Background: The World Health Organization recommends the development of participatory sexuality education. In health promotion, web-based participatory interventions have great potential in view of the internet’s popularity among young people. Objective: The aim of this review is to describe existing published studies on online participatory intervention methods used to promote the sexual health of adolescents and young adults. Methods: We conducted a systematic review based on international scientific and grey literature. We used the PubMed search engine and Aurore database for the search. Articles were included if they reported studies on participatory intervention, included the theme of sexual health, were conducted on the internet (website, social media, online gaming system), targeted populations aged between 10 and 24 years, and had design, implementation, and evaluation methods available. We analyzed the intervention content, study implementation, and evaluation methods for all selected articles. Results: A total of 60 articles were included, which described 37 interventions; several articles were published about the same intervention. Process results were published in many articles (n=40), in contrast to effectiveness results (n=23). Many of the 37 interventions were developed on websites (n=20). The second most used medium is online social networks (n=13), with Facebook dominating this group (n=8). Online peer interaction is the most common participatory component promoted by interventions (n=23), followed by interaction with a professional (n=16). Another participatory component is game-type activity (n=10). Videos were broadcast for more than half of the interventions (n=20). In total, 43% (n=16) of the interventions were based on a theoretical model, with many using the Information-Motivation-Behavioral Skills model (n=7). Less than half of the interventions have been evaluated for effectiveness (n=17), while one-third (n=12) reported plans to do so and one-fifth (n=8) did not indicate any plan for effectiveness evaluation. The randomized controlled trial is the most widely used study design (n=16). Among the outcomes (evaluated or planned for evaluation), sexual behaviors are the most evaluated (n=14), followed by condom use (n=11), and sexual health knowledge (n=8). Conclusions: Participatory online interventions for young people’s sexual health have shown their feasibility, practical interest, and attractiveness, but their effectiveness has not yet been sufficiently evaluated. Online peer interaction, the major participatory component, is not sufficiently conceptualized and defined as a determinant of change or theoretical model component. One potential development would be to build a conceptual model integrating online peer interaction and support as a component.

Introduction Sexual health is a major issue for young people, and there is a need to promote it. Sexual health promotion messages may be included in Netflix series that are widely watched by young people, with important emotional dimensions in scenarios. Objective The aim of this study is to investigate the explicit sexual health promotion messages integrated in Netflix series popular among young people, and to describe them and how they are delivered. Methods We selected two types of Netflix series, aimed at young people: (1) series whose synopsis is mainly about sexual health and (2) all-subject series. We extracted data from 65 episodes of 6 of the most-watched Netflix series. We used a data extraction grid on EpiData. We analysed sexual health themes and sexual health promotion messages. We described the series and listed all the sexual health and other health themes discussed. For each promotion message, we described scene contents and extracted dialogues. Results We found 62 promotion messages in the 6 analysed series. The two series that highlight sexual health in their synopsis account for 81% (n=50/62) of these identified promotion messages. Messages mainly focus on sexual harassment and violence (19%), on sexually transmitted infections protection (18%) and on contraception (15%). Messages are mainly delivered as verbal information, and mostly feature 16–18 years old characters in school. Analysis highlighted four main points concerning scenarios in these series: (1) there are different ways to deliver sexual health promotion messages; (2) there is depiction of negative value judgements and gender norms; (3) some information may be incomplete or misleading and (4) risky behaviours are represented. Conclusion Netflix series incorporate diverse sexual health promotion messages for young people. Further research could assess how these messages are perceived and whether they increase the knowledge, skills and positive health behaviours of young people.

Background: Participatory education, in the form of peer education, may be an effective way to promote youth sexual health. With the advent of the internet, web-based interventions have potential as an attractive new tool for sexual health promotion by peers. Objective: The aim of this study was to evaluate professional experts’ opinions on the perspectives for web-based participatory interventions to promote sexual health by peers and among young people. Methods: Semistructured interviews were carried out with 20 experts (stakeholders in direct contact with young people, researchers, and institutional actors) specializing in sexual health, health promotion, peer education, youth, internet, and social media. After coding with N’Vivo, data were subjected to qualitative thematic analysis. Results: The majority of experts (18/20, 90%) found this kind of intervention to be attractive, but highlighted the necessary conditions, risks, and limitations attached to developing an acceptable peer intervention on the internet for sexual health promotion among young people. Five main themes were identified: (1) an internet intervention; (2) sexual health; (3) internet skills, and uses and the need for moderation; (4) multifaceted peers; and (5) minority peers. In the absence of youth interest for institutional messages, the experts highlighted the attractive participatory features of web-based interventions and the need for geolocalized resources. However, they also warned of the limitations associated with the possibility of integrating peers into education: peers should not be mere messengers, and should remain peers so as not to be outsiders to the target group. Experts highlighted concrete proposals to design an online participatory peer intervention, including the process of peer implication, online features in the intervention, and key points for conception and evaluation. Conclusions: The experts agreed that web-based participatory interventions for youth sexual health promotion must be tailored to needs, uses, and preferences. This type of action requires youth involvement framed in an inclusive and holistic sexual health approach. Peer education can be implemented via the internet, but the design of the intervention also requires not being overly institutional in nature. Involving young people in their own education in an interactive, safe online space has the potential to develop their empowerment and to foster long-term positive behaviors, especially in the area of sexual health.

Background: Promoting sexual health is key to improving the supportive behaviors and well-being of young people. With the advent of the Internet, web-based features for sexual health promotion may be attractive to a diverse range of young people. This study aims to assess young people’s proposals regarding a web-based intervention for sexual health promotion. Methods: Nineteen French young people aged 15–24 years participated to the study. In a semi-structured interview, they presented their views on a web-based intervention for sexual promotion. Data were coded with N’Vivo and subjected to qualitative thematic analysis to explore their proposals. Results: The majority of participants (n = 18) thought that a web-based intervention for sexual health promotion would be attractive. Young people interviewed made 31 concrete proposals for sexual health promotion on the Internet. Participatory and interactive dimensions on the internet appeared essential, with the need for stimulating activities and interaction with peers, but also with competent professionals and moderation. Face to the risks of the internet, they expressed the need of a secure and confidential space, to generate trust and participation in intervention. For participants, sexual health should be addressed in all its dimensions, taking into account the relational, sexual, and gender dimensions, and by incrementing on the internet valid, credible and personalized content. Conclusions: In sexual health promotion, young people are indispensable stakeholders who can make concrete proposals and can also participate in content creation and research. More broadly, in health promotion, involving target audiences in decisions represents a promising perspective.

Background: Determining the success of population health interventions often involves assessing multiple, multidimensional outcomes rather than a single one, which presents significant methodological challenges under the evidence-based medicine paradigm. This scoping review examines outcome selection, analysis, and interpretation, and the accuracy of conclusions in complex digital health interventions promoting health among adolescents and young adults (DHI-AYA). Methods: A comprehensive search of PubMed, EMBASE, ClinicalTrials.gov, PsycINFO, and CINAHL identified DHI-AYA implemented between 2017 and 2023. Studies were categorised by methodological choice regarding outcome hierarchical position: unique primary, multiple primary, or non-hierarchised outcomes. Outcomes were further classified into effectiveness, process, or economic categories. The authors’ conclusions on intervention success were compared with conclusions drawn by the research team based on the reported outcome analysis strategy. Secondly, four analytical strategies were applied to a subset of selected interventions to illustrate the impact of outcome hierarchical position and number on conclusions about intervention success. Results: Analysis of 100 studies linked to 26 DHI-AYA identified 251 distinct outcomes: 164 effectiveness, 78 process, and 9 economic outcomes. Seven interventions were evaluated using a unique primary outcome, 10 using multiple primary outcomes, and 9 using multiple non-hierarchised outcomes. Primary and secondary outcomes were predominantly effectiveness endpoints. The research team reclassified nine interventions (35%) deemed successful by authors as non-conclusive due to statistically conflicting results across outcomes. Most interventions deemed non-conclusive by the research team were evaluated using non-hierarchised outcomes (7/10, 70%). The choice of outcome analysis strategy substantially affected conclusions on intervention success. Conclusions: Discrepancies in intervention success assessments highlight the need for enhanced transparency, robustness, and trustworthiness in conclusion-drawing processes. In response, five methodological proposals are formulated: (1) developing core outcome sets specific to population health intervention research (PHIR), (2) collaboratively selecting multidimensional outcomes through a steering committee that accounts for stakeholder preferences and existing theoretical models, (3) exploring multi-criteria decision analysis and consensus-driven methods to transparently combine outcomes, (4) enhancing methodological reporting through intervention development and evaluation to improve scientific integrity and reproducibility, and (5) increasing PHIR expert involvement in ethics, funding, and evaluation committees to improve recognition of evidence produced in this field. PROSPERO Registration number: CRD42023401979.