Unprotected Sex, Unsafe Sex
Conditions
Keywords
unsafe sex, unprotected sex, adolescents, Latinas, Hispanic, mobile health applications, unintended pregnancy, teen pregnancy prevention, school-based health centers
Brief summary
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.
Interventions
BEHAVIORALHealth-E You: a computer-based intervention to improve the use of effective contraception among Hispanic adolescents
School-based health centers which were randomized into the intervention arm will use the Health-E You App (n=7 clinics).
Sponsors
Patient-Centered Outcomes Research Institute
University of California, San Francisco
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
FEMALE
Age
14 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
Female 14-18 years of age Hispanic/Latina English or Spanish-speaker Has had sexual intercourse
Exclusion criteria
Currently pregnant Currently using an intrauterine device or implant contraceptive method Male Under 14 or over 19 years of age Not sexually active Non-Hispanic / Latina
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Contraception Use Self-efficacy Scale Score (Aim 1b) | Pre-visit Baseline, Post-visit Follow-up (48 hours after Baseline) | The 3-item attitude scale assessing perceived ability to choose and use contraception was self-administered in an online survey; each item scored on a 0=not at all confident to 10=completely confident scale; scale score is the sum of the 3 items scores, range 0 - 30 (higher score=greater self-efficacy) |
| Contraception Use Self-efficacy Scale Score (Aim 1c) | Baseline, 3 months, 6 months | The 3-item attitude scale assessing perceived ability to choose and use contraception was self-administered in an online survey; each item scored on a 0=not at all confident to 10=completely confident scale ; scale score is the sum of the 3 items scores (range 0-30); higher score=greater self-efficacy |
| Percentage of Participants Who Report Using a Non-barrier Method of Birth Control in the Prior 3 Months (Aim 3b) | Baseline, 3 months, 6 months | Recorded via self-administered online survey |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-study Assessment of Providers' Rating of How the Health-E You APP Improves the Effectiveness of the Clinical Encounter for Patients: App Helps Patients Engage in Contraception Decision Making (Aim 2a1) | Post-study completion | Provider ratings of whether the App improves the effectiveness of the clinical encounter for patients, using a Likert scale (options 1- strongly disagree to 5- strongly agree); then dichotomized into agrees versus neutral/disagrees. |
| Post-study Assessment of Provider Ratings of Whether the Health-E You APP Helps Clinicians Provide Individually Tailored Discussion of Contraception Options (Aim 2a2) | Post-study completion | Provider ratings of whether the App helps clinicians provide more individually tailored discussion of contraception options, using a Likert scale (options 1- strongly disagree to 5- strongly agree); then dichotomized into agrees versus neutral/disagrees. |
| Post-study Assessment of Provider Ratings of Whether the Health-E You APP Improves the Effectiveness of the Clinical Encounter by Integrating Reproductive Health Into All Visits (Aim 2a3) | Post-study completion | Provider ratings of whether the App improves effectiveness of the clinical encounter by integrating reproductive health into all visits, using a Likert scale (options 1- strongly disagree to 5- strongly agree); then dichotomized into agrees versus neutral/disagrees. |
| Post-study Assessment of Provider Ratings of Whether the Health-E You APP Makes Clinic Schedule Run Behind (Aim 2a4) | Post-study completion | Provider ratings of whether the App makes clinic schedules run behind, using a Likert scale (options 1- strongly disagree to 5- strongly agree); then dichotomized into agrees versus neutral/disagrees. |
| Number of Correct Answers to 7-item Contraception Knowledge Measure (Aim 1a) | Immediate pre-app (Baseline), Immediate post-app (< 1 hour) | The same measure was self-administered in an online survey immediately prior to using the Health-E You app (the intervention) and then immediately after app use. The Health-E You Knowledge Scale is a 7-item true/false format with a range of 0-7, a higher score indicates a better outcome. |
| Adolescent Assessment of Health-E You App Benefits: Gave me Useful Information About Birth Control (Aim 2a6) | Immediate Follow-up | Response to query about agreement with App benefits on 5 point Likert scale (1-strongly disagree to 5- strongly agree); dichotomized into agree versus neutral/disagree |
| Adolescent Assessment of Health-E You App Benefits: Helped me Talk With my Health Care Provider About Birth Control (Aim 2a7) | Immediate Follow-up | Response to query about agreement with App benefits on 5 point Likert scale (1-strongly disagree to 5- strongly agree); dichotomized into agree versus neutral/disagree |
| Adolescent Assessment of Health-E You App Benefits: Improved the Quality of my Visit With my Health Care Provider (Aim 2a8) | Immediate Follow-up | Response to query about agreement with App benefits on 5 point Likert scale (1-strongly disagree to 5- strongly agree); dichotomized into agree versus neutral/disagree |
| Adolescent Assessment of Health-E You App Benefits: Helped me Choose a Birth Control Method (Aim 2a5) | Immediate Follow-up | Response to query about agreement with App benefits on 5 point Likert scale (1-strongly disagree to 5- strongly agree); dichotomized into agree versus neutral/disagree |
| Percentage of Participants Who Report Discussing Birth Control With Health Care Provider at Visit (Aim 2b) | Post-visit Follow-up (48 hours after Baseline) | The single yes/no item was self-administered in an online survey |
| Percentage of Participants Who Receive or Make an Appointment to Receive or Receive a Prescription for a Non-barrier Method (Aim 3a) | Post-visit Follow-up | Recorded via self-administered online survey |
Countries
United States
Participant flow
Recruitment details
Individuals were recruited from 18 participating school-based health centers in the Los Angeles UnifiedSchool District starting August 2016 and ending May 31, 2018. Clinic staff provided all female youth who entered the clinic an opportunity to use the iPad with the intervention app (baseline questionnaire for the control group).
Participants by arm
| Arm | Count |
|---|---|
| Health-E You Intervention Arm Intervention arm. Participants answered baseline questions and received individually-tailored contraception and reproductive health information from a web-based computer application on an iPad at one of the 9 school-based health centers that was randomized to the intervention arm. | 693 |
| Control Arm Control Arm. Participants in this arm of the study completed an online baseline questionnaire about their demographic information and sexual and reproductive health behavior on an iPad at one of the 9 school-based health centers randomly assigned to the control arm. | 667 |
| Total | 1,360 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 401 | 269 |
Baseline characteristics
| Characteristic | Health-E You Intervention Arm | Control Arm | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 693 Participants | 667 Participants | 1360 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 693 Participants | 667 Participants | 1360 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Had sex in the past 3 months Missing data | 0 Participants | 16 Participants | 16 Participants |
| Had sex in the past 3 months No did not have sex in past 3 months at Baseline | 107 Participants | 147 Participants | 254 Participants |
| Had sex in the past 3 months Yes had sex in past 3 months at Baseline | 586 Participants | 504 Participants | 1090 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 6 Participants | 4 Participants | 10 Participants |
| Race (NIH/OMB) Asian | 6 Participants | 1 Participants | 7 Participants |
| Race (NIH/OMB) Black or African American | 24 Participants | 20 Participants | 44 Participants |
| Race (NIH/OMB) More than one race | 4 Participants | 5 Participants | 9 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 6 Participants | 6 Participants | 12 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 623 Participants | 614 Participants | 1237 Participants |
| Race (NIH/OMB) White | 24 Participants | 17 Participants | 41 Participants |
| Reason for visit related to reproductive health services Missing data | 6 Participants | 12 Participants | 18 Participants |
| Reason for visit related to reproductive health services Visit not related to reproductive health services | 137 Participants | 306 Participants | 443 Participants |
| Reason for visit related to reproductive health services Visit related to reproductive health services | 550 Participants | 349 Participants | 899 Participants |
| Region of Enrollment United States | 693 participants | 667 participants | 1360 participants |
| Sex: Female, Male Female | 693 Participants | 667 Participants | 1360 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 693 | 0 / 667 |
| other Total, other adverse events | 0 / 693 | 0 / 667 |
| serious Total, serious adverse events | 0 / 693 | 0 / 667 |
Outcome results
Primary
Contraception Use Self-efficacy Scale Score (Aim 1b)
The 3-item attitude scale assessing perceived ability to choose and use contraception was self-administered in an online survey; each item scored on a 0=not at all confident to 10=completely confident scale; scale score is the sum of the 3 items scores, range 0 - 30 (higher score=greater self-efficacy)
Time frame: Pre-visit Baseline, Post-visit Follow-up (48 hours after Baseline)
Population: All participants for whom a self-efficacy score was recorded either at Baseline or at Post-visit Follow-up
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Intervention | Contraception Use Self-efficacy Scale Score (Aim 1b) | Pre-visit Baseline | 23.2 Scores on a scale | Standard Deviation 6.34 |
| Intervention | Contraception Use Self-efficacy Scale Score (Aim 1b) | Post-visit Follow-up (48 hours post Baseline) | 25.22 Scores on a scale | Standard Deviation 5.11 |
| Control | Contraception Use Self-efficacy Scale Score (Aim 1b) | Pre-visit Baseline | 22.45 Scores on a scale | Standard Deviation 6.72 |
| Control | Contraception Use Self-efficacy Scale Score (Aim 1b) | Post-visit Follow-up (48 hours post Baseline) | 23.04 Scores on a scale | Standard Deviation 6.44 |
Comparison: Null hypothesis: No difference between study arms in change in mean self-efficacy from Baseline to Post-visit Follow-upp-value: 0.01195% CI: [0.26, 2.07]Mixed Models Analysis
Comparison: Null hypothesis: No Time difference (Post-visit Follow-up vs. Baseline) in outcomep-value: <0.00195% CI: [1.01, 2.07]Mixed Models Analysis
Comparison: Null hypothesis: No Time difference (Post-visit Follow-up vs. Baseline) in outcomep-value: 0.10895% CI: [-0.1, 1.05]Mixed Models Analysis
Primary
Contraception Use Self-efficacy Scale Score (Aim 1c)
The 3-item attitude scale assessing perceived ability to choose and use contraception was self-administered in an online survey; each item scored on a 0=not at all confident to 10=completely confident scale ; scale score is the sum of the 3 items scores (range 0-30); higher score=greater self-efficacy
Time frame: Baseline, 3 months, 6 months
Population: All participants for whom a self-efficacy score was recorded at Baseline or at 3 months or at 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Intervention | Contraception Use Self-efficacy Scale Score (Aim 1c) | Pre-Visit Baseline | 23.2 Score on a scale | Standard Deviation 6.34 |
| Intervention | Contraception Use Self-efficacy Scale Score (Aim 1c) | 3-month Follow up | 25.22 Score on a scale | Standard Deviation 4.87 |
| Intervention | Contraception Use Self-efficacy Scale Score (Aim 1c) | 6-month Follow up | 26.24 Score on a scale | Standard Deviation 4.38 |
| Control | Contraception Use Self-efficacy Scale Score (Aim 1c) | Pre-Visit Baseline | 22.45 Score on a scale | Standard Deviation 6.72 |
| Control | Contraception Use Self-efficacy Scale Score (Aim 1c) | 3-month Follow up | 23.37 Score on a scale | Standard Deviation 6.11 |
| Control | Contraception Use Self-efficacy Scale Score (Aim 1c) | 6-month Follow up | 23.44 Score on a scale | Standard Deviation 5.98 |
Comparison: Null hypothesis: No difference between study arms in change in mean self-efficacy from Baseline to 3 months or from Baseline to 6 monthsp-value: 0.04Mixed Models Analysis
Comparison: Null hypothesis: No difference between study arms in change in mean self-efficacy from Baseline to 3 monthsp-value: 0.21895% CI: [-0.48, 2.11]Mixed Models Analysis
Comparison: Null hypothesis: No difference between study arms in change in mean self-efficacy from Baseline to 6 monthsp-value: 0.00895% CI: [0.38, 2.77]Mixed Models Analysis
Primary
Percentage of Participants Who Report Using a Non-barrier Method of Birth Control in the Prior 3 Months (Aim 3b)
Recorded via self-administered online survey
Time frame: Baseline, 3 months, 6 months
Population: All participants who reported what they used to prevent pregnancy in the prior 3 months at Baseline or at 3 months or at 6 months
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Intervention | Percentage of Participants Who Report Using a Non-barrier Method of Birth Control in the Prior 3 Months (Aim 3b) | Pre-visit Baseline | 197 Participants |
| Intervention | Percentage of Participants Who Report Using a Non-barrier Method of Birth Control in the Prior 3 Months (Aim 3b) | 3-month Follow up | 162 Participants |
| Intervention | Percentage of Participants Who Report Using a Non-barrier Method of Birth Control in the Prior 3 Months (Aim 3b) | 6-month Follow up | 185 Participants |
| Control | Percentage of Participants Who Report Using a Non-barrier Method of Birth Control in the Prior 3 Months (Aim 3b) | Pre-visit Baseline | 197 Participants |
| Control | Percentage of Participants Who Report Using a Non-barrier Method of Birth Control in the Prior 3 Months (Aim 3b) | 3-month Follow up | 161 Participants |
| Control | Percentage of Participants Who Report Using a Non-barrier Method of Birth Control in the Prior 3 Months (Aim 3b) | 6-month Follow up | 166 Participants |
Comparison: Null hypothesis: No difference between arms in change in percentage of participants using non-barrier method from Baseline to 3 months or to 6 monthsp-value: 0.025Mixed Models Analysis
Comparison: Null hypothesis: No difference between arms in change in percentage of participants using non-barrier method from Baseline to 3 monthsp-value: 0.04295% CI: [1.04, 10.36]Mixed Models Analysis
Comparison: Null hypothesis: No difference between arms in change in percentage of participants using non-barrier method from Baseline to 6 monthsp-value: 0.00595% CI: [1.7, 18.06]Mixed Models Analysis
Secondary
Adolescent Assessment of Health-E You App Benefits: Gave me Useful Information About Birth Control (Aim 2a6)
Response to query about agreement with App benefits on 5 point Likert scale (1-strongly disagree to 5- strongly agree); dichotomized into agree versus neutral/disagree
Time frame: Immediate Follow-up
Population: Intervention group adolescents
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Intervention | Adolescent Assessment of Health-E You App Benefits: Gave me Useful Information About Birth Control (Aim 2a6) | Agree APP gave useful birth control information | 250 Participants |
| Intervention | Adolescent Assessment of Health-E You App Benefits: Gave me Useful Information About Birth Control (Aim 2a6) | Neutral/disagree APP gave useful information | 37 Participants |
Secondary
Adolescent Assessment of Health-E You App Benefits: Helped me Choose a Birth Control Method (Aim 2a5)
Response to query about agreement with App benefits on 5 point Likert scale (1-strongly disagree to 5- strongly agree); dichotomized into agree versus neutral/disagree
Time frame: Immediate Follow-up
Population: Intervention group adolescents
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Intervention | Adolescent Assessment of Health-E You App Benefits: Helped me Choose a Birth Control Method (Aim 2a5) | Agree APP helped choose method | 198 Participants |
| Intervention | Adolescent Assessment of Health-E You App Benefits: Helped me Choose a Birth Control Method (Aim 2a5) | Neutral/disagree APP helped choose method | 89 Participants |
Secondary
Adolescent Assessment of Health-E You App Benefits: Helped me Talk With my Health Care Provider About Birth Control (Aim 2a7)
Response to query about agreement with App benefits on 5 point Likert scale (1-strongly disagree to 5- strongly agree); dichotomized into agree versus neutral/disagree
Time frame: Immediate Follow-up
Population: Intervention group adolescents
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Intervention | Adolescent Assessment of Health-E You App Benefits: Helped me Talk With my Health Care Provider About Birth Control (Aim 2a7) | Agree it helped me talk with provider | 192 Participants |
| Intervention | Adolescent Assessment of Health-E You App Benefits: Helped me Talk With my Health Care Provider About Birth Control (Aim 2a7) | Neutral/disagree it helped me talk with provider | 95 Participants |
Secondary
Adolescent Assessment of Health-E You App Benefits: Improved the Quality of my Visit With my Health Care Provider (Aim 2a8)
Response to query about agreement with App benefits on 5 point Likert scale (1-strongly disagree to 5- strongly agree); dichotomized into agree versus neutral/disagree
Time frame: Immediate Follow-up
Population: Intervention group adolescents
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Intervention | Adolescent Assessment of Health-E You App Benefits: Improved the Quality of my Visit With my Health Care Provider (Aim 2a8) | Agree it helped quality of visit with provider | 200 Participants |
| Intervention | Adolescent Assessment of Health-E You App Benefits: Improved the Quality of my Visit With my Health Care Provider (Aim 2a8) | Neutral/disagree it helped quality of visit | 87 Participants |
Secondary
Number of Correct Answers to 7-item Contraception Knowledge Measure (Aim 1a)
The same measure was self-administered in an online survey immediately prior to using the Health-E You app (the intervention) and then immediately after app use. The Health-E You Knowledge Scale is a 7-item true/false format with a range of 0-7, a higher score indicates a better outcome.
Time frame: Immediate pre-app (Baseline), Immediate post-app (< 1 hour)
Population: Intervention participants who used app
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Intervention | Number of Correct Answers to 7-item Contraception Knowledge Measure (Aim 1a) | Pre-App Knowledge Scale | 3.31 Scores on a scale | Standard Deviation 1.61 |
| Intervention | Number of Correct Answers to 7-item Contraception Knowledge Measure (Aim 1a) | Post-App Knowledge Scale | 4.94 Scores on a scale | Standard Deviation 1.74 |
Comparison: Null hypothesis: No change in contraception knowledge from immediate pre-app to immediate post-app among Intervention group participantsp-value: <0.00195% CI: [1.43, 1.82]Mixed Models Analysis
Secondary
Percentage of Participants Who Receive or Make an Appointment to Receive or Receive a Prescription for a Non-barrier Method (Aim 3a)
Recorded via self-administered online survey
Time frame: Post-visit Follow-up
Population: All participants who answered the appropriate items at Post-visit Follow-up
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Intervention | Percentage of Participants Who Receive or Make an Appointment to Receive or Receive a Prescription for a Non-barrier Method (Aim 3a) | 236 Participants |
| Control | Percentage of Participants Who Receive or Make an Appointment to Receive or Receive a Prescription for a Non-barrier Method (Aim 3a) | 221 Participants |
Comparison: Null hypothesis: No difference between study arms in percentage of participants who receive/make appointment/get prescription for a non-barrier methodp-value: 0.22795% CI: [0.73, 3.78]Regression, Logistic
Secondary
Percentage of Participants Who Report Discussing Birth Control With Health Care Provider at Visit (Aim 2b)
The single yes/no item was self-administered in an online survey
Time frame: Post-visit Follow-up (48 hours after Baseline)
Population: All participants who completed the item at Post-visit Follow-up (48 hours post-visit)
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Intervention | Percentage of Participants Who Report Discussing Birth Control With Health Care Provider at Visit (Aim 2b) | 285 Participants |
| Control | Percentage of Participants Who Report Discussing Birth Control With Health Care Provider at Visit (Aim 2b) | 301 Participants |
Comparison: Null hypothesis: No difference between study arms in percentage of participants who discussed birth control with health care provider at visitp-value: 0.05595% CI: [0.98, 5.01]Regression, Logistic
Secondary
Post-study Assessment of Provider Ratings of Whether the Health-E You APP Helps Clinicians Provide Individually Tailored Discussion of Contraception Options (Aim 2a2)
Provider ratings of whether the App helps clinicians provide more individually tailored discussion of contraception options, using a Likert scale (options 1- strongly disagree to 5- strongly agree); then dichotomized into agrees versus neutral/disagrees.
Time frame: Post-study completion
Population: Clinical providers in Health-E You Intervention Clinics
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Intervention | Post-study Assessment of Provider Ratings of Whether the Health-E You APP Helps Clinicians Provide Individually Tailored Discussion of Contraception Options (Aim 2a2) | Agrees it helps clinicians | 9 Participants |
| Intervention | Post-study Assessment of Provider Ratings of Whether the Health-E You APP Helps Clinicians Provide Individually Tailored Discussion of Contraception Options (Aim 2a2) | Neutral/disagrees it helps clinicians | 3 Participants |
Secondary
Post-study Assessment of Provider Ratings of Whether the Health-E You APP Improves the Effectiveness of the Clinical Encounter by Integrating Reproductive Health Into All Visits (Aim 2a3)
Provider ratings of whether the App improves effectiveness of the clinical encounter by integrating reproductive health into all visits, using a Likert scale (options 1- strongly disagree to 5- strongly agree); then dichotomized into agrees versus neutral/disagrees.
Time frame: Post-study completion
Population: Clinical providers in Health-E You Intervention Clinics
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Intervention | Post-study Assessment of Provider Ratings of Whether the Health-E You APP Improves the Effectiveness of the Clinical Encounter by Integrating Reproductive Health Into All Visits (Aim 2a3) | Agree it helps integrate reproductive care | 6 Participants |
| Intervention | Post-study Assessment of Provider Ratings of Whether the Health-E You APP Improves the Effectiveness of the Clinical Encounter by Integrating Reproductive Health Into All Visits (Aim 2a3) | Neutral/disagrees it helps | 6 Participants |
Secondary
Post-study Assessment of Provider Ratings of Whether the Health-E You APP Makes Clinic Schedule Run Behind (Aim 2a4)
Provider ratings of whether the App makes clinic schedules run behind, using a Likert scale (options 1- strongly disagree to 5- strongly agree); then dichotomized into agrees versus neutral/disagrees.
Time frame: Post-study completion
Population: Clinical providers in Health-E You Intervention Clinics
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Intervention | Post-study Assessment of Provider Ratings of Whether the Health-E You APP Makes Clinic Schedule Run Behind (Aim 2a4) | Agrees App makes clinic schedules run behind | 0 Participants |
| Intervention | Post-study Assessment of Provider Ratings of Whether the Health-E You APP Makes Clinic Schedule Run Behind (Aim 2a4) | Neutral/disagree APP makes schedules run behind | 12 Participants |
Secondary
Post-study Assessment of Providers' Rating of How the Health-E You APP Improves the Effectiveness of the Clinical Encounter for Patients: App Helps Patients Engage in Contraception Decision Making (Aim 2a1)
Provider ratings of whether the App improves the effectiveness of the clinical encounter for patients, using a Likert scale (options 1- strongly disagree to 5- strongly agree); then dichotomized into agrees versus neutral/disagrees.
Time frame: Post-study completion
Population: Providers seeing patients for care in Health-E You Intervention Clinics
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Intervention | Post-study Assessment of Providers' Rating of How the Health-E You APP Improves the Effectiveness of the Clinical Encounter for Patients: App Helps Patients Engage in Contraception Decision Making (Aim 2a1) | Agree helps patients in decision making | 10 Participants |
| Intervention | Post-study Assessment of Providers' Rating of How the Health-E You APP Improves the Effectiveness of the Clinical Encounter for Patients: App Helps Patients Engage in Contraception Decision Making (Aim 2a1) | Neutral/disagree helps in decision making | 2 Participants |