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    Teens open Pandora’s Box with sexting behaviors

    Many of today’s practicing pediatric nurse practitioners (PNPs) grew up during the “difficult and rebellious” adolescent years when teenagers were trying alcohol, marijuana, drag racing, and attempting to access birth control. In retrospect, that adolescent lifestyle was simplistic in comparison to the complex, tumultuous adolescent life of today. Teens have access to smartphones, computers, and numerous social media outlets with instantaneous responses and gratifications from friends and potential harm from Internet and social media predators. It is so easy for teens to unknowingly participate in behaviors that have serious consequences, as Dr Bass discusses in his article titled Pediatricians’ Primer on Sexting.

    In his article, Dr Bass provides a wealth of information about the basics and complexities of sexting and the current research that is building a sexting knowledge base that PNPs may or may not be applying in clinical practice, including the links between sexting and substance abuse, suicide, child pornography, and punitive laws recently enacted in some states that impact teens who participate in sexting.

    Insufficient research

    Search results in CINAHL (www.ebscohost,com) using the Boolean search terms “Adolescents AND Sexting AND Research” reveal only 4 research articles, of which one is a qualitative meta-synthesis and one an integrative review. Searching with the same terms on PubMed (www.pubmed.gov) reveals 25 articles. There is an undeniable need for rigorous quality improvement studies and research investigations on the topic of sexting. Doctorate in Nursing Practice students may conduct Quality Improvement projects to improve the assessment standards for adolescents who receive their care in primary office settings. Doctor of Philosophy students can design and conduct high-quality quantitative, qualitative, and mixed-methods studies that either test or develop psychometrically sound screening tools to investigate interventions that prevent and/or change teen sexting behaviors. Rigorous studies are essential to support the development of evidence-based best practice guidelines for the assessment of teen sexting behaviors and evidence-based interventions that successfully impact and reduce the incidence of these behaviors.

    Online is forever

    In addition, we must investigate the role of high schools in addressing sexting behaviors. Is this topic included in a high school health course or teen discussions? Pediatric nurse practitioners, high school psychologists, social workers, as well as NPs and nurses in school-based clinics have an opportunity to collaborate interprofessionally to identify and prevent teen sexting behaviors and their adverse consequences. Additionally, we need to determine parental knowledge about this problem and actions parents are taking in their homes to keep their teens safe.

    Research studies that survey PNPs to determine whether they are routinely asking adolescents about sexting and interventions that are being used to discourage these behaviors must be conducted. Sexting behaviors will leave a lasting “digital footprint” that has the potential to impact high school life, college admissions, college life, employment, and the future careers of teens. Are PNPs consistently asking about sexting behaviors and mentioning the “digital footprint” during the adolescent’s annual visit or in school-based clinics? Is one office-based intervention adequate, or do high schools and parents need to play a significant role in prevention?

    Sexting teens have opened “Pandora’s box.” Pediatric nurse practitioners and our interprofessional colleagues must gain control of and close “Pandora’s box” before any more teens suffer adverse consequences from participating in sexting behaviors. 


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