Designing Digital Tools Capable of Reaching Disadvantaged Adolescents and Improving their Sexual Health: A Mexican Experience

Abstract

In Mexico, underprivileged adolescents have a higher than average teen pregnancy rate, lower use of contraceptives, and little access to reproductive health services. Yet, few evidence-based attempts to build more equitable, accessible, and available reproductive health services for disadvantaged adolescents than their counterparts have been made. The objective is to describe the design and development process of new content that has been integrated to work in synergy with an existing website to promote sexual and reproductive health among Mexican adolescents. We adopted a user-centered participatory action research approach. We developed a set of nine interactive activities that promote knowledge and skills on self-esteem, gender equity, self-efficacy, and decision-making; a chat with live counseling for healthy sexual and reproductive behavior; and a video with a message that highlights the importance of delaying motherhood. By incorporating this type of constructivist strategy, we seek to meet adolescents' needs more easily and improve the acceptability of interventions.

Participatory Action Research for Adolescent Sexual and Reproductive Health: A Scoping Review

“…The characteristics of included studies are reported in Table 1. Of the 30 included studies, two studies involved younger adolescents (aged 10-14 years) [13,14], 14 involved older adolescents (aged 15-19 years) [5,[15][16][17][18][19][20][21][22][23][24][25][26][27], and 13 studies involved both [13,[28][29][30][31][32][33][34][35][36][37][38][39]; however, one study did not define the age groups [40]. -Indicate what changes need to be made to the original intervention informing adaptation, implementation, and evaluation plans.…”

“…The studies were based in a range of different settings. Approximately half (n = 16) of the studies were conducted in high-income countries (HIC) [5,13,15,[17][18][19][20][21][22][23][27][28][29][30]33,39], and the other half (n = 14) was conducted in low-and middle-income countries (LMIC) [14,16,[24][25][26]31,32,[34][35][36][37][38]40,41]. There were nine from the USA [13,20,22,23,27,29,30,33,39], three studies from Australia [5,15,17], two each from Canada [18,19], and South Africa [24,26], one each from China [14], Kenya [38], Mexico…”

“…Of those studies that defined settings, 12 studies based in an urban setting [15,18,19,21,23,28,30,[32][33][34]40,41], with six of those conducted in schools [21,23,28,32,33,41] and six in community [15,18,19,30,34,40], as well as 12 studies in rural settings [13,14,16,17,24,25,27,31,[35][36][37]39], with four of those based in schools [14,17,36,39] and eight in community [13,16,24,25,27,31,35,37].…”

“…Sample sizes ranged from 9 to 2643 participants. Of all the included studies, 2 were experimental studies [13,32], 23 were observational or qualitative [14,16,[18][19][20][21][22][23][24][25][26][29][30][31][33][34][35][36][37][38][39][40][41], and 5 were mixed methods [5,15,17,27,28].…”

“…Some used one method and others used a combination of co-designed workshops, focus group discussions, semi-structured interviews, in-depth interviews, photovoice sessions, and youth advisory committees or youth working groups/youth club meetings. The PAR framework for codesigning was used for preparing intervention programs for abortion [15], sex education material [16,21,23,27,28,31,32,41], contraception [17,40], risky sexual behaviour leading to STI/HIV [14,18,20,22,24,25,29,33,[37][38][39], adolescent pregnancy [30,34,35], preconception health [5], and peer education program [19,26,36]. Each of the included studies was assessed to understand the stages of PAR incorporated in co-designing SRH interventions for adolescents.…”