Texting for Sexual Health: Examining the Questions Adolescents Ask the BrdsNBz Text Message Warm Line

Theoretical Background and research questions/hypothesis: Adolescence is a time of development and change that can lead to questions, including questions about sexuality and sexual health. Although adolescents may have these types of questions, they may not feel completely comfortable addressing certain topics with sources they often turn to for health information, such as parents or physicians, because of embarrassment. However, mobile health applications such as the BrdsNBz Text Message Warm Line provide adolescents with a way to reach out for free and anonymously to receive medically-accurate and up-to-date information related to their sexual health queries. The BrdsNBz allows adolescents in North Carolina ages 14 to 19 to text any question about sexual health to the service and receive a personalized, medically accurate response within 24 hours. Because the service uses text messaging, which is a form of computer mediated communication, it is possible that adolescents are willing to ask questions they may not feel comfortable discussing in other situations. Computer mediated communication has been found to lead to greater levels of self disclosure. Because text messaging could provide a way for adolescents to ask questions they may not normally ask, an evaluation of BrdsNBz will attempt to determine the topics of questions adolescents ask of the service.

Methods:  A quantitative content analysis of the text messages sent to the BrdsNBz Text Message Warm Line was conducted in Spring 2011. All messages sent from February 2009 to March 2011 were assessed. Coding was done in progressive stages with messages first coded as to their dominant topic. Once messages were coded as pertaining to sex/sexual health, additional coding was done to examine how many questions addressed categories including contraception, unplanned pregnancy, HIV/AIDS, STDS, sexual intercourse, abortion, homosexuality, unprotected sex, masturbation, waiting for sex, development, rape/sexual violence, or other. Additional coding was conducted for categories to determine what type of questions adolescents had on certain topics. For example, additional measures included examing whether the question addressed the issue of access to contraceptives. Questions about pregnancy were coded as to whether the question was about prevention, detection, notification or other. STDs and HIV/AIDS were also coded further to determine if the question was about the topic in general, prevention, detection, treatment or other.  Additionally, questions were coded into one of three categories: information seeking, advice seeking or reassurance of normalcy.

Results:  At this stage, not all messages have been fully analyzed.  The content analysis will be completed by April 28.

Conclusions: From the findings, we will be able to see which type of questions adolescents are asking in an anonymous setting about sexual health.

Implications for research and/or practice: These findings will have implications for practitioners because the findings will allow them to see what topics adolescents may be unsure about or desire additional information about. Additionally, this study may provide information on topics practitioners and medical providers should address with youth in clinical and other settings to assure that youth are receiving as much information as they desire about reproductive health and safety education.