Acceptability and efficacy of a sexual health texting intervention designed to support adolescent females


Rinehart, Deborah J.; Leslie, Sarah; Durfee, M. Joshua; Stowell, Melanie; Cox-Martin, Matthew; Thomas-Gale, Tara; Shlay, Judith C.; & Havranek, Edward P. (2019). Acceptability and efficacy of a sexual health texting intervention designed to support adolescent females. Academic Pediatrics.


Objective To evaluate the feasibility, acceptability and initial efficacy of a pilot texting intervention (“t4she”) in primary care designed to increase sexual health knowledge and promote dual protection strategies to reduce unintended pregnancies and sexually transmitted infections among adolescent females. Methods Participants were recruited from 2 federally qualified health centers. Eligibility included: being 13-18 years of age; assigned female at birth; English-speaking; not currently pregnant and/or intending to become pregnant; and having texting capabilities. A randomized controlled trial assessed between-group differences at 3 and 6-months on knowledge, Health Belief Model constructs, and sexual behaviors. Input on intervention acceptability was obtained at 3 months. Results Among 244 participants enrolled and randomized, the average age was 16 (±1.6), 80% were Hispanic/Latina, 53% had ever had vaginal sex, and 50% had used prescription birth control with 24% currently using a long-acting reversible method. Among those sexually active, 29% reported consistent condom use and 24% reported engaging in dual protection behaviors at last sex. Among participants with all follow-up data (N=136), intervention participants had significant increases in sexual health knowledge and reported more prescription birth control use at follow-up than control participants. No significant outcome differences were found for condom use or dual protection behaviors. Intervention participants reported receiving messages, being introduced to new information, and reading and sharing the messages. Conclusions The pilot t4she sexual health intervention significantly improved knowledge and use of short-acting prescription birth control among young females in primary care and was acceptable by youth and feasible to implement.



adolescent sexual health

Reference Type

Journal Article

Journal Title

Academic Pediatrics


Rinehart, Deborah J.
Leslie, Sarah
Durfee, M. Joshua
Stowell, Melanie
Cox-Martin, Matthew
Thomas-Gale, Tara
Shlay, Judith C.
Havranek, Edward P.

Year Published






Reference ID