat responsible for letting things get out of hand"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater rape myth acceptance, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Rape Myth Acceptance	13-items (e.g., "If a girl is raped while she is drunk, she is at least somewhat responsible for letting things get out of hand"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater rape myth acceptance, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Efficacy to Intervene as Bystander	5-items (e.g., "I could talk to a friend who I suspected is in an abusive relationship"); participants rate their confidence that they could do the action on a scale from 0-100; higher scores indicate greater bystander efficacy, which is a more favorable outcome; range = 0-100. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Efficacy to Intervene as Bystander	5-items (e.g., "I could talk to a friend who I suspected is in an abusive relationship"); participants rate their confidence that they could do the action on a scale from 0-100; higher scores indicate greater bystander efficacy, which is a more favorable outcome; range = 0-100. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Efficacy to Intervene as Bystander	5-items (e.g., "I could talk to a friend who I suspected is in an abusive relationship"); participants rate their confidence that they could do the action on a scale from 0-100; higher scores indicate greater bystander efficacy, which is a more favorable outcome; range = 0-100. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Intent to Intervene as Bystander	4-items (e.g., "Approach a friend if I thought they were in an abusive relationship and let them know that I am here to help"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to intervene as a bystander, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Intent to Intervene as Bystander	4-items (e.g., "Approach a friend if I thought they were in an abusive relationship and let them know that I am here to help"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to intervene as a bystander, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Intent to Intervene as Bystander	4-items (e.g., "Approach a friend if I thought they were in an abusive relationship and let them know that I am here to help"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to intervene as a bystander, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Sexual Health Knowledge	23-items (e.g., "True or False: You can tell if someone has an STI by looking at him/her"); For each item, participants who answer correctly will receive a "1" and participants who answer incorrectly will receive a "0"; items will be summed; higher scores indicate greater sexual health knowledge; range = 0-23 The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Sexual Health Knowledge	23-items (e.g., "True or False: You can tell if someone has an STI by looking at him/her"); For each item, participants who answer correctly will receive a "1" and participants who answer incorrectly will receive a "0"; items will be summed; higher scores indicate greater sexual health knowledge; range = 0-23. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Sexual Health Knowledge	23-items (e.g., "True or False: You can tell if someone has an STI by looking at him/her"); For each item, participants who answer correctly will receive a "1" and participants who answer incorrectly will receive a "0"; items will be summed; higher scores indicate greater sexual health knowledge; range = 0-23. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Attitudes Toward Risky Sexual Behaviors	5-items (e.g., "It is okay to…have sex with someone who has had many sexual partners"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards risky sexual behaviors, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Attitudes Toward Risky Sexual Behaviors	5-items (e.g., "It is okay to…have sex with someone who has had many sexual partners"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards risky sexual behaviors, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Attitudes Toward Risky Sexual Behaviors	5-items (e.g., "It is okay to…have sex with someone who has had many sexual partners"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards risky sexual behaviors, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Attitudes Toward Unprotected Sex	1-item ["It is okay to…have unprotected sex (not including when people are trying to get pregnant)"]; rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards unprotected sex; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Attitudes Toward Unprotected Sex	1-item ["It is okay to…have unprotected sex (not including when people are trying to get pregnant)"]; rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards unprotected sex; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Attitudes Toward Unprotected Sex	1-item ["It is okay to…have unprotected sex (not including when people are trying to get pregnant)"]; rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards unprotected sex; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Attitudes Toward Contraception/Protection	9-items (e.g., "It is wrong to use birth control"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate more favorable attitudes towards contraception; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Attitudes Toward Contraception/Protection	9-items (e.g., "It is wrong to use birth control"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate more favorable attitudes towards contraception; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Attitudes Toward Contraception/Protection	9-items (e.g., "It is wrong to use birth control"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate more favorable attitudes towards contraception; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Attitudes Toward Communication With Partners and Medical Professionals	4-items (e.g., "Before deciding to have sex, people should…talk with their partner about HIV/AIDS and other STIs"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards communication, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Attitudes Toward Communication With Partners and Medical Professionals	4-items (e.g., "Before deciding to have sex, people should…talk with their partner about HIV/AIDS and other STIs"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards communication, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Attitudes Toward Communication With Partners and Medical Professionals	4-items (e.g., "Before deciding to have sex, people should…talk with their partner about HIV/AIDS and other STIs"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate positive attitudes towards communication, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Descriptive Norms of Unprotected Sex	1-item (e.g., "What percentage of people your age have had unprotected sex?"); participants write in their estimate of what percentage of their peers are engaging in the behavior; higher scores indicate participants think more of their peers are engaging in unprotected sex; range = 0-100. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Descriptive Norms of Unprotected Sex	1-item (e.g., "What percentage of people your age have had unprotected sex?"); participants write in their estimate of what percentage of their peers are engaging in the behavior; higher scores indicate participants think more of their peers are engaging in unprotected sex; range = 0-100. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Descriptive Norms of Unprotected Sex	1-item (e.g., "What percentage of people your age have had unprotected sex?"); participants write in their estimate of what percentage of their peers are engaging in the behavior; higher scores indicate participants think more of their peers are engaging in unprotected sex; range = 0-100. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Descriptive Norms of Risky Sexual Activity	5-items (e.g., "What percentage of people your age…have had oral, anal, or vaginal sex with someone who has not been tested for STIs or whose STI status is unknown?"); participants write in their estimate of what percentage of their peers are engaging in each behavior; higher scores indicate participants think more of their peers are engaging in risky contraception use/protection practices; range = 0-100. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Descriptive Norms of Risky Sexual Activity	5-items (e.g., "What percentage of people your age…have had oral, anal, or vaginal sex with someone who has not been tested for STIs or whose STI status is unknown?"); participants write in their estimate of what percentage of their peers are engaging in each behavior; higher scores indicate participants think more of their peers are engaging in risky contraception use/protection practices; range = 0-100. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Descriptive Norms of Risky Sexual Activity	5-items (e.g., "What percentage of people your age…have had oral, anal, or vaginal sex with someone who has not been tested for STIs or whose STI status is unknown?"); participants write in their estimate of what percentage of their peers are engaging in each behavior; higher scores indicate participants think more of their peers are engaging in risky contraception use/protection practices; range = 0-100. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Sex Refusal Self-efficacy	5-items (e.g., "I can easily say 'no' to someone who is pressuring me to have sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater sex refusal self-efficacy, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Sex Refusal Self-efficacy	5-items (e.g., "I can easily say 'no' to someone who is pressuring me to have sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater sex refusal self-efficacy, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Sex Refusal Self-efficacy	5-items (e.g., "I can easily say 'no' to someone who is pressuring me to have sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater sex refusal self-efficacy, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Self-efficacy to Refuse Unprotected Sex	1-item ("I can easily say 'no' to sex if we do not have protection even if I really want to have sex with that person"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to refuse unprotected sex, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Self-efficacy to Refuse Unprotected Sex	1-item ("I can easily say 'no' to sex if we do not have protection even if I really want to have sex with that person"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to refuse unprotected sex, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Self-efficacy to Refuse Unprotected Sex	1-item ("I can easily say 'no' to sex if we do not have protection even if I really want to have sex with that person"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to refuse unprotected sex, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Self-efficacy to Use a Condom	1-item (e.g., "I can use a condom correctly or explain to my partner how to use a condom correctly"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to use a condom, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Self-efficacy to Use a Condom	1-item (e.g., "I can use a condom correctly or explain to my partner how to use a condom correctly"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to use a condom, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Self-efficacy to Use a Condom	1-item (e.g., "I can use a condom correctly or explain to my partner how to use a condom correctly"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to use a condom, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Self-efficacy to Communicate With Partners and Medical Professionals About Sex	4-items (e.g., "I can discuss preventing STIs with my partner"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to communicate, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Self-efficacy to Communicate With Partners and Medical Professionals About Sex	4-items (e.g., "I can discuss preventing STIs with my partner"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to communicate, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Self-efficacy to Communicate With Partners and Medical Professionals About Sex	4-items (e.g., "I can discuss preventing STIs with my partner"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to communicate, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Risky Sexual Behavior Intentions	5-items (e.g., "In the next 6 months, how likely is it that you will have oral, anal, or vaginal sex with a casual partner"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to engage in risky sexual behaviors, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Risky Sexual Behavior Intentions	5-items (e.g., "In the next 6 months, how likely is it that you will have oral, anal, or vaginal sex with a casual partner"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to engage in risky sexual behaviors, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Risky Sexual Behavior Intentions	5-items (e.g., "In the next 6 months, how likely is it that you will have oral, anal, or vaginal sex with a casual partner"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to engage in risky sexual behaviors, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Intentions to Have Unprotected Sex	1-item ("In the next 6 months, how likely is it that you will…have unprotected sex?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to have unprotected sex, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Intentions to Have Unprotected Sex	1-item ("In the next 6 months, how likely is it that you will…have unprotected sex?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to have unprotected sex, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Intentions to Have Unprotected Sex	1-item ("In the next 6 months, how likely is it that you will…have unprotected sex?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to have unprotected sex, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Intentions to Use a Condom	1-item (e.g., "If you were to decide to have sexual intercourse in the next 6 months, how likely would you be to use a condom?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to use protection/contraception, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Intentions to Use a Condom	1-item (e.g., "If you were to decide to have sexual intercourse in the next 6 months, how likely would you be to use a condom?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to use protection/contraception, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Intentions to Use a Condom	1-item (e.g., "If you were to decide to have sexual intercourse in the next 6 months, how likely would you be to use a condom?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to use protection/contraception, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Intentions to Communicate With Partners and Medical Professionals About Sex	6-items (e.g., "If you were to decide to engage in sexual activity with a new partner in the next 6 months, how likely would you be to…talk with a partner about HIV/AIDS or other STIs?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to communicate, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Intentions to Communicate With Partners and Medical Professionals About Sex	6-items (e.g., "If you were to decide to engage in sexual activity with a new partner in the next 6 months, how likely would you be to…talk with a partner about HIV/AIDS or other STIs?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to communicate, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Intentions to Communicate With Partners and Medical Professionals About Sex	6-items (e.g., "If you were to decide to engage in sexual activity with a new partner in the next 6 months, how likely would you be to…talk with a partner about HIV/AIDS or other STIs?"); rated on a 4-point Likert-type scale from 1 (not at all likely) to 4 (extremely likely); higher scores indicate greater intentions to communicate, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Willingness to Have Unprotected Sex	1-item (e.g., "Suppose you were with your boyfriend/girlfriend/partner. He/she wants 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?";); rated on a 4-point Likert-type scale from 1 (very unwilling) to 4 (very willing); higher scores indicate greater willingness to have unprotected sex, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Willingness to Have Unprotected Sex	1-item (e.g., "Suppose you were with your boyfriend/girlfriend/partner. He/she wants 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?";); rated on a 4-point Likert-type scale from 1 (very unwilling) to 4 (very willing); higher scores indicate greater willingness to have unprotected sex, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Willingness to Have Unprotected Sex	1-item (e.g., "Suppose you were with your boyfriend/girlfriend/partner. He/she wants 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?";); rated on a 4-point Likert-type scale from 1 (very unwilling) to 4 (very willing); higher scores indicate greater willingness to have unprotected sex, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Willingness to Engage in Risky Sexual Behaviors	5-items (e.g., "Suppose you wanted to have sex with someone but you did not know their STI status. In this situation, how willing would you be to have sex anyway?"); rated on a 4-point Likert-type scale from 1 (very unwilling) to 4 (very willing); higher scores indicate greater willingness to engage in risky sexual behaviors, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Willingness to Engage in Risky Sexual Behaviors	5-items (e.g., "Suppose you wanted to have sex with someone but you did not know their STI status. In this situation, how willing would you be to have sex anyway?"); rated on a 4-point Likert-type scale from 1 (very unwilling) to 4 (very willing); higher scores indicate greater willingness to engage in risky sexual behaviors, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Willingness to Engage in Risky Sexual Behaviors	5-items (e.g., "Suppose you wanted to have sex with someone but you did not know their STI status. In this situation, how willing would you be to have sex anyway?"); rated on a 4-point Likert-type scale from 1 (very unwilling) to 4 (very willing); higher scores indicate greater willingness to engage in risky sexual behaviors, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
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 represent the extent to which participants identify the implied message of the advertisement. Range: 0-3. Higher scores indicate a more favorable outcome. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Injunctive Norms - Most People	3-items (e.g., "Most people believe that it is okay for people my age to have unprotected sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate riskier injunctive norms, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Injunctive Norms - Most People	3-items (e.g., "Most people believe that it is okay for people my age to have unprotected sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate riskier injunctive norms, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Injunctive Norms - Most People	3-items (e.g., "Most people believe that it is okay for people my age to have unprotected sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate riskier injunctive norms, which is a less favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Injunctive Norms - Friends	1 item ("My friends think I should use protection when I have sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores less risky injunctive norms, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Injunctive Norms - Friends	1 item ("My friends think I should use protection when I have sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores less risky injunctive norms, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Injunctive Norms - Friends	1 item ("My friends think I should use protection when I have sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores less risky injunctive norms, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Descriptive Norms - People Like me	1-item ("Most people like me use protection when they have sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores less risky descriptive norms, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Descriptive Norms - People Like me	1-item ("Most people like me use protection when they have sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores less risky descriptive norms, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Descriptive Norms - People Like me	1-item ("Most people like me use protection when they have sex"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores less risky descriptive norms, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Frequency of Communication With Sexual Partner	1 item used to calculate change in frequency of sexual communication with a partner(s) [e.g., "In the past month, how often did you talk to your partner(s) about using condoms and/or other forms of contraception before engaging in sexual activity?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always); higher scores indicate more frequent communication, which is a more favorable outcome. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Frequency of Communication With Sexual Partner	1 item used to calculate change in frequency of sexual communication with a partner(s) [e.g., "In the past month, how often did you talk to your partner(s) about using condoms and/or other forms of contraception before engaging in sexual activity?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always); higher scores indicate more frequent communication, which is a more favorable outcome. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6-month follow-up
Frequency of Communication With Sexual Partner	1 item used to calculate change in frequency of sexual communication with a partner(s) [e.g., "In the past month, how often did you talk to your partner(s) about using condoms and/or other forms of contraception before engaging in sexual activity?"]; items rated on a 4-point Likert-type scale from 1 (never) to 4 (always); higher scores indicate more frequent communication, which is a more favorable outcome. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12-month follow-up
Percentage of Participants That Communicated With a Doctor	1-item used to calculate change in whether participants communicated with a doctor about sex ["In the past month, had you talked to a doctor or other medical professional about sex, contraception, and/or relationships?"]; participants answered "yes" (1) or "no" (0)	posttest (4-weeks after pretest)
Percentage of Participants That Communicated With a Doctor	1-item used to calculate change in whether participants communicated with a doctor about sex ["In the past month, had you talked to a doctor or other medical professional about sex, contraception, and/or relationships?"]; participants answered "yes" (1) or "no" (0)	6-month follow-up
Percentage of Participants That Communicated With a Doctor	1 item used to calculate change in whether participants communicated with a doctor about sex ["In the past month, had you talked to a doctor or other medical professional about sex, contraception, and/or relationships?"]; participants answered "yes" (1) or "no" (0)	12-month follow-up
Self-efficacy to Use a Dental Dam	1-item (e.g., "I can use a dental dam correctly or explain to my partner how to use a dental dam correctly"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to use a dental dam, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	posttest (4-weeks after pretest)
Self-efficacy to Use a Dental Dam	1-item (e.g., "I can use a dental dam correctly or explain to my partner how to use a dental dam correctly"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to use a dental dam, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	6 month follow-up
Self-efficacy to Use a Dental Dam	1-item (e.g., "I can use a dental dam correctly or explain to my partner how to use a dental dam correctly"); rated on a 4-point Likert-type scale from 1 (strongly disagree) to 4 (strongly agree); higher scores indicate greater self-efficacy to use a dental dam, which is a more favorable outcome; range = 1-4. The overall number of participants analyzed in each Arm/Group includes all participants who completed pretest. Posttest data was imputed for participants that were present at pretest but not at posttest.	12 month follow-up

Collaborators and Investigators

• Sponsor: Innovation Research & Training
• Collaborators: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
• Investigators: Principal Investigator: Tracy M Scull, PhD, innovation Research and Training

Study record dates

Study Major Dates

• Study Start (Actual): July 21, 2021
• Primary Completion (Actual): March 24, 2024
• Study Completion (Actual): March 24, 2024

Study Registration Dates

• First Submitted: May 3, 2021
• First Submitted That Met QC Criteria: June 25, 2021
• First Posted (Actual): July 6, 2021

Study Record Updates

• Last Update Posted (Actual): August 14, 2025
• Last Update Submitted That Met QC Criteria: July 28, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: CCHealthStudy-R01-20-007; R01HD099134 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No