Health-E You: Reducing Unintended Pregnancies Among Hispanic Adolescents
Condition: Unprotected Sex; Unsafe Sex
Study type: Interventional

Summary: 
      Health -E-You is an interactive, individually tailored computer application (App) that was
      developed to educate adolescent girls about contraceptive methods and assist them in
      selecting a contraceptive method that meets their individual needs. The goal is to reduce
      disparities in unintended pregnancy rates among Hispanic adolescent females.

      The App was designed in close collaboration with clinicians and Hispanic adolescents.
      Health-E You was designed to be used in conjunction with a clinical encounter to prime both
      the patient and provider prior to the face-to-face visit to facilitate the discussion and
      provision of appropriate contraception. It is founded on key principles of Social Cognitive
      Theory.

      Through an interactive approach, Health-E-You assesses the users' sexual health risks,
      knowledge and contraceptive use history and preferences to facilitate a sense of agency and
      self-efficacy around selecting an effective contraceptive method. First, the user selects
      their preferred language (English or Spanish) and according to the selected language, the App
      provides a brief description of the module and consents the user to participate. It then
      assesses sexual health knowledge using an interactive truth vs. myth game. Correct answers to
      the truth vs. myth statements are then presented to the user as short, easy-to-read
      explanations. Next, the App assesses the user's individual contraceptive needs and
      preferences. The user is also screened for possible medical contraindications to
      contraceptive methods. Based on the user's input, the App provides individually tailored
      messaging and recommendations for contraceptive methods according to the user's own timeline
      for childbearing and their lifestyle preferences, past experiences and needs. The
      recommendations are presented on a visual continuum of effective contraceptive options based
      on desired duration of action and efficacy. Users then have the option to learn more about
      the recommended method(s) and they also have the option to learn more about any of the
      contraceptive options. Evidence-based contraceptive information is presented in a
      user-friendly format that includes YouTube style videos. Users can select to view brief video
      vignettes that feature clinicians who provide additional information about the method of
      interest and/or videos of diverse young women who discuss their experiences with each of the
      contraceptive methods. At the end of the App, adolescents are asked to select the method (s)
      they are most interested in using. They are also encouraged to use condoms to protect against
      sexually transmitted infections (STIs) and provided information about emergency
      contraception. Users can review a summary of a key information gathered from the App and are
      offered the opportunity to share that information with their clinician so that the clinician
      can better support the adolescent in selecting and using an effective and appropriate
      contraceptive method.

      The objective of this study is to evaluate the effectiveness of Health-E You on its ability
      to address disparities in contraceptive knowledge, access and utilization among Hispanic
      adolescents. The long term goal is to reduce the incidence of unprotected sexual intercourse
      (and associated unintended pregnancies and STIs) over time. A total of 14 School-Based Health
      Centers (SBHCs) affiliated with the Los Angeles Unified School District, will be randomized,
      with equal chance, to use the Health-E You App or to provide usual care (without the App). A
      total of 1400 Hispanic adolescents will be selected to participate in the study (700 at
      intervention clinics and 700 at the control clinics). The investigators hypothesize that
      adolescents who use the Health-E You App will have greater sexual health knowledge and will
      be more likely to use effective contraceptive than adolescent who do not use the App. The
      investigators will also evaluate the effectiveness of the App on its ability to improve the
      effectiveness and efficiency of the health visit. Participants will be asked to complete
      follow-up surveys immediately following the clinical encounter and at three and six months
      after the clinical encounter.

      The ultimate goal of this study is address health disparities in the use of effective
      contraceptives and ultimately reduce the incidence of unintended pregnancies and STIs among
      at-risk Hispanic adolescent girls.
    


Intervention name(s): Health-E You: a computer-based intervention to improve the use of effective contraception among Hispanic adolescents
Intervention type(s): Behavioral
Intervention description(s): School-based health centers which were randomized into the intervention arm will use the Health-E You App (n=7 clinics).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: unsafe sex; unprotected sex; adolescents; Latinas; Hispanic; mobile health applications; unintended pregnancy; teen pregnancy prevention; school-based health centers