Long-Term Efficacy of a Web-Based Sexual Health Promotion Program Using a Media Literacy Education Approach in a National Sample of Community College Students.

Young adults attending community college are an underserved population that is at high risk for STIs and unplanned pregnancy. A recent evaluation of a web-based, sexual health program, Media Aware, that uses a media literacy education approach, revealed positive short-term effects after 1 month on the sexual health cognitions and behaviors of community college students (ages 18-19) including a reduction in risky sexual behaviors. The purpose of the current study is to replicate and extend the findings reported in this earlier evaluation to a larger sample of community college students from across the USA in a longer-term study examining 12-month follow-up data. In a cluster randomized controlled trial, students from 23 community college campuses (N = 1139) either received the intervention (i.e., Media Aware) or were assigned to the Wait-list Control group, and the two groups were compared on their media literacy cognitions and sexual health cognitions and behaviors. Using an intent-to-treat design, results indicate that after 12 months, students who received Media Aware held healthier normative beliefs about risky sex and reported media messages to be less realistic, compared to students in the control group. There were no differences across groups in sexual health behaviors. Moderation analyses by gender and pretest scores were conducted. Findings show the efficacy of Media Aware for bringing about long-term changes in media and health cognitions. The findings also underscore the need for multi-level interventions that reduce community- and system-level barriers to engaging in sexual health behaviors. TRN: NCT04950686; Date of registration: 5/03/2021.