Engaging Adolescents With Sexual Health Messaging: A Qualitative Analysis

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

doi:10.1016/j.jadohealth.2019.05.029

Engaging Adolescents With Sexual Health Messaging: A Qualitative Analysis

J Adolesc Health. 2019 Nov;65(5):660-666. doi: 10.1016/j.jadohealth.2019.05.029. Epub 2019 Sep 6.

Authors

Affiliations

¹ Division of Pediatric Emergency Medicine, Department of Emergency Medicine and Pediatrics, Columbia University Medical Center, New York, New York. Electronic address: lc2243@columbia.edu.
² Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York.
³ Division of Pediatric Emergency Medicine, Department of Emergency Medicine and Pediatrics, Columbia University Medical Center, New York, New York.
⁴ Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York; Department of Child and Adolescent Health and Department of Pediatrics, Columbia University Medical Center, New York, New York.
⁵ Department of Psychology, Columbia University Medical Center, New York, New York.
⁶ Department of Nursing and Bioinformatics, Columbia University Medical Center, New York, New York.
⁷ Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York; Department of Obstetrics-Gynecology, Columbia University Medical Center, New York, New York.

Abstract

Purpose: Personalized and interactive text messaging interventions may increase participant engagement; yet, how to design messages that retain adolescent attention and positively affect sexual health behaviors remains unclear. The purpose of this study was to identify the characteristics of sexual health text messages perceived as engaging by sexually active adolescent females.

Methods: We conducted semistructured, open-ended interviews with sexually active females aged 14-19 in one urban emergency department. Participants received automated sexual health information sent via an interactive, two-way texting format. The 343 messages viewed by participants were based on key stakeholder input, relevant theoretical models, and existing evidence-based guidelines. Interviews elicited feedback. Enrollment continued until saturation of themes. Interviews were recorded, transcribed, and coded based on thematic analysis using NVivo 10.

Results: Participants (n = 31) were predominantly Hispanic (28; 90%), insured (29; 94%), and recently sexually active (24; 77%). Themes were as follows: (1) Tone: messages should be direct, factual, entertaining, and respect adolescent autonomy; messages should not be intrusive, presumptive, or preachy. (2) Emotion evoked: participants preferred messages that provoked thought, validated feelings, and empowered. Messages from a reliable source felt comforting, making participants feel cared for and special. (3) Interactivity: participants favored messages that offered choices, such as a mini-conversation. (4) Personalization: messages should look similar to adolescent digital preferences but be individually tailored with relatable characters.

Conclusions: This study informs the tone, structure, and style of sexual health text messages directed toward adolescent females in the emergency department. Future work should consider these characteristics when designing digital interventions to engage adolescent females.

Keywords: Adolescent health; Behavioral health; Reproductive health; Sexual health; Text messaging.

MeSH terms

Adolescent
Adult
Female
Health Promotion / methods*
Humans
Pregnancy
Pregnancy in Adolescence / prevention & control
Qualitative Research
Sexual Health / education*
Surveys and Questionnaires
Text Messaging*
Young Adult

Abstract

MeSH terms

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