Risky sexual behaviors (RSBs) among college students pose a substantial threat to both physical and mental health and are associated with sexually transmitted infections and unintended pregnancies. However, many existing interventions demonstrate limited sustainability in achieving lasting behavioral change. This study aimed to develop a theory-driven, evidence-based intervention program to reduce RSBs among college students in China. A sequential mixed-methods study design was employed. Program development was guided by the Behavior Change Wheel (BCW) and conducted in two phases. Phase 1 involved developing a preliminary intervention draft informed by a systematic literature review and semi-structured interviews with college students who reported RSBs, with the aim of identifying barriers and facilitators mapped to the Capability, Opportunity, Motivation-Behavior (COM-B) model. Phase 2 consisted of a two-round Delphi consultation with multidisciplinary experts to evaluate and refine the program. Data were analyzed using thematic analysis and descriptive statistics, including the authority coefficient and Kendall’s coefficient of concordance (W). The literature review identified 1893 records, of which 21 studies were included in the synthesis. Fifteen students participated in qualitative interviews, generating three themes and eight subthemes that mapped directly onto COM-B components. Thirteen experts completed both rounds of the Delphi consultation, yielding a 100% response rate and a high authority coefficient (Cr = 0.819). Kendall’s W increased from 0.313 (Round 1) to 0.437 (Round 2; P < 0.05), indicating improved consensus. The finalized intervention program comprises six primary indicators (COM-B domains), 12 secondary indicators (intervention functions), and 39 tertiary indicators (specific activities). The program is delivered as a six-week, group-based peer intervention (90 min per week), integrating education, skills training, and environmental restructuring. A theory- and evidence-informed intervention program targeting RSBs among Chinese college students was developed and refined through expert consensus. The program provides a structured blueprint for potential implementation in university settings; however, its feasibility, acceptability, and effectiveness should be examined in future pilot and evaluation studies.
Zhang et al. (Sun,) studied this question.