Harnessing the Power of Technology to Improve Sexual and Reproductive Youth Health in Nicaragua: A Randomized Field Study.

Introduction: Nicaragua is among the poorest countries in Latin America and has one of the highest adolescent pregnancy rates in the region. One in four of pregnancies are adolescents and they are more likely to experience poverty and gender and economic inequality. Method: This pilot randomized field study assessed use, satisfaction, and impact of a brief e-learning short-term intervention to improve the sexual and reproductive health (SRH) knowledge, skills, motivations, and behaviors among 14-17-year-old Nicaraguan youth. Results: While access to technology and internet were significant barriers, App and email delivery channels were feasible means for communicating with youth who had access to the internet and mobile devices. Youth who used the app were most likely to complete the entire intervention. Youth were very satisfied with the intervention (98%) and significantly improved SRH knowledge, skills and motivations, and delayed age at the first sexual encounter. Conclusion: Results are promising and indicate potential for the scalability of this type of intervention.

Improving Family Communication.

INTRODUCTION: TeenSmart International harnesses the power and flexibility of technology to empower youth to take personal responsibility for their health and lifestyle choices. Access to the Internet via mobile phones is often cheaper than paying to connect to a wired broadband service, and in rural areas, mobile networks may be the only means of accessing the Internet. This study assessed the feasibility, acceptability, and impact of "cues to action" or brief motivating cell phone text messages to improve adolescent family communication and relationships. METHOD: A quasi-experimental design using a voluntary sample of 100 Nicaraguan youth at high risk for poor family communication participated. Pre- and posttest quantitative measures using Student t statistical analysis, a focus group, and a participant testimony provided the evaluation evidence. RESULTS: Findings suggest that there are economic and motivational barriers to the use of text messages, but when barriers are eliminated, the behavioral results are positive. Youth who received two weekly text messages over a 6-month period demonstrated statistically significant improvements in family communication perceptions, attitudes, and behaviors, strengthening their family communications and relationships. CONCLUSION: Brief and personalized text messaging "cues to action" may be a cost-effective intervention to improve adolescent healthy lifestyle behaviors.