Background: Adolescents frequently report barriers to obtaining sexual health education. Purpose: The purpose of this study was to determine adolescents' views regarding how new technologies could be used for sexual health education. Methods: Focus group interviews were conducted with a purposeful sample of adolescents between 14 and 19 years old. Facilitators asked participants for their views regarding use of social networking web sites (SNSs) and text messaging for sexual health education. Tape-recorded data were transcribed; transcripts were manually evaluated then discussed to determine thematic consensus. Results: Twenty-nine adolescents (65.5% female) participated in five focus groups. Three themes emerged from our data. First, adolescents preferred sexual health education resources that are accessible. Second, adolescents preferred online resources that are trustworthy. Third, adolescents discussed preference for "safe" resources. Discussion: Adolescents were enthusiastic and insightful regarding technology for enhancing sexual health education. The themes that influence adolescents' preferences in sexual health education using technology are similar to barriers that exist in other aspects of adolescent health communication. Translation to Health Education Practice: Findings suggest ways in which health organizations can understand adolescents' views and concerns about how their interactions with professionals take place regarding sexual health.
Sexual behavior among adolescents presents major public health concerns. In 2007, 47.8% of adolescents reported ever being sexually active, (1) with 35% reporting sexual activity in the last three months. (2) The adolescent birth rate rose 5% from 2005 to 2007 after 14 years of decline and dropped only 2% the following year; (3) rates of sexually transmitted infections (STIs) have also been steadily increasing in adolescents. (4)
Many comprehensive sex education programs have been shown to increase adolescents' knowledge and use of contraception, and some have reduced pregnancy and STI transmission. (5-7) Despite successes in decreasing sexual activity and increasing condom use among adolescents, (1,8) the continued high prevalence of adolescent pregnancy and STIs indicate that further educational efforts are necessary. Many interventions to educate adolescents about pregnancy and STI prevention have been set in the school classroom. The explosion of electronic technology may present new opportunities to provide sexual health education to adolescents. These technologies are particularly compelling given adolescents' access to them; adolescents report almost universal access to the Internet either at home or school. (9,10) Two popular technologies among adolescents are social networking sites (SNSs) and text messaging.
A social networking site (SNS) is defined as "an online place where a user can create a profile and build a personal network that connects him or her to other users." (11) SNSs, such as MySpace and Facebook, are extremely popular among American adolescents, approximately 73% of adolescents report use of at least one SNS. (12)
Text messaging is another commonly used form of technology among adolescents. At present, 75% of adolescents own a mobile phone and 88% of those adolescents use the text messaging function. (13) Adolescents who use text messaging send and receive an average of 1,500 texts per month, though about 14% of texting teens send and receive over 6,000 texts monthly. (13)
The use of these forms of technology for patient communication has been studied in several aspects of health care. Social support sites for patients with chronic disease are increasingly the object of research, (14,15) while text messaging has been shown to be promising when communicating with patients about chronic illnesses such as asthma (16) and diabetes, (17,18) or providing online applications such as appointment reminders. …