title: A conceptual framework for the evolution of sexual medicine and a model for the development of alternative sexual health services: 10-year experience of the center for sexual and reproductive health.
abstract: BACKGROUND
  Sexual health services are limited and inadequate to reduce factors that hinder treatment and adequate care, despite the growing interest for public awareness and prevention strategies.
  
  
  OBJECTIVE
  The aim of this study was to present an integrative conceptual framework, which led to the development of a model of alternative sexual health services and the 10-year experience of the practice of the service.
  
  
  METHODS
  Multiple-level needs assessments.
  
  
  METHODS
  The conceptual framework is composed of four distinct elements: (i) it adopts a social/ecological perspective; (ii) it assumes that results are optimal when multiple interventions are used; (iii) interventions are influenced by behavioral theories; and (iv) sexual health is conceptualized through the biopsychosocial model. Based on this model, a Sexual and Reproductive Health Center was developed, dedicated to research, education, and public awareness.
  
  
  RESULTS
  Over 10 years of experience show that the present approach constitutes a process which: (i) facilitates our understanding of the needs at individual, community, and system level; and (ii) increases the individuals', community and systems' capacity to control sexual health.
  
  
  CONCLUSIONS
  Alternative models for sexual and reproductive health services should be encouraged, in order for best practices to be explored and identified. In addition, future research in the effectiveness of such interventions shall be beneficial in order for evidence-based interventions to be designed.
authors.affiliation: Center for Sexual and Reproductive Health, Aristotle University, Thessaloniki, Greece. pskirana@gmail.com
authors.forename: Paraskevi-Sofia
authors.initials: PS
authors.lastname: Kirana
authors.forename: Stamatis
authors.initials: S
authors.lastname: Papaharitou
authors.forename: Loukas
authors.initials: L
authors.lastname: Athanasiadis
authors.forename: Evangelia
authors.initials: E
authors.lastname: Nakopoulou
authors.forename: George
authors.initials: G
authors.lastname: Salpiggidis
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Moysidis
authors.forename: Chryssa
authors.initials: C
authors.lastname: Pipilaki
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Hatzimouratidis
authors.forename: Vassilios
authors.initials: V
authors.lastname: Tzotstzis
authors.forename: Aleka
authors.initials: A
authors.lastname: Portseli
authors.forename: Maria
authors.initials: M
authors.lastname: Iraklidou
authors.forename: Apostolos
authors.initials: A
authors.lastname: Apostolidis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Bekos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Hatzichristou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D008962:Models, Theoretical; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000706:statistics & numerical data*; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012735:Sexual Dysfunction, Physiological; D020018:Sexual Dysfunctions, Psychological; D019529:Sexuality / Q000706:statistics & numerical data*; D013997:Time Factors