Unsafe Sex Clinical Trial
Official title:
Health-E You: Reducing Unintended Pregnancies Among Hispanic Adolescents Using a Computer-based Intervention
Health -E-You is an interactive, individually tailored computer application (App) that was
developed to educate adolescent girls about contraceptive methods and assist them in
selecting a contraceptive method that meets their individual needs. The goal is to reduce
disparities in unintended pregnancy rates among Hispanic adolescent females.
The App was designed in close collaboration with clinicians and Hispanic adolescents.
Health-E You was designed to be used in conjunction with a clinical encounter to prime both
the patient and provider prior to the face-to-face visit to facilitate the discussion and
provision of appropriate contraception. It is founded on key principles of Social Cognitive
Theory.
Through an interactive approach, Health-E-You assesses the users' sexual health risks,
knowledge and contraceptive use history and preferences to facilitate a sense of agency and
self-efficacy around selecting an effective contraceptive method. First, the user selects
their preferred language (English or Spanish) and according to the selected language, the App
provides a brief description of the module and consents the user to participate. It then
assesses sexual health knowledge using an interactive truth vs. myth game. Correct answers to
the truth vs. myth statements are then presented to the user as short, easy-to-read
explanations. Next, the App assesses the user's individual contraceptive needs and
preferences. The user is also screened for possible medical contraindications to
contraceptive methods. Based on the user's input, the App provides individually tailored
messaging and recommendations for contraceptive methods according to the user's own timeline
for childbearing and their lifestyle preferences, past experiences and needs. The
recommendations are presented on a visual continuum of effective contraceptive options based
on desired duration of action and efficacy. Users then have the option to learn more about
the recommended method(s) and they also have the option to learn more about any of the
contraceptive options. Evidence-based contraceptive information is presented in a
user-friendly format that includes YouTube style videos. Users can select to view brief video
vignettes that feature clinicians who provide additional information about the method of
interest and/or videos of diverse young women who discuss their experiences with each of the
contraceptive methods. At the end of the App, adolescents are asked to select the method (s)
they are most interested in using. They are also encouraged to use condoms to protect against
sexually transmitted infections (STIs) and provided information about emergency
contraception. Users can review a summary of a key information gathered from the App and are
offered the opportunity to share that information with their clinician so that the clinician
can better support the adolescent in selecting and using an effective and appropriate
contraceptive method.
The objective of this study is to evaluate the effectiveness of Health-E You on its ability
to address disparities in contraceptive knowledge, access and utilization among Hispanic
adolescents. The long term goal is to reduce the incidence of unprotected sexual intercourse
(and associated unintended pregnancies and STIs) over time. A total of 14 School-Based Health
Centers (SBHCs) affiliated with the Los Angeles Unified School District, will be randomized,
with equal chance, to use the Health-E You App or to provide usual care (without the App). A
total of 1400 Hispanic adolescents will be selected to participate in the study (700 at
intervention clinics and 700 at the control clinics). The investigators hypothesize that
adolescents who use the Health-E You App will have greater sexual health knowledge and will
be more likely to use effective contraceptive than adolescent who do not use the App. The
investigators will also evaluate the effectiveness of the App on its ability to improve the
effectiveness and efficiency of the health visit. Participants will be asked to complete
follow-up surveys immediately following the clinical encounter and at three and six months
after the clinical encounter.
The ultimate goal of this study is address health disparities in the use of effective
contraceptives and ultimately reduce the incidence of unintended pregnancies and STIs among
at-risk Hispanic adolescent girls.
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