Sexting: A Trending Risky Behavior For Young Adults

Sexting was never a concern when our parents were young adults. Today though, through advances in technology, it now is an integral part of our lives; and now is negatively impacting the health of this vulnerable population. This article will identify the risk, introduce a behavioral change theory, and through the implementation of the theory, will offer suggestions on how practitioners can implement it into their practice. Nurses Announcements Archive Article

  1. In your practice today, is sexting included in your sexual history gathering?

    • 2
      Yes
    • 15
      No
    • 1
      No, but sexting will be included now!

8 members have participated

Sexting: A Trending Risky Behavior For Young Adults

In today's world, technology is around us everywhere we turn. Particularly, the technology of cell phones is one that has gone through numerous advances and increased in popularity. Young adults are a population that now has grown up with this technology and cannot fathom their lives without. In fact, 85% of people over the age of 18 years old own their own cell phone (Levine, 2013). An emerging trend amongst the young adult population that poses a risk to their health is sexting. Nurse practitioners have the opportunity to identify this risky behavior in the primary care milieu. Once the risky behavior is identified, knowledge can be pulled from behavioral theories, in hopes of preventing or changing the behavior before it becomes detrimental to their health.

Risky Behavior: Sexting

Sexting is defined as sharing sexually suggestive messages or photos through the use of cell phones (Levine, 2013). When sexting is discussed, a question that commonly arises is, "why would young adults do this?" The research proposes that: young adults feel sexting is a safe sex practice, sexting is risqué and that sexting is a cultural norm of sexually active couples (Levine, 2013). Regardless of the why, it is imperative that as practitioners it is recognized that "yes" this is occurring, and how sexting can affect the overall health of their patient.

Sexting has been associated with substance use, multiple sexual partners, unprotected sex and sexually transmitted infections (STIs) (Benotsch, Snipes, Martin, Bull, 2013). In one study, 44% of participants admitted to sexting and of those 44%, they were more than twice as likely to report multiple sexual partners and having unprotected sex (Benotsch et al., 2013). Close to one-third of participants in the same study also reported having sex with someone for the first time after sexting (Benotsch et al., 2013). A key point to remember here is that the above-reported behaviors all run the risk of having life long consequences. Substance abuse can turn into addiction, multiple sexual partners can lead to unplanned pregnancies and STIs that will not go away with a course of antibiotics.

Not only does sexting have potentially physical complications, but also sexting can affect the young adult's mental health as well. In the realm of dating, numerous dating violence education programs include unwanted text and sext messaged in their definitions of dating violence (Gordon-Messer, Bauermeister, Grodzinski & Zimmerman, 2013). It is reported that psychological harm can come in the form of a young adult feeling pressured to sext (Gordon-Messer et al., 2013). Psychological harm can also be caused to the young adult when the sext is accidentally sent to the wrong person (Gordon-Messer et al., 2013). As much as the physical effects of sexting can last a lifetime, it is important to remember that the psychological effects can last a lifetime as well. Further driving home how risky of a behavior sexting can be to the young adult population.

Behavioral Theory: Theory Of Planned Behavior

One behavioral theory that can be utilized with risky behavior is through the further understanding of the Theory of Planned Behavior (TPB). TPB is composed of five key components: attitude toward the behavior, subjective norms, perceived behavioral control, intention to perform the behavior and actually performing the behavior (Roncancio, Ward & Fernandez, 2013). The TPB focuses on the factors of attitude toward the behavior, subjective norms and perceived behavioral control to predict the patient's intention to perform the behavior (Roncancio et al., 2013). Intention is the determining factor and the glue of the TPB (Roncancio et al., 2013). Intention is what will lead to the patient actually changing their behavior or to do nothing at all (Roncancio et al., 2013). When the TPB is compared to other motivational models (health belief model, social cognitive theory and protective motivation theory) in a meta-analysis, TPB was shown to be superior in predicting behavioral outcomes (Roncancio et al., 2013). The above information about TPB is echoed and utilized is multiple studies including those performed by Nelson, Cook, & Ingram (2014) and Dunstan, Covic & Tyson (2013).

Implementing Theory Into Practice

Obtaining A Sexual History: When obtaining the sexual history of a young adult, ask questions surrounding sexting. Questions can include but are not limited to: Are you currently sexting? Have you ever felt pressured to sext? Do you hear about your friends' sexting? Have you ever been pressured to sext? Has your sext ever been sent to the wrong person? Have you ever been embarrassed or felt down after you have sexted? Using these or similar questions will allow you to gauge the amount of harm or damage already occurred from sexting.

Patients Intention To Change: If it is identified that sexting is occurring with the young adult, offer education surrounding the topic of sexting. At the appropriate time, ask the patient if they feel sexting is or can be harmful to their health? If yes, ask the patient if they have the intention of changing their behavior? If yes again, then according to the research above, there is a good probability that the patient will carry through with changing their risky behavior of sexting. Reducing their risk of lifelong consequences associated with the behavior.

Discussing Factors That Control A Patient's Intention: If the patient has no intention to change the risky behavior of sexting, dive into what factors predict intent. As described above those factors are: attitude toward the behavior, subjective norms and perceived behavioral control (Roncancio et al., 2013). Hopefully, through gaining a trusting provider-patient relationship, your patient will hear you out and in expressing your concern for their overall health. Hopefully, if nothing else, the patient will remember the conversation surrounding sexting and might think twice about it when they are next in the situation. Also, plan to revisit this topic at follow up appointments to reinforce the severity of the issue.

Educating Other Healthcare Professionals: A nurse practitioner's practice does not only include the patients they serve but also their colleagues. Nurse practitioners through conversations; have the ability to be continuously sharing new knowledge with other healthcare professionals. Personal conversation is not the only way to share their wealth of knowledge. Nurse practitioners can share their education through hosting an office meeting, through interaction on professional social media outlets or performing a literature review with the intent to become published in medical or nursing journals.

Conclusion

With technology here to stay, it is imperative that nurse practitioners remain current on risky behaviors that affect young adults and in investigating different ways to incorporate theory into practice. Sexting has been proven to be a risky behavior that has consequences that could affect the young adult now, and for the rest of their lives. The TPB is a theory that has been proven above other behavioral theories and is used throughout the literature. Nurse practitioners are on the front lines of healthcare and have a unique ability to make a change and intervene at the ground level. The ability to not only have an influence on this generation of young adults, but generations to follow.

References

Benotsch, E. G., Snipes, D. J., Martin, A. M., & Bull, S. S. (2013). Sexting,

substance use, and sexual risk behavior in young adults. Journal Of Adolescent Health, 52(3), 307-313. doi:10.1016/j.jadohealth.2012.06.011

Dunstan, D. A., Covic, T., & Tyson, G. A. (2013). What leads to the expectation

to return to work? Insights from a Theory of Planned Behavior (TPB) model of future work outcomes. Work, 46(1), 25-37. doi:10.3233/WOR-2012-1481

Gordon-Messer, D., Bauermeister, J. A., Grodzinski, A., & Zimmerman, M.

(2013). Sexting among young adults. Journal Of Adolescent Health, 52(3), 301-306. doi:10.1016/j.jadohealth.2012.05.013

Levine, D. (2013). Sexting: A terrifying health risk ... or the new normal for

young adults?. Journal Of Adolescent Health, 52(3), 257-258. doi:10.1016/j.jadohealth.2013.01.003

Nelson, J. M., Cook, P. F., & Ingram, J. C. (2014). Utility of the theory of planned

behavior to predict nursing staff blood pressure monitoring behaviors. Journal Of Clinical Nursing, 23(3/4), 461-470. doi:10.1111/jocn.12183

Roncancio, A. M., Ward, K. K., & Fernandez, M. E. (2013). Understanding

cervical cancer screening intentions among latinas using an expanded theory of planned behavior model. Behavioral Medicine, 39(3), 66-72. doi:10.1080/08964289.2013.799452

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Trauma Columnist

traumaRUs, MSN, APRN

88 Articles; 21,249 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

Excellent article and very timely with the Spring Break upon us. Thank you.

Specializes in Mental Health Nursing.

This article has really opened my eyes. As a nurse, I never thought to include sexting as part of history gathering. I see how it can be an identifier for more serious sexual/behavioral problems.

Specializes in psychiatric.

Excellent article and it should be posted on the general forum, as it is applicable to everyone not just NP's. It is helpful to me as a PMHNP student who deals with adolescents and parents. Very well written, thank you.

jadelpn, LPN, EMT-B

9 Articles; 4,800 Posts

A wonderful article. Very informative. Also included in education, and equally as risky is the "tinder" type apps that allow casual sexual encounters at a keystroke.

I am amazed at how many well educated young adults are using these type of apps as entertainment and don't have any sense of the danger or risk--until they are Plan B'ing a couple times a month.

And most parents have no clue that this is happening--from cell phones that are on the parent's plan to happening at dorms that are part of a really expensive education--that the parents pay for. Otherwise, it is out of sight out of mind and the kids are taking giant risks.

carachel2

1,116 Posts

When I have an adolescent in for a well exam, I have the kiddos step out after we are done and spend about 5 minutes teaching parents how to snoop on Twitter (you can find all your kids friends accounts sooo easily); Instagram and the like. Very eye opening !

Also, parents and kids need to know of the seriousness of texting. My daughters class has had at least one incident every few years since Jr. high (you would think these kids would learn!) and every incident involves technology police at the school searching hundreds of kids phones; arrests and severe severe expulsions. It is HUGE deal. Illegal.

NutmeggeRN, BSN

2 Articles; 4,620 Posts

Specializes in kids.

It would be nice to see it included with the CRAAFT screening tool, CRAAFTS

S Could be use of media Sexually explicit media