Currently submitted to: JMIR Formative Research
Date Submitted: May 26, 2026
Open Peer Review Period: Jun 1, 2026 - Jul 27, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Predictors of Intention to Use Mobile Health Apps for Comprehensive Sexuality Education Among School-Attending Young People in Bukavu, Democratic Republic of Congo: A Correlational Study
ABSTRACT
Background:
Comprehensive sexuality education (CSE) is essential to the health and well-being of young people. In the Democratic Republic of Congo, where 65% of the population is under the age of 25, access to interpersonal CSE remains limited owing to sociocultural and structural barriers. This exposes young people to persistent social and health vulnerabilities. In this context, mobile health apps (MHAs) constitute a promising solution, supported by the growing use of smartphones among young Congolese. However, this group’s intention to use MHAs for CSE has been the subject of little research to date.
Objective:
The aim of this study was to identify predictors of intention to use MHAs for CSE among school-attending young people in Bukavu, Democratic Republic of Congo, based on an adapted version of the extended Unified Theory of Acceptance and Use of Technology (UTAUT2).
Methods:
A predictive correlational study was conducted in 8 public secondary schools in Bukavu, Democratic Republic of Congo, with a stratified random sample of 859 students. Predictors of intention to use—performance expectancy (PE), effort expectancy (EE), social influence (SI), facilitating conditions (FC), and perceived risk (PR)—and moderators—age, sex, and past MHA experience—were measured from data collected through a self-administered UTAUT questionnaire. Descriptive and multivariate analyses were performed using SPSS software (version 28; IBM Corp).
Results:
The mean age of participants was 16.3 years (SD 1.5). Male students represented 55.1% (473/859) of the sample. Overall, 51.0% (438/859) of participants owned a smartphone; among smartphone owners, 62.3% (273/438) reported having easy access to mobile data, and 16.2% (139/859) of the total sample were already using MHAs to learn about sexual health. Intention to use MHAs for CSE was positively associated with PE (β=.412; B=0.428, 95% CI 0.342-0.513; P<.001), EE (β=.098; B=0.078, 95% CI 0.028-0.128; P=.002), and SI (β=.131; B=0.100, 95% CI 0.052-0.149; P<.001). FC (P=.289) and PR (P=.682) were not significantly associated with intention to use MHAs for CSE. Age (β=–.063; P=.044) and sex (β=.101; P=.009) moderated the relationship between PE and intention to use MHAs for CSE. The final model explained 44.7% of the variance.
Conclusions:
Intention to use digital CSE among school-attending young people was explained primarily by PE, EE, and SI, while the relationship between PE and intention was moderated by age and sex. To strengthen this intention, stakeholders should promote digital health behavior change interventions for CSE that are useful, easy to use, socially valued, and tailored to school-attending young people’s needs and the local context.
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