Web-Based Intervention (WIFI-SRY) Development And Feasibility On Empowering Sexual Health Rights Among Youth

Abstract

There was limited availability of web-based intervention to promote health to the youth generation. Youth prone to be internet-savvy and independent but lacked of guidance on their sexual reproductive health rights. Existing comprehensive sexuality education used rights-based and gender-focused approach in educating young people on their sexual and reproductive matters. Current level of knowledge in SRH matter and understanding of SRHR is still low and not fully disseminated. HIV / AIDS is now showing high incidence among 20 – 30 years old as opposed to the older age group before. This makes it worthwhile to intervene the youth for better generation. Furthermore, two third of youth in Malaysia are able to enroll in higher education level, thus a web-based intervention will serve as the right platform to intervene. Present study aimed to develop and assess feasibility of using web-based intervention in improving knowledge and attitudes on SRHR among them. A sequential exploratory mixed method design was used involving two phases. The first phase used document review analysis on 16 modules and in-depth interviews thematic analysis with identified technical experts followed by validation of the intervention content outline via survey and focus group discussion with similar experts. This phase aimed in confirming SRHR as the correct study focus area and developing Web-based Intervention on Sexual Health Rights for Youth or in short, WifiSRY. In the second phase, feasibility of Wifi-SRY was assessed in four areas namely; acceptability, demand, implementation and preliminary efficacy. Post intervention evaluation was used to assess acceptability, demand and implementation while quasiexperimental pre-post design was used to assess preliminary efficacy. Demand assessment was also done via usage data from Wix.com as the web hosting. Usage data and semistructured FGD was also used to assess implementation. Feasibility was tested among undergraduates of Universiti Kebangsaan Malaysia aged 20 -24 years from Medical as well as Social Sciences and Humanities Faculties. From Phase 1, document review analysis revealed that SRHR was an appropriate study focus area. Three themes came out from in-depth interview analysis: (1) study implementation aspects; (2) web-based content development guide and (3) future target population. First two formed the basis of the intervention outline. Two theories were applied in the web-based intervention development, Technology Acceptance Model and Context – Input – Process – Product Evaluation Framework Model. Wifi-SRY was then developed covering sexuality, relationship, marriage preparedness and contraception domains using multimedia. It offered interactive online activities. Chat Box allowed users to post enquiries and obtained supportive feedback. The participated experts gave S-CVI/Ave of 0.88. In Phase 2, 336 students were approached, 54 joined Wifi-SRY at week 1, giving response rate of 16.1%. Continuity of involvement dropped leaving only eight participants who completed the post intervention evaluation at Week 7. Acceptability scoring and its precursors had mean score of four and above except for perceived enjoyment (1.63, s.d0.74). In term of demand, total visiting sessions recorded were 506 with 244 unique visitors. The average visiting session duration was 24 minutes 19 seconds. First time visitor constituted 79.9% of the total visitors while only 20% were returning visitors. Confidentiality, non-mobilefriendly and web features were some of barriers in sustaining engagement. All final eight participants were knowledgeable at post-test (mean score increment: 6.0) and had good attitude towards SRHR (mean increment score: 2.62). In conclusion, Wifi-SRY showed good acceptability score. There was increment in the mean pre and post-test score. However, improvement is needed on web design and content to ensure initial and sustainable engagement of users.