Sexuality and the self: studying gender-, social- and cultural differences in sexual self-concept as an explanation for unplanned pregnancies and abortion in teenagers

In the Netherlands, annually 1 on each 100 teenage girls (15-19 years) has an
abortion and 15% of the total number of abortions that are carried out take
place among women younger than twenty years. These percentages and numbers have
recently increased.The most important explanation for this recent development
seems to be the absolute and relative increase of risk groups affected by
unplanned pregnancies, particularly ethnic minority women and girls. Minority
young people do not often use contraceptives, or use them inadequately. Safe
sex education for young people should be adapted to how adolescents experience
sexuality. The way individuals experience sexuality depends on their sexual
development, but also on their gender and culture. These factors are apparent
in the sexual self-concept of adolescents. Many young people engage in sexual
behaviour without having a clear and unambiguous sexual self-concept. This
hampers the preparation of contraceptive behavior and increases the risk of
unplanned pregnancies. It is plausible that minority young women have a less
clear sexual self-concept, because of a stronger taboo on sexuality in some
cultures

Aim of the research is the development and evaluation of an intervention to
promote the sexual and reproductive health of adolescents who differ in
cultural background. Fundamental idea is that sex education is more effective
if the information is tailored to the sexual self-concept and situation of
adolescents. The intervention is therefore developed as online instrument, in
which the sex education message is tailored to the sexual self-concept and
situation of the respondent. Moreover, respondents will receive also
information concerning suitable strategies which should help them to enact this
safe sex behavior.

The research, in the form of an RCT, will test if information that is tailored
to characteristics of the individual respondent (among which the sexual
self-concept) is more effective than a non-tailored message. To test the
intervention, a 2 x 2 research design has been developed. At random it is
decided whether adolescents do or do not recieve feedback about the possible
influence of their sexual self-concept on safe sex behavior, and whether
adolescents will or will not be offered appropriate strategies for actually
enacting safe sex behaviors. The impact of the intervention is assessed by
means of assessment of differences in social cognitive aspects of safe sex
behavior (attitude, social norm, intention and self-efficacy). After several
weeks, a follow-up will take place to also examine the effect on adolescents
actual safe sex behavior.

Findings from previous research conducted as part of this project provided some
clear points of departure for the development of an intervention to promote the
sexual and reproductive health of adolescents from diverse ethnic backgrounds.
The fundamental idea on which the intervention rests is that information is
more effective if it is adapted to the sexual self-concept of adolescents.
During the intervention, adolescents are stimulated to practice safe sex in a
manner that is optimally tailored to their own experiences and cultural
background. Moreover, adolescents are stimulated to clarify their own aims and
and plans in the area of sexuality. This way, we hope to improve the prevention
of unplanned pregnancies, by adapting sex education to the individual needs of
adolescents from differing backgrounds

Completing the intervention will take approximately 45 minutes up to an hour.
When adolescents also indicate that they want to participate in follow-up
research, this will involve one half hour of extra time. Participating in the
intervention entails a minimal burden and is without risk, in particular in
view of the importance of reducing unplanned pregnancies and abortions among
adolescents. Participation is entirely voluntary and respondents can only take
part after consent has been obtained from their parents./guardians.
Furthermore, the respondent can stop participation at any time. When a
respondent drops out of the study, data will not be stored.