iMedicalApps and JMIR Publications have partnered to help disseminate interesting & innovative digital health research being done worldwide. Each article in this series will feature summaries of interesting studies to help you keep up to date on the latest in digital health research. We invite you to share your thoughts on the study in the comments section.
Young people’s views and experiences of a mobile phone texting
1. What was the motivation behind your study?
Risk of poor sexual health, including sexually transmitted infections (STIs), is greatest amongst young people. Innovative and acceptable interventions to improve sexual health are required. Mobile phone text messaging interventions have potential to reach large numbers of people at relatively low cost, but greater understanding is needed on how they should be developed and how they work. We developed a text messaging intervention designed to promote safer sex behaviors amongst young people. The motivation behind this study was to explore views of and experiences of the intervention.
2. Describe your study.
Participants aged 16-24 were interviewed for a UK pilot trial of the text message intervention. They received sexual health promotion messages based on behavior change techniques. Content, tailored by gender and STI status, included support for correct STI treatment and promotion of safer sex. Young people were eligible if they had received a positive chlamydia test or had had more than one partner and sex without a condom more than once in the last year. Telephone interviews were conducted 2-3 weeks after first receiving texts. We followed a topic guide and conducted a thematic analysis.
3. What were the results of the study?
Intervention participants (n=16) found text messages easy to understand, friendly and trustworthy. They considered frequency and timing of messages appropriate, and delivery via phones convenient. Support by text allowed recipients to assimilate information at their own pace. For some, messages increased knowledge of how to correctly use condoms. Some described how messages had increased confidence and reduced stigma, enabling them to disclose infection to partners and/or to do so sooner and more calmly. Discussing messages with partners reportedly enabled some women to negotiate condom use.
4. What is the main point that readers should take away from this study?
Intervention participants (n=16) found text messages easy to understand, friendly and trustworthy. They considered frequency and timing of messages appropriate, and delivery via phones convenient. Support by text allowed recipients to assimilate information at their own pace. For some, messages increased knowledge of how to correctly use condoms. Some described how messages had increased confidence and reduced stigma, enabling them to disclose infection to partners and/or to do so sooner and more calmly. Discussing messages with partners reportedly enabled some women to negotiate condom use.
5. What was the most surprising finding from your study?
The most surprising finding was how young people shared messages with partners, friends or family. One way the messages may work is by helping recipients talk to their partner about the importance of protecting themselves against STIs, such as giving them the words which could be used when having these discussions or sharing the actual texts. The fact that this was done in a way which reduced stigma and was not pressured or judgmental assisted the communication with others.
6. What are the next steps? How do you envision this work ultimately translating into clinical practice or affect R&D?
A randomised controlled trial of the intervention to investigate its effectiveness in improving sexual health outcomes is now underway. Messages have been refined so they are relevant to lesbian gay, bisexual and transgender young people. The collection of biological markers, using vaginal self-swabs for women and urine for men to test for STIs, will allow us to validate reported outcomes in a main trial. If our trial shows the intervention is effectives it will be low cost and could be integrated with electronic systems so it is automatically sent to patients when they receive test results.
Interview partner name
This Q&A was contribured by Rebecca French from the London School of Hygiene & Tropical Medicine. Rebecca is a Senior Lecturer in Sexual & Reproductive Health with an interest in the development and evaluation of behaviour change interventions designed to promote sexual and reproductive health, particularly using email and text messaging.
