Hookup: Is Texting Still an Effective Method to Reach Youth to Promote Sexual Health?

Background:  Launched in 2009, California Family Health Council’s (CFHC) Hookup program uses short message service (SMS) technology to deliver youth-developed sexual and reproductive health tips to subscribers ages 13-24 and connect users to local clinics.  

Methods:  In June-August 2015, we implemented a mixed-method evaluation to assess whether texting is still an effective platform to promote sex education and link youth to services, and how Hookup could adapt to better engage diverse populations. We conducted 14 Key Informant Interviews (KII), four focus groups with 25 youth, and a text-based survey to 3,904 current Hookup subscribers. 

Results:  The KIIs indicated Hookup content was helpful but could be improved by making sure each text included an action item, and that program impact could be enhanced by targeting subpopulations of youth, including rural and younger youth. Those interviewed thought the clinic finder was an important component, but questioned its success connecting youth to clinics. Focus group participants found message content helpful and funny, but indicated interactive features and tailored content for subpopulations of youth could greatly improve usability. Participants felt that texting was still a relevant way to receive sexual health information because it was convenient and private, but suggested that we increase program promotion through social media advertising and outreach to schools. Survey response rate was 18% (n=711).  Respondents were primarily 15-24 years old (78%), female (69%), and identified as straight (69%) or bisexual (22%). Respondents indicated positive changes attributed to their participation, including sharing facts with friends (59%), using contraception (36%), getting an STD test (27%) and delaying sexual debut (19%). 

Conclusions: Despite the evolving landscape of mobile technology, Hookup’s text-message program continues to engage youth and normalize sex education among subscribers. Users and stakeholders identified several opportunities to improve text-messaging based programs including integrating tailored text content and interactive elements, and investing in program promotion.