Reproductive Health, Sexual Health, Sexually Transmitted Diseases
Conditions
Keywords
male adolescent, condom use, mhealth
Brief summary
This study will involve evaluating Health-E You/Salud ìTu™, a web-based, pre-visit mobile app designed to support adolescent male youth and his clinicians in discussing sexual and reproductive health (SRH) topics and care. It will test its efficacy among male patients in clinical settings using a stepped wedge cluster randomized controlled trial design.
Detailed description
Health-E You is a pre-visit, web-based mobile app designed to support an adolescent male youth and his clinician in discussing SRH topics and care. It is shared with an adolescent patient prior to a clinic visit, and contains initial questions that subsequently provide the patient with individually-tailored health information. In addition, the app provides relevant information to the clinician on patients' SRH to optimize the time together as part of the visit. In total, the app takes approximately 10-15 minutes to complete. The purpose of this study is to evaluate the efficacy of the Health-E You app among male youth ages 13-21 using a cluster-randomized stepped-wedge design. A participant will be considered to have completed the study if the participant has completed the baseline assessment, worked through the app, an immediate follow-up assessment, and a 2-month post-visit follow-up assessment. The end of the study is defined as completion of the 2-month follow-up assessment. Hypotheses include compared to usual care, app users will have greater improvements in male method use behaviors (i.e., condom use) as well as knowledge about pregnancy and sexually transmitted infection (STI) prevention methods, male method use self-efficacy, improved knowledge about SRH care, self-efficacy talking with a clinician about SRH, beliefs about SRH promotion, and SRH care receipt.
Interventions
OTHERHealth-E You app
When clinics are in the intervention condition, all patients presenting for any reason will get a study weblink 24 hours before the visit; walk-ins will get a study link code in clinic. If the participants agree to participate and meet study criteria, the participants will get a survey link and then Health-E You content to complete before the visit. Previously enrolled males will not be enrolled again to maintain the research study's integrity. Thus, participants will only have one opportunity for administration to the Health-E You app. Participants will be considered to have completed the Health-E You app if the participants answer all of the app's initial tailoring questions and receive recommendations for SRH topics to discuss with the clinician. As a technology-based intervention, no direct interactions with interventionists with participants are required.
Sponsors
Johns Hopkins University
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
This study will use a cluster-randomized stepped-wedge design that is a type of one-way crossover design. Under this design, each clinic will start the study under the control condition that involves standard usual care, and end the study in the intervention condition.
Eligibility
Sex/Gender
MALE
Age
13 Years to 21 Years
Healthy volunteers
Yes
Inclusion criteria
* Assigned male sex at birth * Age 13 to 21 years old * English and/or Spanish as preferred language to read, listen, and converse * Self-reported engagement in vaginal and/or anal sex in the past 12 months * Access to phone or internet for follow-up study activities
Exclusion criteria
* Aged 12 or younger or older than 21 * Primary language other than English or Spanish * Not able to provide informed consent * Unable to communicate due to cognitive, mental, language, or other difficulties * Not sexually active, engaged in oral sex only, or more than 12 months have passed since last vaginal and/or anal sex. * Previous participation in a Health-E You study activity or the app
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Correct Condom Use Self-Efficacy Scale | Baseline, 24 hours after visit, 2-month follow-up | Higher score indicates greater self-efficacy for correct use of male condoms. This measure is scaled with range from 1 (very difficult) to 5 (very easy); range 7-35. |
| Perceived efficacy in patient-physician interactions (PEPPI) | Baseline, 24 hours after visit, 2-month follow-up | Higher score indicates greater efficacy in patient-physician interaction about sexual and reproductive health. This measure is scaled with range from 1 (not at all confident) to 5 (very confident); range 5-25. |
| Frequency condom use | Baseline, 2-month follow-up | Measures frequency condom use with main \& non-main partners in past year and last 2 months |
| Sexual and reproductive care receipt | Baseline, 24 hours after visit, 2-month follow-up | Measures receipt of the recommended sexual and reproductive care package, based on national guidelines outlined by the Centers for Disease Control and Prevention (CDC) Office of Population Affairs (OPA) Quality Family Planning guidance \& American Academy of Pediatrics' Bright Futures |
Countries
United States
Contacts
CONTACTArik V Marcell, MD, MPH
CONTACTSofia Osio, MSPH
PRINCIPAL_INVESTIGATORArik V Marcell, MD, MPH
Johns Hopkins Dept of Pediatrics / Division of Adolescent/Young Adult Medicine
Outcome results
None listed