title: Internet-based educational intervention to prevent risky sexual behaviors in Mexican adolescents: study protocol.
abstract: BACKGROUND
  Risky sexual behaviors of adolescents in Mexico are a public health problem; 33.4 % of adolescent girls and 14.7 % of boys report not having used any protection at their first intercourse. The fertility rate is 77 births/1000 girls aged 15-19 years. The infrequent contact of adolescents with health services and the limited extent of school sex and reproductive health education require the support of innovative strategies. The objective of this paper is to present the design of an internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents.
  
  
  METHODS
  A field trial with intervention and comparison group and with ex-ante and ex-post measurements will be conducted in two public secondary schools. Adolescents between 14 and 15 years of age will participate. The intervention will be conducted in one school and the second school will serve as a comparison group where the investigators will observe the usual sex education provided by the school. The intervention will be delivered using an internet web page that includes four educational sessions provided during a 4 week period. Follow-up will last 3 months. Information on the study variables will be obtained through an Internet-based self-applied questionnaire and collected on three occasions: 1) when the adolescents enter the study (baseline), 2) once the intervention is completed (at 1 month) and 3) after 3 months of follow-up (at the fourth month). There will be three outcome variables: 1) knowledge in regard to sexually transmitted infections, 2) attitudes regarding condom use, and 3) self-efficacy toward consistent condom use. The generalized linear model will be used to assess changes in each outcome variable controlling for baseline measures and for study covariates.
  
  
  CONCLUSIONS
  The design and evaluation of an Internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents is important in order to provide a new, large-scale, easily implemented preventive tool.
  
  
  BACKGROUND
  The study was registered at the ClinicalTrials.gov ID: NCT02686736 .
authors.affiliation: Epidemiology and Health Services Research Unit, CMN Siglo XXI, Mexican Institute of Social Security, Av. Cuauhtemoc 330, Mexico City, 06720, Mexico.
authors.forename: Svetlana V
authors.initials: SV
authors.lastname: Doubova
authors.affiliation: Instituto de Investigaciones Sociales, Universidad Nacional Autónoma de México, México City, Mexico.
authors.forename: Claudia
authors.initials: C
authors.lastname: Infante-Castañeda
authors.affiliation: Hospital Infantil de Mexico Federico Gomez, Calle Doctor Marquez 162 Colonia Doctores, Mexico City, Pc: 06720, Mexico. rperez@iadb.org.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pérez-Cuevas
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D008800:Mexico; D012309:Risk-Taking; D012572:School Health Services; D020377:Self Efficacy; D012736:Sex Education / Q000379:methods*; D012725:Sexual Behavior / Q000523:psychology*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D011795:Surveys and Questionnaires
keywords: Adolescents; Internet-based educational intervention; Prevention; Risky sexual behaviors