J Adolesc Health. 2017 Oct 19. pii: S1054-139X(17)30404-4. doi: 10.1016/j.jadohealth.2017.07.021.

Texting to increase contraceptive initiation among adolescents in the emergency department

Chernick LS, Stockwell MS, Wu M, Castaño PM, Schnall R, Westhoff CL, Santelli J and Dayan PS


Purpose: To evaluate the feasibility and acceptability of a text messaging intervention to increase contraception among adolescent emergency department patients.

Methods: A pilot randomized controlled trial of sexually active females aged 14-19 receiving 3 months of theory-based, unidirectional educational and motivational texts providing reproductive health information versus standardized discharge instructions. Blinded assessors measured contraception initiation via telephone follow-up and health record review at 3 months.

Results: We randomized 100 eligible participants (predominantly aged 18-19, Hispanic, and with a primary provider); 88.0% had follow-up. In the intervention arm, 3/50 (6.0%) participants opted out, and 1,172/1,654 (70.9%) texts were successfully delivered; over 90% of message failures were from one mobile carrier. Most (36/41; 87.7%) in the intervention group liked and wanted future reproductive health messages. Contraception was initiated in 6/50 (12.0%) in the intervention arm and in 11/49 (22.4%) in the control arm.

Conclusion: A pregnancy prevention texting intervention was feasible and acceptable among adolescent females in the emergency department setting.

Comment: Adolescents use their mobile phone for everything and this paper shows how mobile phones can be used as a vehicle for reproductive health information, increasing the effective use of contraceptives (HMV).