Development and pilot testing of a cell-phone enhancement to TOP

Introduction Effective teen pregnancy prevention programs are limited by the numbers of people they can reach and lack of sustainability. We wish to enhance an effective program with supplemental text messaging to reinforce and intensify program effects.

Methods We partnered with Boys and Girls Clubs (BGC) to convene six focus groups with 59 youth to generate suggestions for using cell phones to enhance Wyman's Teen Outreach Program (TOP®). We then developed a four-week pilot with text messages to supplement and enhance TOP® delivered in the BGC. We completed baseline assessments with 96 participants and follow-up assessments with 60 participants. Twelve participants completed in-depth interviews gauging reaction to the pilot.

Results More than 2/3 of participants identified as Latino and 22% as African American. Participants had multiple risk behaviors including early age at sexual debut and lack of condom and contraceptive use at last sex. In-depth interviews revealed unanimous enthusiasm for the program. Participants received an average of 58 text messages through the pilot period including reminders to use condoms and information on how to access contraceptive services.

Conclusions A text message enhancement to an effective teen pregnancy prevention program offers the opportunity to reinforce for all youth that deliberate planning to use condoms and contraception the next or first time they have sex can reduce the risk for STI and pregnancy. Youth at risk will participate in TOP® and embrace text messages.