Effectiveness of a Nurse-Assisted Digital Sexual Literacy and Consent Education Intervention on Sexual Decision-Making, The risk Perception, and Help-Seeking Behaviour Among Rural Adolescents

Nursing

Abstract Background: Adolescents in rural areas often do not have access to comprehensive and structured sexual health education because of cultural and social hurdles, a lack of school-based programmes, and a lack of services that are friendly to teens. This gap leads to wrong knowledge, an inability to understand risks clearly, bad sexual decisions, and a failure to ask for help when needed. School nurses are in a unique position to provide digital interventions that are culturally sensitive and appropriate for the child's age that improve sexual health literacy and encourage safe practices. Objective: To assess the efficacy of a nurse-led digital sexual health literacy and consent education intervention for sexual decision-making, risk perception, and help-seeking behaviour among rural teenagers. Methods: A cluster randomised controlled study was executed, including 240 adolescents aged 13–17 years from four rural educational institutions. We randomly put schools into two groups: an intervention group (n=120) and a control group (n=120). The intervention was an 8-week organised digital program administered by certified school nurses, encompassing puberty education, consent, boundaries, online safety, risk recognition, and access to support services. Data were gathered at baseline, immediately after the intervention, and during a three-month follow-up using validated standardised scales. Independent t-tests and repeated measures ANOVA were used for statistical analysis, and the p-value was fixed at p<0.05. Results: The intervention group exhibited substantial enhancements in sexual decision-making (48.6±8.2 to 71.4±7.5), risk perception (52.1±9.1 to 78.3±8.4), and help-seeking behaviour (34.5±6.7 to 59.8±7.2), in contrast to negligible alterations in the control group (p<0.001). The benefits persisted during the three-month follow-up. Conclusion: Nurse-led digital sexual health literacy treatments significantly improve protective decision-making and help-seeking behaviour among rural adolescents. It is highly suggested that these kinds of activities are included in school health services.

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