Division of Pediatric Emergency Medicine, Department of Emergency Medicine and Pediatrics, Columbia University Medical Center, New York, New York.
Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York.
J Adolesc Health. 2019 Nov;65(5):660-666. doi: 10.1016/j.jadohealth.2019.05.029. Epub 2019 Sep 6.
Personalized and interactive text messaging interventions may increase participant engagement; yet, how to design messages that retain adolescent attention and positively affect sexual health behaviors remains unclear. The purpose of this study was to identify the characteristics of sexual health text messages perceived as engaging by sexually active adolescent females.
We conducted semistructured, open-ended interviews with sexually active females aged 14-19 in one urban emergency department. Participants received automated sexual health information sent via an interactive, two-way texting format. The 343 messages viewed by participants were based on key stakeholder input, relevant theoretical models, and existing evidence-based guidelines. Interviews elicited feedback. Enrollment continued until saturation of themes. Interviews were recorded, transcribed, and coded based on thematic analysis using NVivo 10.
Participants (n = 31) were predominantly Hispanic (28; 90%), insured (29; 94%), and recently sexually active (24; 77%). Themes were as follows: (1) Tone: messages should be direct, factual, entertaining, and respect adolescent autonomy; messages should not be intrusive, presumptive, or preachy. (2) Emotion evoked: participants preferred messages that provoked thought, validated feelings, and empowered. Messages from a reliable source felt comforting, making participants feel cared for and special. (3) Interactivity: participants favored messages that offered choices, such as a mini-conversation. (4) Personalization: messages should look similar to adolescent digital preferences but be individually tailored with relatable characters.
This study informs the tone, structure, and style of sexual health text messages directed toward adolescent females in the emergency department. Future work should consider these characteristics when designing digital interventions to engage adolescent females.
个性化和互动式短信干预措施可能会提高参与者的参与度；然而，如何设计既能吸引青少年注意力又能对其性行为产生积极影响的信息仍然不清楚。本研究旨在确定被认为具有吸引力的青少年女性性行为短信的特点。
我们对一家城市急诊室中 14-19 岁的活跃性活跃女性进行了半结构式、开放式访谈。参与者通过一种交互式、双向短信格式接收自动发送的性健康信息。参与者查看的 343 条信息是基于主要利益相关者的投入、相关理论模型和现有的循证指南。访谈中收集了反馈。在主题达到饱和之前，继续招募参与者。根据主题分析，使用 NVivo 10 对访谈进行记录、转录和编码。
参与者（n=31）主要为西班牙裔（28；90%）、有保险（29；94%）且最近有过性行为（24；77%）。主题如下：（1）语气：信息应该直接、真实、有趣，尊重青少年的自主权；不应具有侵入性、自以为是或说教性。（2）引起的情感：参与者更喜欢能引发思考、验证情感和赋权的信息。来自可靠来源的信息令人感到安慰，使参与者感到被关心和特别。（3）互动性：参与者倾向于提供选择的信息，例如小型对话。（4）个性化：信息应类似于青少年的数字偏好，但应根据个人情况进行个性化定制，使用可引起共鸣的角色。
本研究为面向急诊室青少年女性的性健康短信的语气、结构和风格提供了信息。未来的工作在设计吸引青少年女性的数字干预措施时应考虑这些特点。
