Strengths and Limitations
multiple-risk behaviors
To date, interventional research on sexting remains scarce. Therefore, this study represents a critical starting point for public health interventions aimed at addressing sexting-related issues in Malaysia. The use of theory-based intervention and web-based animated videos can be seen as a new direction for future public health interventions on SRH topics among young adults, particularly students in HEIs. Moreover, since this study was designed as an RCT, there was a greater internal validity to evaluate the effectiveness of the intervention. In addition, only a few previous RCTs that used a PWM-based intervention reported the effect size of the intervention. We chose to publish the effect magnitude for future comparisons and not depend solely on the There are a few limitations to this study. First, the findings were limited to the study population, and they cannot be generalized to the young adult population as a whole. Moreover, the use of the self-reported questionnaire in this study could lead to an information bias. Given the nature of the topic, which involved sexually sensitive questions, the participants might avoid revealing their actual actions or opinions. However, they were reminded that the study aimed to evaluate the effectiveness of the educational material and that no judgment would be made on them. Furthermore, this study did not measure sexting and other multiple-risk behaviors associated with sexting. It would be beneficial to assess the effect of our intervention on the actual sexting behavior, but it would involve a great deal of time and opinions of experts and stakeholders, not to mention the major ethical considerations related to the sensitive nature of the study subject and sexting being considered as punishable under Malaysian law. Finally, it was quite difficult to ensure that all participants in the intervention group adhered to and complied with the intervention, as the animated video delivered via YouTube in this study lacked any monitoring mechanisms.