Principles of Sexual Health Promotion
Learning Objectives
By the end of this module, students will be able to:
Understand the roles of Information, Motivation, and Behavioural Skills (IMB) in changing sexual health related behaviour.
Understand the roles of Elicitation, Intervention, and Evaluation in applying the IMB model to sexual health promotion activities.
Apply the Elicitation, Intervention, and Evaluation framework and the Information, Motivation, and Behavioural Skills model to sexual health promotion activities.
Become aware of opportunities for further professional development in the area of human sexuality.
Topic Overview
The primary objectives of this course are to encourage a critical understanding of the social context of human sexuality and to introduce key theories and concepts relevant to the study of human sexuality. A significant focus has been placed on applying these concepts to the work of health professionals who address sexuality issues in their practices.
As we explore the developmental tasks at each phase of the life-cycle and discuss topics such as gender, sexual orientation, and disability, it becomes increasingly clear that sexuality and sexual health are vital components of individual and community well-being. The shift from a restrictive to a permissive sexual ideology in Western culture has fostered an understanding that health professionals—such as nurses, rehabilitation counselors, social workers, and educators—must be equipped to address issues of sexuality comprehensively and holistically.
To utilize our expertise in human sexuality for the benefit of our students, clients, and communities, it's crucial to incorporate effective, well-tested approaches to sexual health promotion in our work. The aim of this final module is to provide a foundational approach toward developing and implementing effective sexual health promotion activities.
Importance of Comprehensive Approaches
To effectively promote sexual health, health professionals will benefit from employing behaviorally focused approaches that have been proven effective in enhancing sexual health and preventing problems. Currently, we stand at a unique moment in history with the opportunity to create global, national, and community strategies for promoting sexual health. This moment has been shaped by recent sexual revolutions and significant public health concerns. Just like the revolutions of the 1960s and 1970s, today's changes are driven by remarkable scientific advancements alongside substantial social and economic transformations. In response to a variety of sexual health issues impacting societies, health ministries are pressured to develop comprehensive approaches for sexual health promotion (Coleman, 2002, p. 3).
Information, Motivation, Behavioural Skills (IMB) Model for Sexual and Reproductive Health Promotion
In previous modules, specifically Module #8, Part 2, we have discussed the IMB theoretical model, which can be applied to adolescent sexuality education. Initially developed to guide interventions aimed at HIV/AIDS sexual risk reduction, the IMB model serves as a robust framework for various sexual health promotion and education activities (SIECCAN, 2019). Whether programs are designed for individuals, groups, or communities, this model provides a fundamental, evidence-based conceptual framework to ensure interventions are effective and meet their goals.
Understanding Sexual and Reproductive Health Behaviors
Sexual and reproductive health behaviors can encompass a range of actions, including:
Promotion of sexual function
Utilization of contraceptives
Prevention of STDs/HIV
Screening for reproductive cancers
Adaptations to sexual activities due to aging, illness, or disabilities
Each behavior is a sexualized event that holds meaning derived from social ascription, individual learning, and the biological and physiological contexts surrounding sexual actions. All such behaviors are influenced by a common set of determinants that include information, motivation, and behavioral skills, making them modifiable through targeted interventions focused on these factors to foster sexual health (Fisher & Fisher, 1998, pp. 39-40).
Components of the IMB Model
Acquisition of Information: Individuals must learn relevant and applicable information concerning sexual and reproductive health behavior.
Development of Motivation: Individuals must find personal and/or social reasons to engage in sexual and reproductive health behaviors.
Development of Behavioural Skills: Individuals need to acquire specific behavioral skills that enable them to perform the sexual and reproductive health behaviors effectively.
Although it seems self-evident that effective sexual health promotion requires information, motivation, and behavioral skills, very few existing programs adequately include all three elements. Many programs tend to be predominantly information-based and often overlook the necessity of practical skills training.
Key Point
The extent to which individuals can enact sexual health-promoting behaviors heavily relies on their levels of information, motivation, and behavioral skills.
Case Example: IMB Model Intervention for Women with Sexual Function Difficulties Related to Chemotherapy
Research indicates that difficulties with sexual functioning can be a distressing problem for long-term breast cancer survivors, often linked to vaginal dryness secondary to chemotherapy (e.g., Broeckel, Thors, Jacobsen, Small, & Cox, 2002). A sexual health education intervention could address areas of information, motivation, and behavioral skills concerning the use of vaginal lubrication before sexual activity.
Information Examples:
Many women treated for breast cancer experience challenges related to sexual function.
Such challenges are frequently associated with vaginal dryness.
Methods like using lubricants prior to sexual activities can enhance sexual function for breast cancer survivors.
Lubricants (e.g., Astroglide) can be purchased over the counter at pharmacies in the Family Planning section alongside condoms.
Motivation Examples:
Restoring sexual function is crucial for recuperating an overall sense of well-being after cancer treatment (personal motivation).
Using a lubricant prior to sexual activity is an effective and straightforward method of restoring function (personal motivation).
Many women facing vaginal dryness find lubricants beneficial, and health professionals endorse their application (social motivation).
Behavioural Skills Training Examples:
Instructions on locating lubricants at the pharmacy.
Guidance on how to apply vaginal lubrication effectively (emphasis on practice and experimentation).
Discussions on when to incorporate lubrication in sexual encounters.
Role-playing exercises aimed at practicing dialogue with partners regarding lubricant use, providing explicit communication strategies.
Applying the IMB Model: Elicitation, Intervention, Evaluation
The application of the IMB model in sexual health promotion involves a three-step process: elicitation, intervention, and evaluation.
Elicitation Phase: During this phase, program planners assess the target audience’s information, motivation, and behavioral skills pertaining to specific sexual health behaviors. This can be conducted through methods such as focus groups, client interviews, or questionnaires. Elicitation research identifies informational, motivational, or behavioral skill deficits in the target audience, ensuring interventions are relevant and impactful rather than based on assumptions.
Intervention Phase: In this stage, programs are developed and implemented according to the identified deficits from the elicitation phase, addressing information, motivation, and behavioral skills weaknesses within the audience.
Evaluation Phase: The effectiveness of the program is periodically assessed (through focus groups, interviews, or questionnaires) to confirm it positively impacts the audience's information, motivation, and behavioral skills. This feedback loop allows for continuous refining and improving of the intervention.
Key Point
The comprehensive application of an IMB-based sexual health promotion program navigates through the processes of elicitation research, intervention implementation, and evaluation. This structured approach aids in achieving effective sexual health promotion activities.
Required Reading and Resources
Your assigned reading for this module consists of a section from the Canadian Guidelines for Sexual Health Education, specifically titled "Key Components," which provides more extensive discussion regarding the IMB model. These guidelines serve as a vital resource for health professionals involved in sexual health education and promotional endeavors.
Key Point
The Canadian Guidelines for Sexual Health Education offer valuable direction for the development and execution of effective sexual health education and promotion initiatives.
Opportunities for Further Professional Development in the Area of Sexuality
The field of sexology has made significant strides in recent decades. This increased openness towards sexuality in Western culture corresponds with a growing acknowledgment of the importance of research in human sexuality and sexual health promotion. As we have explored throughout the course, addressing sexuality and sexual health is gradually becoming an integrated element of numerous helping professions.
Despite these advancements, it is also crucial to recognize that sexology has not yet attained recognition as a distinct academic discipline. For instance, only one dedicated sexology department exists in Canada at the University of Quebec at Montreal (UQAM), which offers programs in French. Various universities, however, offer programmatic opportunities that allow students to specialize in human sexuality, such as graduate programs in Family Studies at the University of Guelph or Interdisciplinary Studies in Sexuality, Marriage, and the Family at the University of Waterloo.
For students aspiring to become specialists in sexuality research, education, counseling, or therapy, pursuing graduate studies in relevant disciplines (e.g., nursing, clinical psychology, counseling psychology, education) while focusing on sexuality enhances their opportunities. Numerous graduate programs have faculty with interests in sexology who offer related courses, providing students with enhanced qualifications by combining broader training grounded in traditional disciplines with specialized knowledge in sexology.
Recommendations for Students
Train as an educator first if you wish to become a sexuality educator.
Train as a physician or nurse first if interested in becoming a medical sexologist.
Pursue therapist training initially for those wishing to become sex therapists.
By establishing credentials in a foundational discipline, individuals will be better equipped to focus on sexuality in a professional setting.
Training in Sex Therapy
In a Canadian context, no licensing bodies exist that certify sex therapists directly. Most qualified sex therapists have significant graduate education in disciplines such as medicine, psychology, social work, or nursing, complemented by specialized training in sex therapy. Such training options are available through organizations like the American Association of Sex Educators, Counselors, and Therapists (AASECT) and the Association of Sex Therapy in Ontario (ASTO).
Conclusion
This course has ambitiously aimed to cultivate a deep understanding of the social context of human sexuality. You have been equipped with a wide-ranging grasp of critical sexuality issues and concepts essential for effective promotion of sexual health. You have initiated an important journey in developing the necessary knowledge and skills to contribute positively to the sexual health of those individuals, couples, families, and communities you will encounter throughout your career. Enhancing healthy sexuality, recognized as a fundamental aspect of human well-being, is an achievement to be acknowledged. Congratulations and best of luck in your future endeavors!
Alex McKay