A sex risk reduction text-message program for young adult females discharged from the emergency department

J Adolesc Health. 2013 Sep;53(3):387-93. doi: 10.1016/j.jadohealth.2013.04.006. Epub 2013 May 23.


Purpose: To pilot test a text message (SMS) sex risk reduction program among at-risk young adult female patients discharged from an emergency department (ED).

Methods: A convenience sample of 52 female patients with hazardous drinking behavior and recent risky sexual encounters were recruited from an urban ED and randomized to the SMS program (n = 23) or a control group (n = 29). All participants completed a web-based questionnaire in the ED and at 3-month follow-up. For 12 weeks, SMS participants were asked to report whether they had a risky sexual encounter in the past week, received theory-based feedback, and were asked if they were willing set a goal to refrain from having another risky encounter.

Results: Thirty-nine percent of SMS participants completed all weeks of SMS reports, and noncompletion increasing from 12% on week 1 to a 33% by week 12. Three-month follow-up was completed in 56% of participants. In the intervention group, there was an increase in the proportion with condom use with last vaginal sex from 20% (95% CI 4%-48%) to 53% (95% CI 27%-79%) and an increase in always condom use over the past 28 days from 0% (95% CI 0%-22%) to 33% (95% CI 12%-62%). These changes were not statistically different from control participants.

Conclusions: SMS programs may be useful to reduce risk for sexually transmitted diseases among at-risk young adults being discharged from the ED. Future trials should examine ways to improve adherence to SMS dialog over time and measure objective outcomes in a larger sample.

Keywords: Health promotion; Sexual health; Text messaging; Young adult.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Emergency Service, Hospital
  • Female
  • Health Promotion / methods*
  • Humans
  • Patient Discharge
  • Pennsylvania
  • Pilot Projects
  • Risk Reduction Behavior
  • Sexually Transmitted Diseases / prevention & control*
  • Surveys and Questionnaires
  • Text Messaging*
  • Urban Population