Barriers and facilitators to providing sexual health programming at community colleges across the United States: a qualitative study with administrators, faculty, and staff.

Community colleges have limited budgets and lack resources specifically dedicated to sexual health promotion.

• Participants identified financial constraints as a major barrier to adopting and implementing sexual health programming.
• Funding specifically reserved for improving student health was identified as a potential facilitator.
• The study used qualitative thematic analysis with 32 administrators, faculty, and staff from 23 campuses.
• Dedicated employees funded specifically to implement programming were suggested as a solution to resource limitations.

Buy-in from upper-level administrators is often required to approve sexual health programming, making their support a critical facilitator.

• Participants indicated that upper-level administrator approval is often needed before programs can be purchased or provided to students.
• Presenting data on students' positive attitudes toward programming and evidence of student need (e.g., low rates of condom use) was identified as a strategy to encourage administrator support.
• Administrator support was identified as one of six major themes from thematic analysis of interview data.

Personnel who champion student health are critical to successful implementation, but many champions are overworked and unable to sustainably manage additional responsibilities.

• The presence of a champion for student health was identified as a key facilitator of sexual health programming.
• Overwork among these champions was simultaneously identified as a sustainability barrier.
• This tension between the importance of champions and their capacity constraints was identified as a distinct major theme.
• Hiring dedicated employees was suggested as a way to address champion burnout and sustainability concerns.

Participants perceived that students will not participate in optional sexual health programming, creating a barrier to implementation.

• Low anticipated voluntary student participation was identified as a barrier to offering sexual health programs.
• Colleges were interested in implementing programming that students want and that addresses their needs.
• Integrating sexual health programming into existing requirements such as new student orientation was suggested as a strategy to ensure student participation.
• Student engagement was identified as one of six major themes from the thematic analysis.

Many colleges are hesitant to implement mandatory student programming because it is perceived as a barrier to student graduation.

• Resistance to mandatory programming was identified as a distinct barrier, separate from general concerns about student participation.
• The concern was specifically framed around mandatory programming being perceived as an obstacle to graduation.
• This finding was derived from interviews with 32 community college administrators, faculty, and staff across 23 campuses in the United States.
• Embedding programming in existing mandatory activities (e.g., orientation) rather than creating new requirements was suggested as a workaround.

Colleges' decisions to implement sexual health programming are often tied to the presence of on-campus housing, leaving commuter students especially underserved.

• The presence of on-campus housing was identified as a facilitator of sexual health programming at community colleges.
• Commuter students, who represent a large proportion of community college populations, were identified as especially in need of sexual health resources.
• The link between housing status and programming availability was identified as one of six major themes.
• This finding highlights a structural equity gap in sexual health resource access at community colleges.

Very little research has focused on understanding the factors influencing sexual health program implementation specifically at community colleges, despite community colleges serving a large population of young adults.

• Community colleges are less likely than 4-year colleges to provide sexual health programming.
• The study used a convenience sample of 32 community college administrators, faculty, and staff from 23 campuses across the United States.
• The study employed qualitative thematic analysis of interview data.
• The authors note that community colleges serve a large population of young adults for whom sexual health programs can be highly effective.