BrdsNBz: A Mixed Methods Study Exploring Adolescents' Use of a Sexual Health Text Message Service

Sexual health text message services are becoming increasingly popular, but little is known about who uses such services and why. This project details the implementation of a campaign promoting a state-wide sexual health text message service that allows teens to text directly with a health educator and uses a mixed method design to assess who uses the service, what motivates use, and potential barriers to using the service. A theory of information seeking through text messaging is posited based on previous information seeking and communication theory and tested with adolescents. A social marketing campaign was created promoting a North Carolina sexual health text message service and conducted in six middle and high schools in the North Carolina Piedmont region in Fall 2012. More than 2000 students in four schools completed online questionnaires that assessed awareness of the service, perceptions, and use. Focus groups and in depth interviews were then conducted with middle and high school students. Results indicate teens who are sexually active and in relationships are more likely to use the service. A teens' level of uncertainty about sexual health influences affect, which in turn leads adolescents to assess various information options. Positive attitudes toward the service and credibility perceptions are direct predictors of intentions to use. Efficacy was found to be an indirect predictor, working through credibility perceptions to influence intentions to use. Although teens may have an interest in using the service, there are barriers associated with use. Survey findings and qualitative results indicate that teens are interested in using a sexual health text message service, but perceived costs, fear of parents finding out about service use, and a lack of understanding of how to use the service were barriers for some teens. This study has implications for sexual health text message services, especially those that allow teens to connect directly with a health educator.Doctor of Philosoph

Effects of Website Interactivity on Skin Cancer-Related Intentions and User Experience: Factorial Randomized Experiment

BACKGROUND: Digital media technologies provide users with the ability to interact with content and to receive information based on their preferences and engagement. OBJECTIVE: We used skin cancer and sun protection as a health topic to explore how modality interactivity, interface tools that afford users greater activity, resulting in greater depth and breadth of mentally representing and experiencing mediated content, and message interactivity, the extent to which the system allows users to exchange messages back and forth on health websites, influenced users\u27 attitudes, knowledge, behavioral intentions, and experience. METHODS: We employed a 2×2 (modality interactivity: high vs low; message interactivity: high vs low) between-subject online experiment for which 4 websites were created. Participants (n=293) were recruited using Amazon Mechanical Turk and randomly assigned into to 1 of 4 conditions. After browsing the website, participants completed an online survey regarding their experience and cognitive perceptions. General linear models and path analysis were used to analyze the data. RESULTS: Both modality interactivity (P = .001) and message interactivity (P \u3c .001) had an impact on intention to use sun protection. Attitudes toward health websites and perceived knowledge mediated the effects of modality interactivity and message interactivity on sun protection use intention, individually. Participants in the high modality interactivity and high message interactivity condition felt more satisfied (P = .02). Participants in the low message interactivity condition had more interest in the experience with health websites than participants in the high message interactivity condition (P = .044). CONCLUSIONS: Findings suggested that modality interactivity influenced intention to use sun protection directly as well as via attitudes toward the websites. Message interactivity impacted intention to use sunscreen directly and also through perceived knowledge. Implications for designing health websites and health intervention content are discussed

Influence of perceived interactivity of a sexual health text message service on young people's attitudes, satisfaction and repeat use

Sexual health text message services are becoming an increasingly popular way to reach young people with sexual health information. A variety of service types exist: some send automated messages on a set schedule; others provide personalized responses to individual questions. Young people's perceptions of interactivity, which is often based on system responsiveness, may vary. This study examines perceptions of interactivity for users of a two-way text message service that connects young people directly with a health educator and examines the relationship between perceived interactivity and attitudes toward the service, service satisfaction, and repeated service use. Data from 131 users in the southeastern U.S.A. were analysed. Perceived interactivity was associated with positive attitudes, user satisfaction and repeat use. Data suggest that for sexual health information seeking, young people may view a program as more useful if they perceive it is interactive. Services that provide a back-and-forth dialog between health educators and users may be perceived as interactive, and those perceptions of interactivity can influence attitudes toward the service as well as behaviors, such as using the service repeatedly. Since such services offer accurate and timely health information, repeated use allows for the additional exchange of health information and educational opportunities

eHealth interventions for HIV prevention

The rapidly changing media landscape and proliferation of new technologies creates vast new opportunities for HIV prevention. The fast growth of the relatively new eHealth field is a testament to the excitement and promise of these new technologies. eHealth interventions in HIV prevention tested to date include computer- and Internet-based interventions; chat room interventions; text messaging interventions; and social media. The current article provides a brief review of these types of interventions in HIV prevention, including their unique advantages and evidence of efficacy. Implications for future research in the eHealth HIV prevention field are discussed

Incarceration and unstable housing interact to predict sexual risk behaviours among African American STD clinic patients

Given dramatic racial disparities in rates of HIV/STDs among African Americans, understanding broader structural factors that increase the risk for HIV/STDs is crucial. This study investigated incarceration history and unstable housing as two structural predictors of HIV risk behavior among 293 African Americans (159 men/134 women, M(age)=27). Participants were recruited from an urban STD clinic in the southeastern U.S. Approximately half the sample had been incarcerated in their lifetime (54%), and 43% had been unstably housed in the past 6 months. Incarceration was independently associated with number of sex partners and the frequency of unprotected sex. Unstable housing was independently associated with the frequency of unprotected sex. However, these main effects were qualified by significant interactions: individuals with a history of incarceration and more unstable housing had more sex partners and more unprotected sex in the past three months than individuals without these structural barriers. Implications for structural-level interventions are discussed

Perceptions of a campus-wide condom distribution programme: An exploratory study

Condom distribution programmes are an important means of preventing sexually transmitted infections (STIs); yet little research has examined their perceived and actual impact on college campuses. Quantitative, cross-sectional study. Large public university in the Southeastern USA. Approximately 2 months after a campus-wide condom distribution programme began, we utilised intercept surveys with 355 students (68% women; 43% racial/ethnic minorities) to examine their perceptions of the availability, accessibility and acceptability of condoms, and their perceptions and use of the newly installed condom dispensers. Students perceived condoms to be available and accessible on campus after implementation of the condom dispensers. Students had heard about the dispensers from other people (36%), through social media (18%) and the campus newspaper (15%). Most students (71%) had seen the dispensers. Almost one in four students (23%) had taken a condom from the dispensers; among those who were sexually active during the 2months that the dispensers were available, 33% had used them. More than one-third of students (37%) - and 53% of sexually active students - indicated intentions to use the dispensers in the next 6months. Multiple regression analysis controlling for age, gender and race revealed that prior condom use, attitudes about the dispensers and comfort with the dispensers were significant predictors of sexually active students' intentions to use the dispensers ( <.001). Overall, results indicate that over a short time period, this condom distribution programme was successful in reaching students and providing free condoms. Implications for implementing condom distribution programmes on college campuses as well as future directions for research are discussed

Sexual Partnerships, Risk Behaviors, and Condom Use among Low-Income Heterosexual African Americans: A Qualitative Study

The purpose of the current investigation was to contextualize the sexual relationships and risk behaviors of heterosexually active African Americans. A total of 38 participants (20 females and 18 males) aged 18–44 years were recruited in a large city in the southeastern U.S. to participate in focus group discussions exploring sexual partnerships, general condom perceptions, and condom negotiation. Results indicated that participants distinguished among at least three partner types–one-night stand, “regular” casual partner, and main partner. Partner types were found to shape and influence types of sexual behaviors, perceptions of risk and condom use, and condom negotiation. Participants also shared general perceptions about condoms and elucidated situations in which intentions to use condoms were not realized. Gender differences emerged in many of these areas. Implications of these findings are discussed and directions for future research on sexual partnerships and risk behavior are offered