Date of Award

Summer 7-27-2023

Degree Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing

First Advisor

Jennifer Stewart-Glenn, PhD, FNP


Sexually transmitted infections (STIs) are a significant public health concern, with 26 million new cases diagnosed annually in the U.S. Emerging adults aged 18 to 25 years, which are included in the age group of Americans who have the highest rates for the three most common STIs: chlamydia, gonorrhea, and HPV (, 2020). Unfortunately, there is a paucity of research on the effects of STI education interventions on the attitudes and knowledge regarding STIs in this age group, especially in rural youth. While STI rates are high among adolescents and young adults nationally, rural youth have different behavioral risk factors for STI acquisition than their urban peers, such as limited access to care, lower rates of insurance, lower incomes, less education, higher rates of health risk behaviors, and overall poorer health (RHIH, 2017).

This interventional study pilots the use of a self-directed web-based educational intervention for improving college students’ knowledge of STIs based on the health belief model of change. Voluntary participants included students of 18 to 25 years old from a rural Tennessee university. After the participants had reviewed a series of five web-based STI educational videos, the participants’ knowledge and attitudes regarding sexual behavior and safer sex self-efficacy were measured using the STD-KQ and subsets of the MSQS Attitude and Value Inventory, and their responses were compared to their responses prior to the intervention. Analysis of the participants’ response data revealed that there was a statistically significant improvement in their overall knowledge of STIs as a result of this learning intervention and that the variables of age and rurality did not correlate with this increase in knowledge. The results of the statistical analysis also indicated a significant improvement in safer sex self-efficacy scores but no change in sexual attitude scores. Further statistical analysis indicated that there was a strong correlation between the knowledge gained from STI intervention and changes in sexual attitudes but not with safer sex self-efficacy scores. This latter finding might be due to the limitations of the current study. The results of this study suggest that there is an improvement in knowledge following a brief web based STI prevention program; this improvement correlated with an improvement in attitudes toward STIs and sexual health behaviors. It further supports the addition of educational interventions in a college setting to enhance the knowledge of positive sexual health behaviors and their subsequent implementation to mitigate the risk of STIs in this age group.