A quasi-experimental text messaging trial to improve adolescent sexual and reproductive health and smoking knowledge in Indonesia

Abstract

Background To evaluate the feasibility and acceptability of a text message intervention to improve young people’s knowledge of sexual reproductive health (SRH) and harms related to smoking in Indonesia. Methods: A quasi-experimental short message service (SMS) trial of young people aged 16–24 years receiving twice weekly SMS over a 10-week intervention period. Pre- and post-online demographic and risk behaviour surveys were used to assess changes in knowledge. Among respondents who completed both surveys, we assessed changes in knowledge before and after SMS intervention using paired McNemar’s test and differences in mean knowledge score using a paired t-test. Results: In total, 555 eligible young people were enrolled into the SMS intervention; 235 (42%) completed a follow-up survey, of which 198 (84%) were matched to a baseline survey. Median age of participants was 19 years and the majority were female (63%). The mean knowledge score significantly increased between baseline and follow-up surveys for SRH questions [2.7, (95% CI 2.47, 2.94) vs 3.4 (95% CI 2.99, 3.81) (P = <0.01)] and smoking-related questions [3.8 (95% CI 3.66, 3.99) vs 4.1 (95% CI 3.99, 4.28) (P = 0.03)]. A majority of participants reported that the SMS intervention increased their knowledge (95%) and were a useful reminder (95%). Conclusions: An SMS intervention was feasible, acceptable and improved adolescents’ SRH knowledge and smoking knowledge in a low- to middle-income setting. SMS interventions targeting young people need to be scaled up, with the potential to explore additional topics around healthy lifestyle, nutrition and physical activity.

Test@Work Texts: Mobile Phone Messaging to Increase Awareness of HIV and HIV Testing in UK Construction Employees During the COVID-19 Pandemic

“…Forty-five per cent of the respondents to data collection messages stated that they learnt something new from the text messages, and this aligns with previous studies in which participants admit that regular texts may teach them something they had not a nticipated [88]. When compared to an Indonesian smoking cessation and sex education study which reported 95% of respondents learnt something new [80], our figure appears low. In studies targeting adolescents, 83% of participants reported learning new information [70].…”

“…A small number of participants had privacy concerns (with regards messages being seen by partners) demonstrating the sensitive nature of some of the message content. This has been mirrored in other studies wher e participants felt more comfortable with health related texts compared to sexually themed messages [80] or were worried they may be embarrassed if someone saw the content of the messages [88]. A small number of participants felt that the messages were not appropriate to them -i.e.…”

“…Despite our high engagement and retention rat es, response to the interactive data collection messages was low (13.7% of delivered texts generating a reply to at least one data collection text). Low responses have also been reported in two-way text messaging surveys regarding sexual health and contraception, where response rates have been reported to be 40-44% [14,72,80] and even as low as 5% [71]. A rapid review by Pedder et el al (2020) indicated that the res ponse rate of text messages is highly variable and commonly decreases over time (with the exception of those involving pregnant women or type 1 diabetes) [81].…”

Peer Education and Sexual Risk Behavior Among Adolescents: Does Urban Status Matter?

“…Moreover, it was also reported that millions of. adolescents have encountered challenges on reproductive health and sexual activity, not limited to a high rate of unsafe abortion, contraception issues, and unintended pregnancy [2], [3]. The study also reported that almost 49.8% of adolescents had no idea about the use of birth control [1].…”

“…It is also known where psychological stressors come with the diversity and density of the cities [9], [10]. In urban environments, it is usually easy to find places that sell alcoholic and smoke, which affect the risk for adolescents to engage in drugs and sexual risk behavior [3], [11], [12]. Nevertheless, a developing body of investigation proposes that neighborhood characteristics impact well-being results and behaviors, being counted as sexual behavior.…”