1. Emily Scales, Catherine Mackenzie, Victoria Little Nursing 300: Research Methods Donna MacDonald March 24, 2013

2. * Why did we do this study? * Sexual health knowledge is essential to healthy sexual behavior as it supports healthy sexual practices. It is important to investigate sexual health knowledge, as unsafe sexual activity is associated with risks that include: unplanned pregnancy, and sexually transmitted infections (STIs). * The results of the research can act as a guide for nursing students who are in their final year of the program, as it would identify areas that may be in need of additional education. The results may also show the StFX School of Nursing where improvements to the nursing program curriculum are needed in order to assist students in becoming more knowledgeable about sexual health issues. * Finally, it will identify gaps in sexual knowledge across the university population allowing for directed health promotion efforts to improve the health outcomes of university students.

3. * Bachelor of Science in Nursing students in both first and fourth year will have a greater level of sexual health knowledge compared to fourth and first year students in other programs. * The best predictor of sexual health knowledge will be past sexual experience.

4. * A group-administered questionnaire was used to survey a convenience sample of university students who were enrolled at St.FX * The questionnaire was designed to investigate St.FX students’ sexual health knowledge and the predictive factors for this knowledge acquisition.

5. A. NOMINAL/ORDINAL VARIABLES NUMBER PERCENTAGE Gender Male 25 22.3 Female 87 77.7 Program of Study BScN 59 52.7 BScHK 29 25.9 BAHK 4 3.6 BSc 20 17.9 Year of Study First 39 34.8 Second 27 24.1 Third 10 8.9 Fourth 32 28.6 Religion Roman Catholic 45 40.9 Other religion 30 27.2 No religion 35 31.8 Race Caucasian 109 97.3 Not Caucasian 3 2.7 B. RATIO VARAIBLES MEAN STANDARD NUMBER OF DEVIATION CASES Age (turning in 2013) 21.08 2.42 111

6. * Overall, the students who participated in the study were knowledgeable about sexual health topics, with the average student knowing close to three-quarters (72%) of the material. When the students were separated by program of study, it was determined that nursing students knew a greater percentage of sexual health material (76%) than their colleagues (67%) who were in non-nursing programs of study. * When the sexual health knowledge assessment variables were categorized according to their specific topics the following results were obtained: STI knowledge (72%), contraception and safer-sex knowledge (75%) and anatomy and physiology knowledge (67%).

7. * It was found that there was a moderately strong and significant relationship between respondents’ perception of their own knowledge and their sexual health knowledge score. This relationship was stronger among females than males and stronger among non-nursing students than nursing students.

8. INDEPENDENT MEAN STANDARD NUMBER OF TEST OF TREND VARIABLES DEVIATION CASES SIGNIFICANCE Gender Male 12.04 3.6 23.001 + Female 14.16 2.5 87 Program of Study BScN 14.50 2.2 59.006 + BScHK 12.48 3.5 27 BAHK 11.50 2.4 4 BSc 13.50 3.1 20 Year of Study First 13.76 2.3 38.006 +/- Second 12.48 3.7 27 Third 12.33 3.0 9 Fourth 14.90 2.1 32 Had/not had intercourse Had 14.11 2.6 88.005 + Had not 12.00 2.7 15 Had/had not pap exam Had 15.08 2.1 48 <.001 + Had not 13.00 2.5 35 Birth Control Pill Used 14.24 2.6 88.009 + Not used 12.00 2.5 10 Other Hormonal Used 16.23 1.6 13.001 + Not used 13.61 2.5 83 Same-sex involvement Female and high 14.20 2.5 81.002 + maternal involvement Female and low 13.00 2.8 5 maternal involvement Male and high 11.67 3.7 18.001 - paternal involvement Male and low 13.40 2.7 5 paternal involvement Same-sex comfort Female and high 14.32 2.6 38.002 + maternal comfort Female and low 13.98 2.4 48 maternal comfort Male and high 14.50 1.3 4.001 + paternal comfort Male and low 11.53 3.7 19 paternal comfort Women’s Lifestyle Read 14.46 2.4 68 <.001 + Not read 12.52 3.1 42 CORRELATIONS OVERALL SEXUAL HEALTH KNOWLEDGE Number of partners.198* *(statistically significant correlation) Results- Summary Table

9. Legend: X axis: Series 1: nursing students 1: First and second year students Series 2: non-nursing students 2: Third, fourth and other students

10. * As stated earlier, the first hypothesis is “Bachelor of Science in Nursing students in both first and fourth year will have a greater level of sexual health knowledge compared to fourth and first year students in other programs”. * The result of this study provide support for this hypothesis as the lower year nursing students had a greater level of sexual health knowledge than the lower year non-nursing students and the same pattern was observed concerning upper year students. * See graph on previous slide

11. * The second hypothesis “The best predictor of sexual health knowledge will be past sexual experience” could not be assessed in its entirety. Further statistical testing, beyond the constraints of this paper, is required to determine the strength of the relationships allowing the determination of which variable is the best predictor of sexual health knowledge to be made. This study could, however, identify variables that are contenders to be the best predictor of sexual health knowledge. These variables are presented in the summary table and indicators of previous sexual experience are included in this list. Support for the hypothesis is provided through the identification of previous sexual experience as a variable that influences sexual health knowledge.

12. * There was no significant relationship between males’ perception of their own sexual health knowledge and their sexual health knowledge score, while there was a significant and moderately strong relationship for females. This may be attributed to the small number or males included in the study’s population. Also, there was a difference in accuracy of perception of sexual health knowledge between nursing and non-nursing students. Nursing students were less adept at estimating the adequacy of their knowledge when compared to non-nursing students. This may be indicative of a flaw in the sexual health education and information system. There may be a phenomenon of false confidence among the nursing students. This is risky business as those who believe they are well informed but are not may not seek out learning opportunities and may assess the risks they take more poorly than those who are aware of any lacking in their knowledge. This relationship should be further explored in future research as, at this point, the current study was the only study found to have investigated this relationship at all.

13. * A variable that was shown to have statistically significant relationships with sexual health knowledge was gender. The direction of the significant relationship was that female students performed better in the knowledge scores than males did. * When the students were separated by program of study, it was determined that nursing students knew a greater percentage of sexual health material (76%) than their colleagues (67%) who were in non-nursing programs of study. The researchers anticipated this trend, as it makes logical sense- programs that are health sciences based will give students an education regarding topics that are relevant to health and well-being. * Upon examination of the relationship between year of study and sexual health knowledge it became apparent that the relationship was statistically significant. Students in fourth year had significantly greater sexual health knowledge than those in first, second or third year. A possible explanation may be that by the time nursing students have entered their fourth year of the program, they have taken Biology 252 (Anatomy and Physiology), Maternity Nursing, Physical Assessment, and various other courses that have integrated sexual health into the curriculum.

14. * All variables used to assess previous sexual experience (with the exclusion of frequency of pap exam and use of spermicidal foam) were found to have a higher sexual health knowledge score associated with having had the experience or used the substance. * One of the most apparent reasons is that with each sexual experience, there is natural learning- for example, someone may learn about Chlamydia after they contracted it from engaging in unprotected intercourse. A second reason, offered by Moore and Smith (2012) state that those who are sexually active may have a greater interest in their own sexual health and they may want to become more knowledgeable about the potential consequences of sex so that they can learn how to avoid them.

15. * In our study statistically significant relationships were found between same-sex parent involvement and comfort talking with for both genders. * The consistent trend (with the below exception) was that the greater the involvement/comfort-talking-with parent of same-sex the greater the sexual health knowledge level of the student. * Surprisingly, males who reported a higher level paternal involvement had lower sexual health knowledge scores than those reporting a lower level of paternal involvement. * Participants who read women’s lifestyle magazines had higher average sexual health knowledge scores compared to participants who read other types of magazines. This relationship determined to be statistically significant. The literature indicates that this relationship may be due to the fact that adolescents often receive information about sexuality from either the media, or their friends; Ironically, the friends’ and classmates’ information about sexual health also came from the media, implying that much of adolescents’ sexual health knowledge comes from media sources.

16. * The findings from this study have generated interesting results that have implications for StFX university students. * The results have given insight into the students’ current knowledge on sexual health topics, as well as their knowledge deficits and learning needs. Having access to this information can aid in the improvement of current educational programs and courses designed to teach students about sexual health by altering the curriculum to target the areas that students are the least knowledgeable in. This research is particularly important for students who are going to be using their knowledge of sexual health to educate others about the same topics, specifically, nursing students