JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth), has shown to be effective in increasing sexual health among youth. Up to date, evaluations mostly refers to interventions delivered via computer, e-mail, and text messages. The possibility to download applications (apps) on mobile devices has opened up opportunities to develop engaging safe sexual health promotion interventions. To attract young users, and get youth to engage with an app on sexual health, it is important to involve youth in the development of the intervention.

Objective:

To explore with youth and obtain their input on the content of a smart phone app intended to promote safe sex among and increase condom use the youth in Stockholm.

Methods:

This study was conducted at the Youth Health Clinics (YHC) in Stockholm County, Sweden. We conducted 15 individual in depth interviews and 2 two focus group discussions (with youth aged 18-23) at the YHC in Stockholm. Areas explored were youth perceptions of condom use - advantages and obstacles, youth perceptions of mHealth to promote safe sexual practices, and youth requests of the content of a smart phone app to promote safe sex.

Results:

The smart phone app was developed based on the categories that emerged from the data. With regard to content, youth requested sexual education, including STI information. Additionally condom specific information including practical usage technique, advice on how to have “the condom talk”, and decrease shame related to condom use were requested. Youth suggested different modes to deliver the content including text messages, movie clips, and push-notices. The tone of the messages delivered, youth suggested, should be fun and entertaining and supportive. The inputs from youth influenced the development of the different sections of the app. These were: Condom obstacles and solutions; Quiz; Games; Self-refection; Challenges; “Others tell” (peers tell their story, the doctor informs); Condom tip, Pep-talk and bosting; and Random facts.

Conclusions:

To use input from youth when developing a smart phone intervention is important as the success of the intervention largely depends on the level of engagement and usage by youth. Furthermore, if proven efficient in increasing condom use, it is important that the development, including content and mode is thoroughly described so that the intervention can be replicated. Likewise, if not proven efficient it is important to learn from mistakes to improve and adjust the intervention. The effect of this smart phone app on safe sexual practices among youth is being evaluated in a pragmatic randomized controlled trial in Stockholm (ISRCTN13212899) and will be reported separately.