mobile health apps to promote sexual health of adolescents
TRANSCRIPT
Health-E You! Mobile Health Applications to Promote the Sexual Health of Adolescents
Kathleen Tebb, PhD University of California, San Francisco
Department of Pediatrics Division of Adolescent & Young Adult Medicine
Adolescent Sexual Health
Adolescents & young adults have disproportionately high rates of preventable sexual health morbidities.
• Chlamydia most common reportable bacterial STI – >900,000 cases annually in US for those <25 yrs.
• Adolescent Pregnancy has declined but still high – >300,000 births annually
Addressing Provider Barriers
• Limited time & comfort to provide comprehensive sexual health information & services
• Computers can be used to: – offload health education and risk assessment from
provider; – “Prime” patient & provider prior to face-to-face
encounter
Project Goals
• Develop interactive, individually tailored mobile health applications to improve sexual health of adolescent girls
• Increase sexual health knowledge and use of services
• Improve efficiency and effectiveness of clinical encounter
Adolescent and Clinician Centered
Extensive input from adolescents • Focus groups • Interviews • Iterative “usability” testing • Revisions
Health-E You: Chlamydia Module
• Assess Risk • Individually tailored education • “Get Tested Now” options • Customized testing instructions • Secure e-mail to clinicians
Nicole’s Story
Angela’s Story
Alex’s Story
Pick a video to the right
Video Menu
…I went with my friend who got tested. It was so easy – I want to get it done now, but I still have some questions…
Exit Program Repeat Audio << Back
…I’ve never heard of Chlamydia, and have no idea
if I want to get tested…
…I heard my friend got chlamydia. I’ve been thinking
about getting tested…
Health-E You Contraceptive Module • Myth-buster game to assess knowledge
• Method selection tailored to their goals, experiences & lifestyle considerations
• Include range of options (hormonal and LARCs)
• Brief video vignettes for each method
• Encourage dual contraceptive use
PRELIMINARY FINDINGS
Clinician & Staff Interview Results (n=10)
• Enhances patient knowledge
• Re-enforced health education msgs.
“It calls their attention because it gives them options and makes them interact with it.”
Clinician & Staff Interview Results (n=10)
• Apps increased adolescent engagement and confidence in their sexual health decisions.
“They seem a bit more confident about their choice. I’m not seeing as many ‘What do you
think…?’’”
Clinician/Staff - Barriers
• Concerns about equipment safety • Increased wait-time (increased by 0-3 minutes) • Tech problems (e.g. e-mail info from apps) • Ease of integrating the apps into clinic related to
staffs’ comfort with tech, clinic space, & staffing
Adolescent Interview Results (n=20)
• Module use averaged 7-10 minutes • 80% reported it increased their
contraceptive/sexual health knowledge
“I learned that condoms prevent STDs and that pills and the patch don’t. I never thought to ask
before I read the app.”
Adolescent Results (cont)
• Many reported it helped them select a method
“It’s helpful because if you don’t now what you want, you’re gonna know what you want by the end of the
video!”
Adolescent Results (cont)
• 60% reported App caused them to want to use a more effective/longer lasting option – preference for implant and IUD because considered
more private
• 30% reported it improved conversations with provider
• 100% reported a positive experience with the App
Results from Apps
Race/Ethnicity (N=256)
5%
8%
8%
15%
18%
46%
Native Am.
Asian
Other
African Am.
Caucasian
Latina
Chlamydia App Users
N=165 Had Sex
30% Test past Yr
70% No Test Past Yr
82% Request Test
18% No Test
Contraceptive App Use
• Significantly increased sexual health knowledge • 16% correct prior to module use vs. 83% post-
use (p<.001)
High Satisfaction with App
>90% agreed with statements: • easy to use • trust the information • learned something new • recommend to help friend pick the best
birth control option for their needs • felt comfortable answering questions • educational videos helped me choose a
birth control method
Conclusions
• Acceptable to adolescents, clinicians & clinic staff • Feasible to implement in SBHCs • Improves sexual health knowledge • Improves efficiency & effectiveness of visit • Facilitate chlamydia screening & • Improve intentions to use more effective &
longer lasting contraceptive method
Special Thanks….
• Mary Jane Puffer, Sang Leng Trieu LA Trust • Rebecca Dudovitz, MD UCLA • Lauren Hartman, MD Kaiser • Clinic Partners (Carson and Jordan Wellness
Centers, Jesse Bethel School-based clinic) • UCLA/RAND Prevention Research Center • Hellman Fellowship Fund • Mt Zion Health Foundation
