Erin Wright of the mHealth Impact Laboratory at the Colorado School of Public Health, provides an overview of Just/Us, a study to analyze the impact of social networking sites to effectively support healthy sexual behavior for young people. Presented at YTH Live 2014 session "Social Media for Sexual Health Outreach."

1. Using Social Media to Support Youth
Healthy Sexual Behavior
Erin Wright, MA
mHealth Impact Laboratory, Colorado School of Public Health
April 6-8, 2014
San Francisco, CA
Annual Conference on Youth + Tech + Health

2. • Social networking sites may be effective venues
for health education interventions, although likely
more effective and more sustainable in
conjunction with other programs.
• Engagement on these sites is an important part
of the intervention; however, it is not yet well
understood.
• Determining whether projects that aim to support
healthy behavior actually have an impact on the
population's health is critical.
Learning Objectives

3. Just/Us: Online social networking for HIV
prevention (NINR R01NR010492)
– To explore, identify and compare strategies
for recruitment and enrollment of networks of
online social networking users.
– To explore, identify and compare strategies
for engagement of social networking users
with sexual health content online
Case Study :: Just/Us (2007-2011)

4. To set up Just/Us pages on Facebook, as
places for participants to interact about
sexual health topics.
– Games, video, blogging, threaded
discussions and quizzes, all about sexual
health.
To explore efficacy of Just/Us in
changing risky sexual behaviors
Just/Us :: Goals

5. – Used a modified respondent driven sampling
approach for seed recruitment
– All “seeds” recruited by staff ; seeds then
referred friends
Just/Us :: Methods

6. Just/Us :: Methods

7. - Seeds and all the friends they referred were
assigned together at random to either the
intervention (Just/Us) or control (18-24 news)
- At the time of enrollment, participants completed
an online informed consent and baseline risk
assessment
- Participants exposed to content for eight weeks
- At the end of eight weeks, a follow-up
assessment and no more new content
- Final assessment at six months
Just/Us :: Methods

9. Primary Outcomes:
– Risk behaviors
• Condom use last sex
• Proportion of protected sex acts
• Partner concurrency
Just/Us :: Methods

10. Just/Us :: Results (at 8 weeks)

11. Of the 653 participants who completed a two-
month follow-up survey:
– 53% looked at our Just/Us Facebook page 4-6
times per week (96% were women)
– 94% of the comments were positive regarding the
project
– People were seeing materials even if they were
not actively going to our page
(only 10% did this).
Just/Us :: Engagement

12. Positive Responses:
“I feel that it’s a good way to stay informed on sex. It’s a little
reminder for those who are in sexual relationship(s) to remind
them to strap it up.”
“Interesting…ya don’t make it awkward.”
“It’s really interesting, I’ve been paying attention to your posts and
a video that I saw. If people actually paid more attention to Just/
Us, they might actually learn more than what they think they
know.”
“I like the daily reminders the project posts.”
Just/Us :: Engagement

13. Negative Responses:
“The people that are looking at the page are the people that
already have the facts and are getting tested and taking proper
care to avoid STDs and pregnancy.”
“Your messages are kind awkward sometimes when I am sitting in
my school’s public library and everyone can see…”
“Not really sure what it’s driving at / what you hope to
accomplish.”
“Honestly, I’m just doing it because my friend
told me to.”
Just/Us :: Engagement

14. • Whether online or offline, working prospectively with
networks is feasible for prevention
• Social media lends itself to working with networks
• We still need to understand
• How to identify the best “seeds”
• How to get content in front of seeds and their networks
• What content is most effective in engaging our
audiences
• How to maximize the medium—linkages
to clinical care and social services?
Just/Us :: Implications

15. We must continue to research and build the
evidence base of best practices that
motivate youth, engage them, and identify
which components best support them to
practice healthy behavior.
Just/Us :: Implications

16. 90% of young adults ages
18-29 use one or more social
networking sites
• Pew Internet & American Life
Project, 2013
Rise of Social Networks & Cell Phones
• 98% of adults ages 18-29
own a cell phone
• 83% of these are smart
phones
• Pew Internet & American
Life Project, 2014

17. MISSION
To maximize mobile and social technology to
improve the health of populations.
VISION
A community of scientists, technology
developers, community practitioners, and
business committed to effectively using
technology to promote improved health
outcomes.
mHealth Impact Laboratory,
Colorado School of Public Health

18. WHY?
• Tech developers and startups create apps but rarely if ever test
them for effectiveness in changing behaviors or improving health.
• Academic researchers evaluate mHealth applications, but
processes are slow, and may render an app obsolete by the time
they show it works.
Knowing whether your program actually works to create change
with end users or customers helps ensure:
• Your program or product can be sustained in the long term;
• You maximize your marketability;
• You are actually changing behavior and improving health.
mHealth Impact Laboratory,
Colorado School of Public Health

19. Our Services
• Consultation on app content, messages and implementation plan
• Access to and engagement with end users to react to ideas,
prototype and pilot apps
• Analysis of qualitative and quantitative data to support user
acceptability of, ease of use and effectiveness of apps
We Provide
• Access to end user populations to react to and pilot programs and
products
• Feedback on app ideas and prototypes
• Preliminary data to indicate the potential for your end
users / customers to make changes in behavior and
have improved health
mHealth Impact Laboratory,
Colorado School of Public Health

20. Erin Wright
erin.wright@ucdenver.edu
@ColoradoSPH