SMS for sexual health: A comparison of service types and recommendations for sexual health text message service providers

Abstract

Objectives: Text message–based interventions may provide sexual health information to young people through a number of service types, from sending information on a regularly scheduled timeline, to providing an automated menu, to allowing young people to connect directly with health educators. While such service types exist, it is not clear which features young adults feel are most effective at allowing them to engage with sexual health information. Design: This study used a mixed-methods design (survey and focus groups) to assess perceptions of three types of sexual health text message services with young adults, a population particularly at risk of negative sexual health outcomes. Setting: College students from the US Pacific Northwest participated in the project. Method: Participants heard about three sexual health text message services, completed questionnaires and discussed each type. Focus groups were gender-separated. Results: Participants reported that services that allowed them to connect with a health educator would be highly useful, but automated services would be beneficial in bringing new topics to their attention. Participants perceived the purpose of the service types as different and felt each could be a useful resource, depending on the situation. Regardless of service type, participants wanted to personalise their experience. Participants wanted messages tailored to them and options to interact with the systems, from influencing topic selection to message timing. Conclusion: Each of the service types can be useful for young adults. Young adults perceive services that provide the opportunity to tailor information and interact with the system as beneficial.

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.…”

“…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.…”

“…adolescents) there are individual differences in language preferences, with some preferring casual language with others perceiving this informality as messages being dumbed down [89]. A comparison of SMS sexual health services in the U.S. showed that people value control over the language of text messages [88], although this level of fine tuning was not practical for the current study. There are also age-related differences in risk perception (irrespective of risk behaviours), since older audiences generally perceive HIV as a di sease that affects gay men whilst still themselves taking part in sexual risk taking behaviours [79,90,91].…”

“…While our uptake was reasonably high, it should be noted that 31.7% of employees chose not to take part. As such, there is a possibility that health promotion information may not have reached those with less health awareness, less knowledge or lower capacity to seek out health information, and this has been mirrored by participants in other programs [88]. For those that did not opt-in, or those who dropped out, offering an alternative messaging format such as email may help to increase retention [94].…”

“…Apps have the ability to reach a wider audience, with an app for adolescent sexual education in New York being downloaded over 22 ,000 times [98]. A similar SMS study aimed at adolescents found that they sought personalisation of content and message timings [88] which could be achieved via electronic and app based approaches, which would allow information to be accessed on demand, w hile also allowing fine measurement of engagement, information requested and frequency which is not measurable in the same way with mobile messaging [99]. With a lack of a 'one size fits all' template for sexual health intervention, and few studies conducted with working-age adults it would be beneficial to study the most appropriate mechanism for delivery of messaging to different age groups in the future.…”