Harnessing Social Media to Enhance Sexual and Reproductive Health Outreach for Mississippi Youth: A Case Study of Launching and Monitoring the Factnotfiction Website

Background: Teen pregnancy and childbearing are major public health concerns in Mississippi, which has the second highest teen pregnancy rate (90%) and the highest teen birth rate (55%) in the nation. Inadequate and delayed comprehensive sexual and reproductive health education (SRHE) has been linked to teen pregnancy and childbearing. In 2011, a randomized survey of Mississippi parents (N=3,600) indicated that 92% supported age-appropriate SRHE in schools. The Mississippi State Legislature passed House Bill 999 in 2011, which required school districts to adopt abstinence-only or abstinence-plus SRHE by 2012, of which 47% chose abstinence-plus. However, regardless of program type, the bill mandates that all SRHE programs require parental consent, it restricts program content (e.g., condom use demonstrations), and it does not require that programs are evidence-based and medically accurate. These mandates limit students’ access to comprehensive SRHE, which is important given that 58% of Mississippi high school students are sexually active (versus 51% nationwide).

Program background: To address this gap, the Women’s Fund of Mississippi launched FactNotFiction.com website (http://www.factnotfiction.com) in October 2012 to provide comprehensive and medically accurate SRHE to Mississippi youth. Our partners included ISIS Inc, a California-based firm with extensive experience in developing technology-based SRHE sites, and the locally based Ramey Agency, who developed and executed the site’s integrated launch/brand campaign for traditional and social media (e.g., radio; Facebook). ISIS developed the site’s initial design and content and—based on their experience that low-income youth have internet-capable cell phones that may not be smart phones—decided to forego a mobile responsive site.

Evaluation Methods and Results: A review of Google Analytics and Facebook Insights data within the first 6 months of the launch indicate that FactNotFiction.com is reaching its target population. For example, the site’s Facebook page has 11,635 “likes”—of which 96% are from 13-24 year olds in Mississippi. The analytics also highlighted two challenges: (1) The site was too static and first-time visitors were not returning; (2) At 79%, the bounce rate among mobile phone users was unacceptably high. Outcomes: (1) We converted the static site into the FactNotFiction Tumblr site in order to create a more dynamic environment and launched it on April 5, 2013; (2) We redesigned the site to become mobile responsive for smart phones and launched it on April 8, 2013.

Conclusions: When using social media to deliver SRHE to youth, the site’s outreach must be closely monitored—especially in the early months of its launch—with analytic tools to evaluate effectiveness. When gaps in outreach are identified, the team must be able to quickly and effectively respond and redesign the site.

Implications for research and/or practice: Research on effective ways to deliver public health education through the strategic use of social media is still in its early stage. Lessons learned from this case study of the initial design and launch of FactNotFiction.com—and responses once gaps in the site’s outreach were identified—add to this growing body of knowledge. Results have implications for the application of technology-based public health outreach and interventions.