Using SMS Text Messages to Reach Youth with Sexual Health Information Andrew Woodruff, MPH Program Director, ISIS National HIV Prevention Conference August 25, 2009 Atlanta, GA

501(c)3 organization founded in 2001 Mission: To use technology and new media for sexual health promotion, disease prevention and development of healthy relationships We partner with communities , corporations and public health agencies to provide digital marketing and intervention services, including: Social Networking Apps, Websites, Mobile Platforms, Text Messaging, Online Contests, and more. Annual Sex::Tech Conference focusing on youth.

501(c)3 organization founded in 2001

Mission: To use technology and new media for sexual health promotion, disease prevention and development of healthy relationships

We partner with communities , corporations and public health agencies to provide digital marketing and intervention services, including: Social Networking Apps, Websites, Mobile Platforms, Text Messaging, Online Contests, and more.

Annual Sex::Tech Conference focusing on youth.

Today’s Talk What is SMS? SexINFO HookUP 365/24-7

What is SMS?

SexINFO

HookUP 365/24-7

SMS Text Messaging SMS = Short Message Service Most used application on mobile phones, greater usage than voice Usage of a short code (5- or 6-digit phone number) to provide mass delivery, adhere to best mobile marketing practices Opt-in model Limited to 160 characters or less (2-3 sentences) in the U.S.

SMS = Short Message Service

Most used application on mobile phones, greater usage than voice

Usage of a short code (5- or 6-digit phone number) to provide mass delivery, adhere to best mobile marketing practices

Opt-in model

Limited to 160 characters or less (2-3 sentences) in the U.S.

SexINFO: A Public Health Response Rising chlamydia/gonorrhea rates among low-income African-American youth in the South East San Francisco Partnership with SF DPH, Community Advisory Board (clergy, CBOs, probation, etc.), and youth Before launch youth focus groups agreed that text messages are a private , accessible and culturally appropriate way to receive health information

Rising chlamydia/gonorrhea rates among low-income African-American youth in the South East San Francisco

Partnership with SF DPH, Community Advisory Board (clergy, CBOs, probation, etc.), and youth

Before launch youth focus groups agreed that text messages are a private , accessible and culturally appropriate way to receive health information

The Service Text Keyword SexINFO to a shortcode Get back menu of commonly asked questions Text another Keyword for answer Receive nugget of information and 2 referrals

Text Keyword SexINFO to a shortcode

Get back menu of commonly asked questions

Text another Keyword for answer

Receive nugget of information and 2 referrals

Marketing Bus shelter ads and posters in target neighborhoods Palm cards handed out in schools Banner ads on Yahoo! Press release picked up by local TV, radio and newspaper, and USA Today

Bus shelter ads and posters in target neighborhoods

Palm cards handed out in schools

Banner ads on Yahoo!

Press release picked up by local TV, radio and newspaper, and USA Today

Usage Statistics April-Oct ’06, 4500 inquires, 55% led to referrals Nov-April ‘07, 2344 inquires, 19% led to referrals Top 3 Inquiries 1. What 2 do if condom broke 2. 2 find out about STDs 3. What 2 do if u think ur pregnant

April-Oct ’06, 4500 inquires, 55% led to referrals

Nov-April ‘07, 2344 inquires, 19% led to referrals

Top 3 Inquiries

1. What 2 do if condom broke

2. 2 find out about STDs

3. What 2 do if u think ur pregnant

Usability Testing Checked service on the street with local youth Found they were not getting past the 4th question of the original 11 Only 1/5 were getting from the questions to the answers We made slight changes to the service based on this market knowledge, then launched a second marketing phase

Checked service on the street with local youth

Found they were not getting past the 4th question of the original 11

Only 1/5 were getting from the questions to the answers

We made slight changes to the service based on this market knowledge, then launched a second marketing phase

Second Round of Marketing Video PSA on YouTube, MTV, BET, local cable access station Radio PSAs on KMEL (hip-hop and R&B) Mobile website m.sextext.org Awards: Webby, Full Circle Fund Technology award, and Grassroots Techie 204 inquiries in first 3 weeks, 97.5% led to referrals

Video PSA on YouTube, MTV, BET, local cable access station

Radio PSAs on KMEL (hip-hop and R&B)

Mobile website m.sextext.org

Awards: Webby, Full Circle Fund Technology award, and Grassroots Techie

204 inquiries in first 3 weeks, 97.5% led to referrals

Preliminary Eval: Awareness AJPH, March 2008 322 surveys collected at 3 SF clinics 11% of clinic patients knew of SexINFO 80% would sign up in the future Patients from target audience MOST likely to know about service: African-American, aged 12-18 Lived in target neighborhoods Had least expensive cell phone provider

322 surveys collected at 3 SF clinics

11% of clinic patients knew of SexINFO

80% would sign up in the future

Patients from target audience MOST likely to know about service:

African-American, aged 12-18

Lived in target neighborhoods

Had least expensive cell phone provider

Partnerships: California Family Health Council and Title X Clinics, CA STD Control Branch, CA Dept. of Public Health

Partnered with ADIQ, California Family Health Council and CA Dept of Public Health Txt Hookup to 365247 Youth generated weekly sex info & life advice Zip code Title X clinic and SBHC search

Partnered with ADIQ, California Family Health Council and CA Dept of Public Health

Txt Hookup to 365247

Youth generated weekly

sex info & life advice

Zip code Title X clinic and SBHC search

Temporary tattoos, removable stickers, email blasts, NYTimes mention

Usage Statistics Launched April 15, 2009 From April to July: 1074 unduplicated subscriptions to the hookup, with 109 unduplicated opt-outs. 386 clinic requests (290 unduplicated) were received, translating to 27% of subscribers requesting clinic referrals, mostly in dense urban locations Evaluation in progress: Via clinic sample and SMS

Launched April 15, 2009

From April to July: 1074 unduplicated subscriptions to the hookup, with 109 unduplicated opt-outs.

386 clinic requests (290 unduplicated) were received, translating to 27% of subscribers requesting clinic referrals, mostly in dense urban locations

Evaluation in progress: Via clinic sample and SMS

Lessons Learned Text messages are good for increasing access to services, appointment reminders and basic education. In-person services are best for complex, customized sexual health issues. Marketing and "stickiness" are iterative processes. Engage with your audience often. Tech trends change very fast.

Text messages are good for increasing access to services, appointment reminders and basic education. In-person services are best for complex, customized sexual health issues.

Marketing and "stickiness" are iterative processes.

Engage with your audience often. Tech trends change very fast.

Thank you! ISIS-INC.org 409 13 th St. 14 th Floor Oakland, CA 94612 (510) 835-9400 [email_address]