Improving Adolescent Sexual and Reproductive Health: Can Mobile Health Interventions Affect Behavior?

In this issue of Pediatrics, Ybarra et al¹ report the results of a national randomized controlled trial of Girl2Girl, a mobile health (mHealth) intervention aiming to reduce pregnancy rates among lesbian, gay, bisexual, and other sexual minority (LGB+) adolescent girls. Researchers randomly assigned 948 girls aged 14 to 18 to the theory-based, user-informed text messaging intervention versus an attention-matched control group. At trial end, 5 months post-enrollment, those in the Girl2Girl intervention group were significantly more likely to have condom-protected sex and use a birth control method other than condoms.

The study allows us to reflect on the overall impact of mHealth interventions to date because few mHealth interventions have been successful in affecting adolescent sexual and reproductive health (SRH) to the level of Girl2Girl.² Several reasons likely contribute to this variation. First, behavior change is multifactorial, especially SRH behaviors, affected by a variety of societal and contextual factors. These factors make behavior change challenging to comprehensively address within one intervention. Next, retention rates in mHealth trials can be suboptimal. Adolescents frequently change phone numbers and experience phone disconnections, making patient follow-up challenging and full intervention delivery problematic.³ Lastly, the adoption of any mHealth intervention competes with a host …

Address correspondence to Lauren S. Chernick, MD, MSc, Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University Irving Medical Center, 3959 Broadway, CHN 1-116, New York, NY 10032. E-mail: lc2243{at}columbia.edu