Using text messaging to affect teen health

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  • , including sexual assault, negative attitudes towards women, and the acceptance of deviant or aggressive sexual behavior among peers,
  • , including sexual assault, negative attitudes towards women, and the acceptance of deviant or aggressive sexual behavior among peers,
  • , including sexual assault, negative attitudes towards women, and the acceptance of deviant or aggressive sexual behavior among peers,
  • , including sexual assault, negative attitudes towards women, and the acceptance of deviant or aggressive sexual behavior among peers,
  • Unclear if this has changed
  • , including sexual assault, negative attitudes towards women, and the acceptance of deviant or aggressive sexual behavior among peers,
  • Unclear if this has changed
  • Unclear if this has changed
  • Unclear if this has changed
  • Unclear if this has changed
  • , including sexual assault, negative attitudes towards women, and the acceptance of deviant or aggressive sexual behavior among peers,
  • Low levels of parental engagement and fidelity in programs can undermine program effectiveness.
  • This may be an indication that non-violent x-rated material affects attitudes and behaviors but does not influence in-person sexual aggression.
  • This may be an indication that non-violent x-rated material affects attitudes and behaviors but does not influence in-person sexual aggression.
  • This may be an indication that non-violent x-rated material affects attitudes and behaviors but does not influence in-person sexual aggression.
  • This may be an indication that non-violent x-rated material affects attitudes and behaviors but does not influence in-person sexual aggression.
  • Using text messaging to affect teen health

    1. 1. Texting 4 Health February 29, 2008, Palo Alto, CA Using Text Messaging to Affect Teen Health Michele Ybarra MPH PhD Center for Innovative Public Health Research * Thank you for your interest in this presentation. Please note that analyses included herein are preliminary. More recent, finalized analyses may be available by contacting CiPHR for further information.
    2. 2. Roadmap 1. General indicators of text messaging use among US teens 2. Our 'philosophy' of technology and health (when to use technology, when to use traditional delivery methods) 3. A case study: TXTing 4 Bettering Parenting project
    3. 3. Roadmap General indicators of text messaging use among US teens
    4. 4. Background: Growing up with Media  National longitudinal survey of 1,588 youth  Youth were 10-15 years of age at baseline  Baseline data collected AugustSeptember, 2006  Funded by the CDC (U49/CE000206)
    5. 5. Prevalence of text messaging  45% of 10-15 year olds own a cell phone  24% have a cell phone and using text messages  13% report texting everyday  16% texting 1 hour or more a day
    6. 6. Cross-tabulation of age and cell phone ownership (n=1,588) Cell phone + text messaging Cell phone No cell phone 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 10 y.o. 11 y.o. 12 y.o. 13 y.o. 14 y.o. Design-based F(9.6, 15139.2) = 9.7 P = <0.001 15 y.o.
    7. 7. Cross-tabulation of sex and cell phone ownership (n=1,588) Cell phone + text messaging Cell phone No cell phone 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Female Design-based F(2.0, 3163.9) = 9.4 P = 0.001 Male
    8. 8. Cross-tabulation of race and cell phone ownership (n=1,588) Cell phone + text messaging Cell phone No cell phone 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% White Balck/African American Mixed Design-based F(5.9, 9360.3) = 0.2 P = 0.97 All other
    9. 9. Cross-tabulation of Hispanic ethnicity and cell phone ownership (n=1,588) Cell phone + text messaging Cell phone No cell phone 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Not Hispanic Design-based F(2.0, 3154.5) = 0.4 P = 0.67 Hispanic
    10. 10. Cross-tabulation of income and cell phone ownership (n=1,588) Cell phone + text messaging Cell phone No cell phone 100% 80% 60% 40% 20% Design-based F(18.9, 29938.2) = 1.8 P = 0.02 $2 50 , 00 0 00 0 $2 00 , 00 0 $1 50 , 00 0 $1 25 , 00 0 00 , 00 $7 5, 0 00 $5 0, 0 00 $3 5, 0 00 $2 5, 0 00 5, 0 $1 $1 < $1 5, 00 0 0%
    11. 11. Benefits of text messaging-based interventions     Girls (AOR: = 2.3, p<.001) Older youth (AOR = 1.4, p<.001) Youth in households with higher income (AOR = 1.2, p<.001) Little differences noted by race or ethnicity AOR = Adjusted odds ratio
    12. 12. Roadmap Our 'philosophy' of technology and health (when to use technology, when to use traditional delivery methods)
    13. 13. Advantages of technology-based interventions  Scalable  Cost effective (fewer personnel and infrastructure costs)  Tailoring of the program
    14. 14. Advantages of mobile phones specifically  ‘Always on’ capability reach people wherever they are  Active vs. reactive
    15. 15. The philosophy of technology-based interventions  In order to reach young people, we need to go where they are (instead of expecting them to come to us)  Young people are on mobile phones  We need to be on mobile phones Go where they are; use the technology they’ve adopted to promote the health behavior we want them to adopt
    16. 16. The philosophy of technology-based interventions  Technology is not a replacement of traditional services, it is an enhancement  Attract youth who would otherwise not utilize traditional smoking cessation services  Not all populations are using newer technologies. Understand who your target population is and where they *are*
    17. 17. Roadmap A case study: TXTing 4 Bettering Parenting project
    18. 18. Teenage pregnancy  The US has the highest teen pregnancy rate in the developed world (Coren et al., 2003).  41.7 / 1,000 adolescents each year (National Center for Health Statistics, 2004)  Adolescent mothers and their children are at risk for a variety medical, psychological, and social challenges (Committee on Adolescence & Committee on Early Childhood, 2001; Coren et al., 2003).
    19. 19. Case study: TXTing 4 Better Parenting Teen parenting programs struggle to (Gomby et al., 1999):  enroll  adequately involve  retain  implement services as intended by their original program models. New delivery models are needed.
    20. 20. Parent Express  Developed in 1992 by Dickinson and Cudaback.  Evaluation studies have consistently reported increases in parenting knowledge and changes in parenting behaviors (Cudaback et al.1985;Cudaback and Jenson, 1992;Martin, et al., 1992;Martin & Weigel, 2001;Riley, 1997;Riley et al., 1991).  Teen mothers increase parent-infant interaction (Riley et al., 1991).
    21. 21. Parent Express  8-page newsletter mailed to new parents monthly for up to 3 years  Age-paced to capitalize on the teachable moment
    22. 22. TXTing 4 Better Parenting  We propose to use this text-based parenting program as the basis for a text messaging-based teen parenting intervention.  3 messages daily:    supportive (e.g., promoting self-efficacy), parenting skills (e.g., infant feeding), and ‘from the baby’ (i.e., helps the mother understand her baby’s ‘perspective’).
    23. 23. TXTing 4 Better Parenting  Parenting skills: lern 2 recogniZ d hunger cry. She may nt B hngry evry tym shes fusy. She may nd burping, a daiper chng, or jst wan2B held.  Supportive: B patient W yrslf. Ur nt solo n ur feelins n dis tym of adjustment wl pass  A message ‘from the baby’: I lk 2 feel warm, +I don’t lk heaps of noyZ
    24. 24. Summary  Young people are using text messaging (1:4 10-15 year olds)  We need to harness the technologies they are using (where they are) to reach them  Don’t re-invent the wheel; adapt existing interventions for new technologies

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