Implementation Patterns and Perceived Value of the SEXIT Method in School Health Care

To explore implementation patterns and perceived value of the SEXIT (SEXual health Identification Tool) method in the school health care (SHC) setting in Sweden.

Mixed method survey using an online questionnaire with closed and free-text response options.

115 SHC professionals who had completed SEXIT training responded to an online questionnaire (response rate 26%), between March and May 2024. Closed questions were answered on a five-point Likert scale, and responses trichotomised. Quantitative data were analysed using descriptive statistics, qualitative data with a deductive qualitative content analysis. CROSS guideline was used.

70 of 115 SHC professionals used SEXIT in their work. Findings suggest that SEXIT is appropriate and useful, supporting communication about topics such as sexual health and violence that both pupils and professionals may avoid addressing. Implementation patterns showed that 61% of those who had completed training also used SEXIT. 63% of those used SEXIT during regular health dialogues, but some did not use it with all pupils. The perceived value was that most SHC professionals felt that SEXIT helped them get a better understanding of the pupil's situation, an objection that it was too time-consuming.

Most SHC professionals who had completed SEXIT training used the method regularly and perceived the method as valuable and facilitating discussions about sexual ill health and experiences of violence with pupils. There are indications that SHC services fail to identify particularly at-risk young people. Sexual health inequity persists, as some structurally marginalised and vulnerable youths are excluded from the SEXIT dialogues. A follow-up study will focus on pupils' experiences.

This study validates SEXIT in a new setting, SHC, and is relevant for the promotion of sexual and reproductive health for all, and for preventing violence and sexual ill health among young people.