The Hookup: Why texting still works to normalize sex education among youth
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Have major advances in mobile technology and increased access to smart phones left you wondering if your SMS-based program is worth the trouble? We had the same question about Hookup – California Family Health Council's program that uses SMS technology to deliver weekly youth-developed sexual and reproductive health tips to youth subscribers and connect them to local clinics. The changing landscape of mobile technology inspired us to reevaluate the program, paying special attention to how California youth who were unfamiliar with Hookup viewed text-messaging as a way to provide them with confidential information and resources on their sexual and reproductive health. Session participants will discover why text-messaging continues to be an important platform to reach youth with sensitive health information, and how advances in mobile technology and expanded youth access to social media can be best utilized to increase program reach, impact and engagement.
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The Hookup: Why texting still works to normalize sex education among youth
- 1. The Hookup: Why Texting Works to Normalize Sex Education Among Youth Sandee Differding California Family Health Council
- 2. Outline • Why Hookup? • Hookup design • Evaluation results + key takeaways • Next steps
- 3. Why Hookup?
- 4. Why Hookup? Barriers to accessing SRH info Want to meet youth where they are In April 2009, launched Hookup!
- 5. Hookup Overview • 2009 Model: statewide text-message-based sexual health information + clinic referral service for CA youth o Supported by CDPH STD Control Branch o Uses Mobile Commons platform • Target population: CA youth 13-24 years • Housed on CFHC’s website: TeenSource.org
- 7. Hookup Design • Youth subscribe by texting “HOOKUP” to 877877 – receive weekly text tip • Youth text “CLINIC” + zip code for clinic locator • Tips written by peer educators + TeenSource interns • Blog posted on TeenSource w/ more info
- 8. Hookup Tip Examples Hookup: Don't leave it to word of mouth! Get the 101 on oral sex at teensource.org and text CLINIC + your zip to find your nearest clinic. Text STOP to end. Hookup: No one should ever judge you 4 your sexuality. Straight, bi, gay.. It's all okay! Find resources & support @ teensource.org. Text STOP to end. Hookup: To virginity and beyond! You can always choose to wait but if you're ready to have sex, go to teensource.org for safe sex info. Text STOP to end.
- 9. Hookup Blog on TeenSource.org
- 11. Hookup Subscribers Over Time 0 500 1000 1500 2000 2500 3000 3500 4000 4500 2009 2010 2011 2012 2013 2014 2015 Total # of Hookup subscribers n=3,944 as of 12/31/15
- 12. Overview of 2011 Evaluation • Results indicated satisfaction w/ Hookup + positive changes in sexual health
- 13. 2015: Is Hookup still working? 1) Is Hookup meeting goals? 2) Is a texting platform still a successful method to reach + educate adolescents? 3) Should program’s target pop. and/or goals change? 4) How should program shift to increase impact?
- 14. Evaluation Methods • Key Informant Interviews (n=14) • Text-based survey for subscribers (n=711) • Youth focus groups (n=4) • Program metrics
- 16. 1) Reaching target group 10-14 4% 15-19 60% 20-24 18% 25-29 8% 30-34 3% 35-44 5% 45+ 2% Age of Hookup survey respondents (n=711)
- 17. 2) Text content is well-received “Helpful, funny, easy to share, and inspires interesting conversations with others, free to use.” – Hookup subscriber
- 18. 3) Texting still a successful way to engage CA youth “Everyone’s like on their phones constantly . . . It’s most likely they will see this [tip] ‘cause we’re always, constantly checking our phones.” – Youth focus group participant
- 19. 4) Target middle school + high school youth “Once you get into freshman year, you’re really influenced and I think that kids that are going into freshman year knowing things [about sex] is the best.” – Youth focus group participant
- 20. 4) Target youth w/ less access “If it’s a [place] where…There’s only like abstinence sort of like teaching instead of harm reduction, then I think something like this would really help a lot, especially since everyone has a phone now.” – Youth focus group participant
- 21. 5) Expand clinic finder “There should be some way to figure out if the clinic that you are going to will be able offer you what you need.” – Youth focus group participant
- 22. 6) Make tip content more helpful “I think you can be more helpful ‘cause like in third one it says, ‘Learn about the risks of anal sex,’ and then it’s like just telling you – you you should learn about it. But maybe you can like tell them like one of the risks in the text so they know how serious it is.” – Youth focus group participant
- 23. 7) Tailor + personalize tip content “I think maybe like . . . when you first send the text message, like there would be codes for like general categories and then you’d only get those types . . . of texts.” – Youth focus group participant
- 24. 8) Make interactive “If you want like information an easy way . . . I feel like instead of texting your friend, you can text the source [of information].” – Youth focus group participant
- 25. 9) Invest in increased promotion “Maybe like find a way to reach more people, ‘cause none of us here had ever heard of it before. So, just kind of get it out there.” – Youth focus group participant
- 26. How will you incorporate findings in work?
- 27. Next Steps
- 28. Next Steps • Investigate cost + feasibility of recommended program improvements • Develop work plan for implementing program improvements • Plan for continued program evaluation
- 29. Questions?
- 30. My contact info Sandee Differding, MPH Digital Adolescent Health Program Manager differdings@cfhc.org 510.486.0412, 2315
- 31. Learn more at TeenSource.org @teensource TeenSource.org @teensourceorg Stay Connected!
Editor's Notes
- We all know youth face many barriers when it comes to accessing medically accurate and teen-friendly sexual and reproductive health information and resources including lack of sex ed in school, stigma, worries about confidentiality, unreliable sources, not knowing where to go, transportation, cost, knowledge of rights etc. We wanted to meet youth where they are –88% of teens have cell phones, avg. of 30 texts/day. Mobile technology offered a unique way to regularly reach youth with sexual and reproductive health info and resources In 2009, launched Hookup – a statewide text-message sexual health information and clinic referral service for youth
- 2011 evaluation was just text survey and focus groups, no stakeholder interviews
- -Can opt out at any time by texting STOP to 877877 -broad sexual and reproductive health related topics (STD screening + prevention, birth control, communication skills, substance abuse, family communication, minor consent laws etc.) -160 characters -in English and Spanish (Spanish since Fall of 2013) - -Have everyone do a clinic search with their phones?
- Blogs are also developed with youth-input from peer educators and TeenSource interns
- -Have increased subscribers + geographical reach since 2011 evaluation -Not including 27 subscribers in Spanish
- However, growth of subscribers has plateaued, with same number of those opting in as opting out the last couple of years -Possible reasons for decrease in subscriptions/increase in “opt outs” in 2013 could be change of short code, could be lack of promotion
- -2011 evaluation looked at subscriber + clinic locator metrics + focus groups + subscriber text survey -Hookup only became available in Spanish in September 2013 -LA focus groups: partnered with Dr. Raymond Perry from UCLA and recruited youth 15-20 from two teen clinics in LA County
- Our key findings were reflected across all three evaluation components: the stakeholder interviews, the text survey, and the youth focus group. For the sake of time and because I think you are most interested in it, I’m going to focus on the feedback we got from youth.
- From evaluation (text survey) we did find that Hookup is reaching its goal of engaging youth ages 13-24 + providing them with SRH information Also, from ongoing metrics slide we already shared we know that we’re also connecting youth to clinics through clinic locator searches (7,108 clinic searches across 51 CA counties)
- We also heard: -“CFHC has done a good job to make sure we are working with teens . . . and generating messages responsibly, not adults sending messages we think are important.” –Key Informant -“I think it’s really unique because I personally never heard of anything like this before… And everything in today’s society is all about technology!” – Youth focus group participant
- We also heard from youth: -“Without me having to remind myself, it’s gonna come on my phone every week, which is helpful.” –Youth focus group participant - “I like the amount of texts sent, very informative and non-judgmental.” – Hookup subscriber
- We also heard: -The best place for us to be is younger kids . . . You can’t send a 14-year-old and a 24-year-old the same message about sex.” – Key Informant -“I think it’s teens because, for example, for me, like I have no clue what’s going on. Like I don’t want to like go to someone and ask someone . . . Like everyone’s on their phones, teens, and I text a lot, so I feel cool with that.” – Youth focus group participant
- We also heard: -“Hookup should try to reach teens either system involved or [who] don’t know where to go…” –Key informant -“I think a lot of teenagers who don’t necessarily have access to other like ways to get sexual health information . . . Teenagers who might not necessarily have other options.” – Youth focus group participant -“I also think it would be good for students that don’t have access to computers or Wi-Fi at home. They can easily get a text . . . it works in the benefit of kids that don’t have that access.” – Youth focus group participant
- We also found that: -36% of key informants were not sure if it was working -30% of subscribers did like the clinic finder feature -focus group participants wanted more info from the clinic listing including services provided, clinic hours, and public transportation options
- We also found: -“Needs to be more thought out: what is each text message trying to do? What are the action steps?” – Key informant -“Go deeper in your weekly tips giving more info than just basic stuff.” –Hookup subscriber
- We also heard: -“Maybe youth could take a little quiz about who they are and that would direct them to a program tailored to where they identify.” – Key informant -“The tips do not resonate with teens. One out of 15 is smart and cute.” – Key Informant
- We also heard: -“It might be more useful for teens to have a space to ask questions and get answers.” – Key informant -“These links . . . at Teensource.org, they should be specific links to that . . . article…so when we click it, it goes immediately to what the topic of the text is about.” – Youth focus group participant
- We also heard: -“One kids thinks it’s cool, he’ll tell, you know, ten other friends!” – Youth focus group participant -“A lot of kids are on social media these days and social media has a lot of ads.” – Youth focus group participant -“People at school definitely put up a ton of flyers. Like if you’re in the bathroom, like on the inside of the stalls.” – Youth focus group participant -“[Collaborate with like-minded programs and organizations to make Hookup] a resources people are clamoring to have!” –Key informant
- Based on the evaluation findings I just shared and your own experience engaging youth in sexual health promotion programs, what are some ways you can use what you learned in your own programs?
- Updates: already streamlined Clinic Finder on TeenSource with Hookup Clinic Finder, improving promotion of Hookup on TeenSource and investing in increased advertising, plan to develop criteria for what makes a good Hookup tip and expanding tip content, looking for opportunities to expand reach nationally,