Development of a Behaviour Change Intervention to Improve Sexual Health Service Use Among University Undergraduate Students

Abstract

Introduction: University undergraduate students are within the highest risk population for acquiring sexually transmitted infections and other negative health outcomes. Effective prevention relies on regular condom use and early detection and treatment. Despite the availability of sexual health services at university health centres, many students delay or avoid seeking care. The aim of this study was to develop intervention strategies to improve sexual health service use among university students.

Methods: This study used a three-phased, sequential explanatory mixed methods research design guided by the Behaviour Change Wheel. In phase one, a secondary analysis of online survey data from two universities in Nova Scotia was conducted to describe the rates and predictors of undergraduate students’ use of sexual health services. In phase two, focus groups and interviews with students, health care providers, and administrators were conducted to identify barriers and enablers to student use of sexual health services. In phase three, stakeholder consultation meetings were held to select intervention content and potential modes of delivery.

Results: A total of 2,625 female students and 1,074 male students were included in the secondary analysis. Only 22% of female students and 8% of male students reported having ever accessed sexual health services at their university health centre. Barriers and enablers to sexual health service use included: knowledge and awareness of sexual health services, service accessibility, peer influence, campus culture, stigma, privacy and confidentiality. Key linkages between opportunity and motivation were found to influence students' access of sexual health services. Six intervention functions and 15 behaviour change techniques were identified as relevant to include in interventions to improve sexual health service use.

Conclusions: This study details the use of the Behaviour Change Wheel to develop interventions strategies aimed at improving university students’ use of sexual health services. The Behaviour Change Wheel provided a useful framework for integrating multiple sources of data to inform the selection of theory- and evidence-based intervention strategies. University administrators and decision-makers can use these strategies to design, implement, and evaluate sexual health service interventions that are feasible within the context of their health centre.