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Background: Youth face many barriers to accessing health education and clinical services to prevent STDs. New mobile communication technologies offer unique opportunities to serve this population. In April 2009, with support from the California STD Control Branch, California Family Health Council (CFHC) launched the Hookup, a statewide text-message sexual health information and clinic referral service for youth.
Methods: To evaluate the Hookup, we conducted three focus groups at two teen clinics in Los Angeles (September 2010) and sent a text-based survey to all subscribers (January 2011).
Results: As of September 2013, there have been 9462 unique subscribers to the Hookup, with 4797 requests for clinic locations across 51 of 58 California counties. Focus group participants (n=26) found message content was informative (providing new and relevant information), simple (automatically limited to short words and phrases), and sociable (easily to share with friends). Participants also cited the convenience and ubiquity of text messaging and felt that the cost of messages was not a barrier. Most felt that text messaging provided a private way to learn about sensitive health topics, although a few expressed concerns about stigma from peers seeing the messages. There was a 34% response rate to the text-based survey (n=842). Respondents were primarily 14-25 years old (90%) and female (92%). Main Hookup referral sources included school (40%), friends (25%), marketing materials (22%), and online sources (10%). The majority of respondents (90%) indicated positive changes in response to subscription, including using condoms (33%), increased sexual health knowledge and awareness (24%), initiation of birth control (15%), and getting tested for STDs (15%).
Conclusions: Respondents reported high levels of satisfaction with the Hookup, and indicated positive changes in their sexual health. This project provides an excellent model of a low-cost program using health communication and mobile technology to facilitate youth access to sexual health information and services.