Review article
Technology-Based Interventions to Reduce Sexually Transmitted Infections and Unintended Pregnancy Among Youth

https://doi.org/10.1016/j.jadohealth.2018.02.007Get rights and content

Abstract

Purpose

Technology-based interventions to promote sexual health have proliferated in recent years, yet their efficacy among youth has not been meta-analyzed. This study synthesizes the literature on technology-based sexual health interventions among youth.

Methods

Studies were included if they (1) sampled youth ages 13–24; (2) utilized technology-based platforms; (3) measured condom use or abstinence as outcomes; (4) evaluated program effects with experimental or quasi-experimental designs; and (5) were published in English.

Results

Sixteen studies with 11,525 youth were synthesized. There was a significant weighted mean effect of technology-based interventions on condom use (d = .23, 95% confidence interval [CI] [.12, .34], p < .001) and abstinence (d = .21, 95% CI [.02, .40], p = .027). Effects did not differ by age, gender, country, intervention dose, interactivity, or program tailoring. However, effects were stronger when assessed with short-term (1–5 months) than with longer term (greater than 6 months) follow-ups. Compared with control programs, technology-based interventions were also more effective in increasing sexual health knowledge (d = .40, p < .001) and safer sex norms (d = .15, p = .022) and attitudes (d = .12, p = .016).

Conclusions

After 15 years of research on youth-focused technology-based interventions, this meta-analysis demonstrates their promise to improve safer sex behavior and cognitions. Future work should adapt interventions to extend their protective effects over time.

Section snippets

Search strategy

We conducted a comprehensive search of Medline, PsycINFO, and Communication Source databases to extract relevant studies published through May 2017. We used the following combination of key words, with asterisks used as “wild cards” to find any variations: (adolescen* or teen* or youth or middle school or high school) AND (sexual health or safe* sex or sex* education or sexually transmitted disease or sexually transmitted infection or STD or STI or HIV or AIDS or pregnancy or reproductive health

Study characteristics

Table 1 provides a summary of the studies included in this meta-analysis, including sample characteristics and moderator variables. A total of 11,525 participants (mean age = 18.42) were enrolled across 16 technology-based interventions for youth. The majority of studies were conducted in the United States (k = 11). Many studies used combined samples of boys and girls (k = 9); however, a few studies analyzed data from boys (k = 3) and girls (k = 4) independently.

The delivery of program content

Discussion

Results of the present meta-analysis, which synthesizes nearly 15 years of research on the development and evaluation of youth-focused technology-based interventions, highlight the great promise of these approaches to improve safer sex behaviors among youth. Pooling data from 16 studies with more than 11,000 adolescents, this meta-analysis found a significant positive effect of technology-based sexual health interventions for improving two key sexual behaviors among youth: increasing consistent

Funding Sources

This research was supported in part by the following National Institutes of Health grants: R00 HD075654 and T32 MH018269. This work was also supported in part by a National Science Foundation Graduate Research Fellowship DGE-1144081.

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    Conflicts of Interest: The authors have no financial relationships relevant to this article to disclose.

    Disclaimer: The content, interpretations, and conclusions of this study are those of the authors and do not necessarily reflect the views of the National Institutes of Health or the National Science Foundation.

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