Texting 4 Sexual Health: Improving Attitudes, Intention, and Behavior Among American Indian and Alaska Native Youth

Patricia Yao, Rongwei Fu, Stephanie Craig Rushing, David Stephens, Joan S. Ash, Karen B. Eden

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Purpose. To design and test the effectiveness of a text messaging intervention to promote condom use and STI/HIV testing among American Indian and Alaska Native youth. Method. A total of 408 study participants, 15 to 24 years old, were recruited, consented, surveyed, were sent intervention messages, and were incentivized via text message over a 9-month period. Complete pre- and postsurvey data were collected from 192 participants using SMS short codes. A mixed-effects logistic regression model was used to analyze before–after change in responses assessing sexual health knowledge, attitude, self-efficacy, intention, and behavior. Results. Participants’ condom use attitude, condom use behavior, and STI/HIV testing intention improved after the intervention (p <.05). Frequent condom use increased from 30% to 42% and was retained by participants at least 3 months postintervention, and the intervention improved participants’ intention to get tested for STI/HIV after changing sexual partners, increasing from 46% to 58% postintervention. Conclusions. Given the widespread use of cell phones by youth, text-based interventions may offer a feasible and effective tool to promote condom use and STI/HIV testing.

Original languageEnglish (US)
Pages (from-to)833-843
Number of pages11
JournalHealth promotion practice
Issue number6
StatePublished - Nov 1 2018


  • American Indian
  • adolescent
  • before–after design
  • mobile health
  • sexual health
  • text messaging intervention

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing (miscellaneous)


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