Sexual Health Texting Intervention to Support Adolescent Females
Condition: Teen Sexual Health
Study type: Interventional

Summary: 
      This study aims to use a text messaging intervention to prevent unintended teen pregnancy and
      transmission of sexually transmitted disease. The study will be informed by a formative
      qualitative phase (February 2014 - January 2015) which will include individual qualitative
      interviews and focus groups with teens to elucidate and explore the barriers to effective
      contraceptive use and sexually transmitted disease (STD) prevention and to obtain feedback on
      the developed intervention. The second efficacy phase will randomize subjects to the texting
      intervention or to usual care.
    

Detailed description: 
      Adolescents, particularly those from disadvantaged backgrounds, are disproportionally
      affected by both unintended pregnancies and STDs. While youth only represent a quarter of the
      sexually active population in the US, they account for almost half of all new STDs and the
      rate of unintended pregnancies among sexually active teens is almost double the rate of all
      sexually active women. Teen mothers experience higher rates of negative social outcomes
      including school dropout and children of teens are more likely to have low birth weight,
      lower academic achievement and more likely to perpetuate the cycle of teen pregnancy
      themselves. Both unintended pregnancies and STDs are much higher among racial/ethnic minority
      populations. Contraceptive methods considered most effective for pregnancy prevention do not
      protect against STDs and HIV transmission. Dual protection methods include being on an
      effective and consistent form of contraception and having an effective STD prevention method
      in place, preferably consistent condom use. Non-penetrative sexual practices can be
      substituted.

      There are many barriers to providing sexual health education and services in the context of
      primary care visits. A recent study of pediatricians found that 61% of pediatricians reported
      discussing contraception, use of condoms and/or STDs with patients at preventive care visits.
      Most providers (76%), however, believed they did not have sufficient time to provide such
      counseling in the visit. The problems are even more acute in resource-limited safety net
      settings. Therefore, a two-tiered approach may prove to be useful, where providers initially
      address reproductive health issues in the visit but where additional support outside the
      visit provides additional information, support, motivation and connection to services. An
      innovative intervention using texting technology may prove to be a cost effective method of
      providing support between visits.
    

Intervention name(s): text message intervention
Intervention type(s): Behavioral
Intervention description(s): Subjects will be sent 58 messages (3-5 per week) over 12 weeks, plus reminder messages for follow up interviews. The content of these messages will focus on contraception methods and effectiveness, sexually transmitted infection (STI) transmission, condom use, partner and parental communication, and healthy relationships. There will also be several text messages asking the participant if they would like to have a health educator contact them. The format will include facts, quizzes, true/false and some will have links to videos/pictures and websites, and some will request a response.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research