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Using Text Messaging to Connect At-Risk Youth to Testing
BAYVIEW HUNTERS POINT
• TOTAL POPULATION=35,890 (SAN FRANCISCO
FOUNDATION, 2010)
• ONE OF THE LARGEST NEIGHBORHOODS THAT
COMPRISE D10
• AVERAGE PER CAPITA INCOME=$19,484 VS.
$26,880 DISTRICT-WIDE AND $44,373 CITY-WIDE
• GREATER THAN 50% OF RESIDENTS HAVE AN
EDUCATIONAL LEVEL OF HIGH SCHOOL OR LESS
UNIQUE PROBLEMS WE FACE
• SUPERFUND SITE: HIGHEST RATES OF CHRONIC
DISEASES (I.E. ASTHMA, DIABETES AND CANCER)
• HIGHEST RATES OF ARRESTS AND INCARCERATION
IN SF
• HIGHER UNEMPLOYMENT RATES
• HIGHER RATES OF STDS IN BOTH ADULTS AND
YOUTH
• INCREASED EXPOSURE TO TRAUMA
ADOLESCENTS…
HOW DO WE CONNECT WITH YOUTH?
DO THEY WANT TO ATTEND GROUPS OR COME TO
THERAPY?
ADOLESCENT COMMUNICATION
PREFERENCES
TEXT MESSAGE INTERVENTIONS
• INDICATIONS OF SUCCESS: ASTHMA
MANAGEMENT, WEIGHT LOSS, MEDICATION
ADHERENCE, DIABETES MANAGEMENT, SMOKING
CESSATION
• DISEASE MANAGEMENT, DISEASE PREVENTION
• PROVIDE INFORMATION
• REMINDERS
OUTCOMES
• GREATER HIV KNOWLEDGE
• IMPROVED CONDOM ATTITUDES
• INCREASED PERCEIVED HIV RISK SCORE
• TREND IN NUMBER ENGAGED IN UNPROTECTED SEXUAL INTERCOURSE
WHY SCREEN?
STUDY DESIGN
CLINIC DATA
TEXTING DATA
• APPROACHED: 153
• REFUSED: 28 (18%)
• INELIGIBLE: 25 (16%)
• CONSENTED: 100
• SENT TEXT: 97
• 5 TEXTS
79
• 5+ TEXTS: 18
• POST-TEST: 88
EXAMPLE TEXTS
• HEY YOU GUYS THIS __, DID YOU KNOW THIRD ST YOUTH CLINIC IS NOW LOCATED ON
1728 BANCROFTS AVE. RIGHT AROUND THE CORNER FROM WINGSTOP
• HEY GIRL THIS _____________ WEN U CUM BCK FRM TEXAS HERE AT THE CLINIC ON
3RD U SHULD STP BI THEY HAV GUD CLASSES N PROGRAM N ULL FEL LYK HOME
• COME TO THE THIRD ST YOUTH CLINIC FOR STD CHECK
• HEY. SO I'M AT THE CLINIC AND I'M GONNA GET TESTED. YOU SHOULD COME GET
CHECKED TOO. I'LL COME WITH YOU IF YOU WANT. IT'S OVER ON 3RD NEXT TO THE NEW
WINGSTOP.
• HEY I'M AT THE THIRD STREET CLINIC IT'S A GOOD IDEA TO GET CHECKED OUT
• I JUST GOT CHECKED OUT AT THE 3RD ST CLINIC AND THEY WERE REALLY NICE THEY
OFFER FREE TESTING AND HELPED ME A LOT, YOU SHOULD COME DOWN TOO.
CONCERNS
• NOTHING (N=55)
• RESPONSE FROM FRIEND (N=17)
• OTHER (N=28)
• THAT FRIENDS WOULD REMEMBER
• THEY WON’T TAKE MY ADVICE
• NOT AGREE TO GO TO CLINIC
• THINK I HAVE SOMETHING
• TOO MANY PEOPLE CALL CLINIC PHONE
•“ARE YOU OK”
•“ARE YOU FINNA BE A DADDY?
•“LOL. WHAT? THAT WAS HECCA RANDOM”
•“LMFAO. NICE. OKAY WELL WHEN I GET HOME”
•“OK!! LET ME CHECK IT RIGHT OUT”
•“FA SHO. WHAT TIME IT ENDS? I GET OUT @ 4”
•“I JUST GOT CHECK, THAT SHIT AIN’T NOTHING TO BE PLAYED WITH”
•“BITCH WHAT YOU TELLING ME FOR? I GO TO MY DR. EVERY 3 MONTHS FOR THE
•FREE AND I DAMN SHO AINT GOT HIV”
RESPONSES
NUMBER OF PATIENTS
STI TESTS
POSITIVE STI
HIV TESTING
CONCLUSIONS & LESSONS LEARNED
• GET RID OF SMALL GROUP INTERVENTIONS?
• TRADE OFFS: INTENSITY VS. REACH
• BEHAVIOR CHANGE MODELS STILL HOLD
• USE THE STRENGTHS OF TECHNOLOGY
• DON’T FORGET THE SCIENCE
• DANGERS?
• OPPORTUNITIES
THANK YOU
Dr. Marguerita Lightfoot
Dr. Ayanna Bennett
National Institute of Drug Abuse
National Institute of Mental Health
William T. Grant Foundation
MAC Foundation
Research Team
Agencies, schools, providers
3rd Street Youth Center & Clinic
Youth willing to share their lives

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Using Text Messaging to Connect At-Risk Youth to Testing

  • 2. BAYVIEW HUNTERS POINT • TOTAL POPULATION=35,890 (SAN FRANCISCO FOUNDATION, 2010) • ONE OF THE LARGEST NEIGHBORHOODS THAT COMPRISE D10 • AVERAGE PER CAPITA INCOME=$19,484 VS. $26,880 DISTRICT-WIDE AND $44,373 CITY-WIDE • GREATER THAN 50% OF RESIDENTS HAVE AN EDUCATIONAL LEVEL OF HIGH SCHOOL OR LESS
  • 3. UNIQUE PROBLEMS WE FACE • SUPERFUND SITE: HIGHEST RATES OF CHRONIC DISEASES (I.E. ASTHMA, DIABETES AND CANCER) • HIGHEST RATES OF ARRESTS AND INCARCERATION IN SF • HIGHER UNEMPLOYMENT RATES • HIGHER RATES OF STDS IN BOTH ADULTS AND YOUTH • INCREASED EXPOSURE TO TRAUMA
  • 4. ADOLESCENTS… HOW DO WE CONNECT WITH YOUTH? DO THEY WANT TO ATTEND GROUPS OR COME TO THERAPY?
  • 6. TEXT MESSAGE INTERVENTIONS • INDICATIONS OF SUCCESS: ASTHMA MANAGEMENT, WEIGHT LOSS, MEDICATION ADHERENCE, DIABETES MANAGEMENT, SMOKING CESSATION • DISEASE MANAGEMENT, DISEASE PREVENTION • PROVIDE INFORMATION • REMINDERS
  • 7. OUTCOMES • GREATER HIV KNOWLEDGE • IMPROVED CONDOM ATTITUDES • INCREASED PERCEIVED HIV RISK SCORE • TREND IN NUMBER ENGAGED IN UNPROTECTED SEXUAL INTERCOURSE
  • 11. TEXTING DATA • APPROACHED: 153 • REFUSED: 28 (18%) • INELIGIBLE: 25 (16%) • CONSENTED: 100 • SENT TEXT: 97 • 5 TEXTS 79 • 5+ TEXTS: 18 • POST-TEST: 88
  • 12. EXAMPLE TEXTS • HEY YOU GUYS THIS __, DID YOU KNOW THIRD ST YOUTH CLINIC IS NOW LOCATED ON 1728 BANCROFTS AVE. RIGHT AROUND THE CORNER FROM WINGSTOP • HEY GIRL THIS _____________ WEN U CUM BCK FRM TEXAS HERE AT THE CLINIC ON 3RD U SHULD STP BI THEY HAV GUD CLASSES N PROGRAM N ULL FEL LYK HOME • COME TO THE THIRD ST YOUTH CLINIC FOR STD CHECK • HEY. SO I'M AT THE CLINIC AND I'M GONNA GET TESTED. YOU SHOULD COME GET CHECKED TOO. I'LL COME WITH YOU IF YOU WANT. IT'S OVER ON 3RD NEXT TO THE NEW WINGSTOP. • HEY I'M AT THE THIRD STREET CLINIC IT'S A GOOD IDEA TO GET CHECKED OUT • I JUST GOT CHECKED OUT AT THE 3RD ST CLINIC AND THEY WERE REALLY NICE THEY OFFER FREE TESTING AND HELPED ME A LOT, YOU SHOULD COME DOWN TOO.
  • 13. CONCERNS • NOTHING (N=55) • RESPONSE FROM FRIEND (N=17) • OTHER (N=28) • THAT FRIENDS WOULD REMEMBER • THEY WON’T TAKE MY ADVICE • NOT AGREE TO GO TO CLINIC • THINK I HAVE SOMETHING • TOO MANY PEOPLE CALL CLINIC PHONE
  • 14. •“ARE YOU OK” •“ARE YOU FINNA BE A DADDY? •“LOL. WHAT? THAT WAS HECCA RANDOM” •“LMFAO. NICE. OKAY WELL WHEN I GET HOME” •“OK!! LET ME CHECK IT RIGHT OUT” •“FA SHO. WHAT TIME IT ENDS? I GET OUT @ 4” •“I JUST GOT CHECK, THAT SHIT AIN’T NOTHING TO BE PLAYED WITH” •“BITCH WHAT YOU TELLING ME FOR? I GO TO MY DR. EVERY 3 MONTHS FOR THE •FREE AND I DAMN SHO AINT GOT HIV” RESPONSES
  • 19. CONCLUSIONS & LESSONS LEARNED • GET RID OF SMALL GROUP INTERVENTIONS? • TRADE OFFS: INTENSITY VS. REACH • BEHAVIOR CHANGE MODELS STILL HOLD • USE THE STRENGTHS OF TECHNOLOGY • DON’T FORGET THE SCIENCE • DANGERS? • OPPORTUNITIES
  • 20. THANK YOU Dr. Marguerita Lightfoot Dr. Ayanna Bennett National Institute of Drug Abuse National Institute of Mental Health William T. Grant Foundation MAC Foundation Research Team Agencies, schools, providers 3rd Street Youth Center & Clinic Youth willing to share their lives