Evaluating a Social Marketing Campaign Promoting Use of a Sexual Health Text Service By Teens

Theoretical Background and research questions/hypothesis:  Sexual health text message services are becoming increasingly popular, but such services often lack promotion. This project details the implementation of a campaign promoting a state-wide sexual health text message service that allows teens to text directly with a health educator and uses a mixed method design to assess the effectiveness of the campaign and potential barriers to using the service.

Methods:  A social marketing campaign was created promoting a North Carolina sexual health text message service and conducted in six N.C. middle and high schools in Fall 2012. Quantitative data from multiple sources, including service use statistics, a text message survey sent to users (n=76), and an in-school online questionnaire (n=2125) in four of the schools that received promotion were used to assess the success of the campaign. Focus groups and in-depth interviews were then conducted with middle and high school students (n=18) to further understand motivations and barriers to use.

Results:  Service data indicated that service use increased in tandem with promotional efforts. The majority (67%) of new users who completed the text survey said they heard about the service through the campaign or their school, which is where the campaign was conducted. In the in-school online survey, half of all respondents had heard of the service, with posters and hearing about the service in a class (e.g., a health educator) being the most frequently mentioned methods of promotion. Overall service use remained low, however, with 6.7% of teens in the schools reporting use of the service. Online questionnaires, focus groups and in-depth interviews indicated a number of potential barriers to service use including not having a sexual health question, a fear parents would see the messages, confusion about how to use the service, and a general lack of thinking of the service as an information option.

Conclusions:  Promotion of text message services is vital to service awareness and use. Overall, this campaign increased awareness of the service, but use still remained low. In part, this could be due to the nature of the specific service, which provided answers to sexual health questions on request. If teens did not have questions during the campaign, they may not have had a need to use the service. Additional barriers were also present, with this research providing insights into perceived barriers to using a sexual health text message service and implications for other service providers. 

Implications for research and/or practice:  In school campaigns promoting sexual health text message services can be an effective way to increase service awareness. Promotion of services may be most effective when using posters and word-of-mouth from credible in-school champions such as health educators. Having teens try the service or save the number in their phones could reduce some service barriers, such as a lack of thinking about the service as an information option and confusion about how the service is used. Results related to barriers have practical implications for those who have text message services or are considering implementing them.