Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Sep 19, 2019
Open Peer Review Period: Sep 19, 2019 - Sep 26, 2019
Date Accepted: Feb 10, 2020
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Preliminary Efficacy of a Multilevel mHealth Application for Substance Use, Sexual Risk Behaviors, and STI/HIV Testing among Youth: A Randomized Controlled Trial
ABSTRACT
Background:
Preventing and reducing substance use disorders, sexually transmitted infections/human immunodeficiency virus (STI/HIV) and teen pregnancy, and the associated risk behaviors (i.e., substance use and sexual risk behaviors) among youth remain public health priorities in the United States. Equally important is improving the uptake of STI/HIV testing among youth. Mobile-health (mHealth) applications (apps) may be a solution to ameliorate these public health concerns; however, few mHealth preventive interventions have demonstrated preliminary efficacy in reducing substance use or sexual risk behaviors, or improving uptake of STI/HIV testing among youth, particularly in clinic settings.
Objective:
This study examined the preliminary efficacy of Storytelling 4 Empowerment (S4E), relative to enhanced usual practice, in reducing past 30-day substance use (i.e., alcohol, tobacco, and other drug use), condomless sex, and alcohol or drug use prior to sex, as well as improving uptake of STI/HIV testing. Additionally, this study examined changes in the potential mechanisms by which behavior change occurs, namely clinician–youth risk communication, prevention knowledge, and substance use and sexual risk refusal self-efficacy.
Methods:
Employing community-based participatory principles, 50 youth aged 13–21 years were recruited from a youth-centered community health clinic in Southeast Michigan; randomized sequentially to either S4E or enhanced usual practice; and assessed at baseline, immediately post-intervention, and 30 days post-intervention.
Results:
Relative to youth in the enhanced usual practice group, S4E participants demonstrated reductions in the proportions of past 30-day overall substance use, as well as past 30-day alcohol, tobacco, and drug use. The results also showed a reduction in the proportion of youth who reported past 30-day condomless sex, and alcohol use prior to sex. Findings also demonstrated an increase in the proportion of youth who reported STI/HIV testing over time. Finally, the results showed increases in youth–clinician risk communication, prevention knowledge, and self-efficacy.
Conclusions:
S4E demonstrated preliminary efficacy in reducing substance use and sexual risk behaviors and improving uptake of STI/HIV testing among youth in a clinic setting, which suggests that a larger randomized controlled trial may be warranted. Clinical Trial: Identifiers: NCT03368456 Unique Protocol ID: HUM00158089 Secondary IDs: Previous HUM00118704 Brief Title: Preventing HIV/STI in Urban Adolescents Via an mHealth Primary Care Intervention
Citation
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Copyright
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