Engaging Adolescents With Sexual Health Messaging: A Qualitative Analysis

Chernick, Lauren S.; Berrigan, Margaret; Gonzalez, Ariana E; Konja, Alexis; Stockwell, Melissa S.; Ehrhardt, Anke Α.; Bakken, Susanne; Westhoff, Carolyn; Santelli, John; Dayan, Peter

doi:10.1016/j.jadohealth.2019.05.029

Cited by 8 publications

(7 citation statements)

References 17 publications

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“…In our study, we also faced challenges with harmonising diverse views from AYP. The divergent views could partly be attributed to the wide age range of AYP we engaged, who were at different developmental stages with different SRH needs compared to other studies that involved narrower age ranges [25,26]. However, the iterative process and triangulation of data from multiple sources enabled us to focus the findings and meaningfully inform the intervention design.…”

Section: Discussionmentioning

confidence: 99%

“…Using participatory and human-centred approaches to inform the design or implementation of interventions has widely been recognised as important for tailoring interventions to meet end-user needs [17,[20][21][22][23][24]. Other qualitative studies that have engaged AYP to shape interventions have used similar approaches to those used in this study [25,26]. Key strengths of our methods were the iterative process of engaging AYP and the use of a deliberative group discussion approach that enabled us to clarify topics that AYP were unfamiliar with so that they provide informed opinions about the intervention design [27].…”

Section: Discussionmentioning

confidence: 99%

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Engaging young people in the design of a sexual reproductive health intervention: Lessons learnt from the Yathu Yathu (“For us, by us”) formative study in Zambia

Simuyaba

Hensen

Phiri

et al. 2021

BMC Health Serv Res

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Background Meeting the sexual and reproductive health (SRH) needs of adolescents and young people (AYP) requires their meaningful engagement in intervention design. We describe an iterative process of engaging AYP to finalise the design of a community-based, peer-led and incentivised SRH intervention for AYP aged 15–24 in Lusaka and the lessons learnt. Methods Between November 2018 and March 2019, 18 focus group discussions, eight in-depth interviews and six observations were conducted to assess AYP’s knowledge of HIV/SRH services, factors influencing AYP’s sexual behaviour and elicit views on core elements of a proposed intervention, including: community-based spaces (hubs) for service delivery, type of service providers and incentivising service use through prevention points cards (PPC; “loyalty” cards to gain points for accessing services and redeem these for rewards). A total of 230 AYP (15 participated twice in different research activities) and 21 adults (only participated in the community mapping discussions) participated in the research. Participants were purposively selected based on age, sex, where they lived and their roles in the study communities. Data were analysed thematically. Results Alcohol and drug abuse, peer pressure, poverty, unemployment and limited recreation facilities influenced AYP’s sexual behaviours. Adolescent boys and young men lacked knowledge of contraceptive services and all AYP of pre and post exposure prophylaxis for HIV prevention. AYP stated a preference for accessing services at “hubs” located in the community rather than the health facility. AYP considered the age, sex and training of the providers when choosing whom they were comfortable accessing services from. PPCs were acceptable among AYP despite the loyalty card concept being new to them. AYP suggested financial and school support, electronic devices, clothing and food supplies as rewards. Conclusions Engaging AYP in the design of an SRH intervention was feasible, informative and considered responsive to their needs. Although AYP’s suggestions were diverse, the iterative process of AYP engagement facilitated the design of an intervention that is informed by AYP and implementable. Trial registration This formative study informed the design of this trial: ClinicalTrials.gov, NCT04060420. Registered 19 August, 2019.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Engaging young people in the design of a sexual reproductive health intervention: Lessons learnt from the Yathu Yathu (“For us, by us”) formative study in Zambia

Simuyaba

Hensen

Phiri

et al. 2021

BMC Health Serv Res

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“…Mobile health (mHealth) technology is gaining recognition in the field because it affords a wide array of user-facing functionality and services [29]. Evidence supporting the feasibility, acceptability, and efficacy of digital interventions is growing [30][31][32], particularly for adolescents [33][34][35][36][37][38][39]. SMS texting is seen as an mHealth technology with specific promise for adolescents [40], thus serving as an opportunistic technology for impacting sexual health behavior [41][42][43][44][45].…”

Section: The Social Role Of Textingmentioning

confidence: 99%

Using ADAPT-ITT to Modify a Telephone-Based HIV Prevention Intervention for SMS Delivery: Formative Study (Preprint)

Davis¹,

DiClemente²,

Prietula³

2020

Preprint

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BACKGROUND African American adolescent females are disproportionately affected by STIs and HIV. Given the elevated risk of STIs and HIV for African American women, there is an urgent need to identify innovative strategies to enhance adoption and maintenance of STI and HIV preventive behaviors. Texting is a promising technology for creating preventive maintenance interventions (PMIs) that extend the efficacy of the original intervention. However, little guidance in the public health literature is available for developing this type of application. OBJECTIVE We describe a formative pilot study that incorporates user experience (UX) methods to design and test PMI texts for Afiya, an original evidence-based intervention (EBI) specifically designed for African American adolescent females. The purpose of this study is to describe the adaptation process of the health educator-lead phone calling to text-based communication. METHODS The formative process followed the ADAPT-ITT framework for adapting EBI and using them in a new setting, for a new target population, or a modified intervention strategy. This study presents the details of how the phases of the ADAPT-ITT framework were applied to the design of the adaptation. An advisory board (AB) from the target population was constituted, consisting of six African American women ages 18 – 24 years, participating in formative activities for 12 weeks, involving components of the PMI design. As Afiya included a telephone-based PMI, developers of the original Afiya consultation scripts crafted the initial design of the SMS-based text and texting protocol. The AB participated in the one-day Afiya workshop, followed by 4 weeks of texting PMI messages, a mid-course focus group, followed by 4 more weeks of texting PMI messages, ending with a final focus group. At the advisory board’s request, this phase included an optional, additional week of text-based PMI messages. RESULTS The methods provided a rich source of data and insights into the fundamental issue involved when constructing SMS-based PMI for this target population, and for this EBI. Prior contact and context are essential, as the health educator was identified as a key persona in the process and the messages were situated in the original (workshop) context. Narrative adaptations for personas emerged from AB discussions. Suggestions on how to expand the PMI to current, specific social contexts indicated the use of narrative analysis is warranted. CONCLUSIONS The use of existing EBI incorporating telephone-based PMI scripts facilitated the initial design of the texts, with subsequent narrative analysis of the AB data providing additional adjustments given the actual context. Post-analysis revealed that personas would offer insight and opportunities for persona-specific modification of texting narratives. CLINICALTRIAL None.

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“…This final exclusion criterion, wanting to become pregnant in the next year, was based on One Key Question, which was developed to respect a woman's desire for or ambivalence about pregnancy. 15,22…”

Section: Introductionmentioning

confidence: 99%

A multi‐media digital intervention to improve the sexual and reproductive health of female adolescent emergency department patients

Chernick

Santelli

Stockwell

et al. 2021

Academic Emergency Medicine

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Background: Adolescent females presenting to emergency departments (EDs) inconsistently use contraceptives. We aimed to assess implementation outcomes and potential efficacy of a user-informed, theory-based digital health intervention developed to improve sexual and reproductive health for adolescent females in the ED. Methods:We conducted a pilot-randomized controlled trial of sexually active female ED patients age 14-19 years. Participants were randomized to the intervention Dr.Erica (Emergency Room Interventions to improve the Care of Adolescents) or usual care. Dr. Erica consists of an ED-based digital intervention along with 3 months of personalized and interactive multimedia messaging. We assessed the feasibility, adoption, and fidelity of Dr. Erica among adolescent female users. Initiation of highly effective contraception was the primary efficacy outcome. Results:We enrolled 146 patients; mean (±SD) age was 17.7 (±1.27) years and 87% were Hispanic. Dr. Erica demonstrated feasibility, with high rates of consent (84.4%) and follow-up (82.9%). Intervention participants found Dr. Erica acceptable, liking (98.0%, on Likert scale) and recommending (83.7%) the program. A total of 87.5% adopted the program, responding to at least one text; a total of 289 weblinks were clicked. Dr. Erica demonstrated fidelity; few participants opted out (6.9%) and failed to receive texts (1.4%). Contraception was initiated by 24.6% (14/57

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Engaging Adolescents With Sexual Health Messaging: A Qualitative Analysis

Cited by 8 publications

References 17 publications

Engaging young people in the design of a sexual reproductive health intervention: Lessons learnt from the Yathu Yathu (“For us, by us”) formative study in Zambia

Engaging young people in the design of a sexual reproductive health intervention: Lessons learnt from the Yathu Yathu (“For us, by us”) formative study in Zambia

Using ADAPT-ITT to Modify a Telephone-Based HIV Prevention Intervention for SMS Delivery: Formative Study (Preprint)

A multi‐media digital intervention to improve the sexual and reproductive health of female adolescent emergency department patients

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