Evaluating the effectiveness of an educational sexual health text-messaging service for teens

Text messaging, a nearly ubiquitous means of communication among teens, may be a useful way to relay health information to a broad audience. Teens have important preventive health needs (including sexual health needs) with short-term and long-term implications, yet they generally interact with the health care system less frequently than adults or children. Other means of health communication that better fit teen lifestyles—such as text messaging—may be necessary and effective. An educational text messaging service focusing on preventive sexual health was developed to send weekly tips to teen subscribers in California. The service also offers a text-based teen clinic locator service and a referral to teensource.org. Students at a Los Angeles County public high school were randomized to receive information about the service or not (n=345). Although students in the intervention group were encouraged to use the intervention, each student could decide whether to subscribe to the service. The intervention period was 4 months; subscribers received 16 different messages and continuous access to the clinic locator. Pre- and post-intervention surveys were administered to evaluate the teens' knowledge, attitudes, self-efficacy, and behaviors related to sexual health. Results of the surveys were analyzed (using intention-to-treat and treatment-received methods) to determine the effectiveness of the text messaging service in improving these outcomes. Findings from this study will be useful in developing text message-based services or other new media interventions to improve health messaging and health outcomes in adolescents. The study is currently ongoing; final results will be available by summer 2011.