There rise in support of the use of online and electronic communication to increase health knowledge, particularly among young adults. Younger groups tend to use the internet as a means to obtain sexual health communication, thus offering the potential to address the knowledge gap of screening and treatment for STI/HIV (Bull, Levine, Black, Schmiege, & Santelli, 2012; Moorhead et al., 2013;Park and Calamaro, 2013). Educational programs have been associated with increased HIV/STI testing and decreased sexual risk taking(Anderson and Tracey, 2001; Bull et al., 2012; Busch, Van Stel, Schrijvers, & de Leeuw, 2013; Hu, Dodd, Oliverio, & Cook, 2014),but youth report that sexual health education in schools is uncoordinated and inconsistent(Elia and Eliason, 2010)Young adults often seek sexual health information on the internet(Rideout, Foehr, & Roberts, 2010)but websites containing technically complex information and controversial topics are most likely to be inaccurate(Buhi et al., 2010)and finding local resources such as clinics or testing sites can be particularly difficult and time consuming(Buhi et al., 2010).
To address this gap, use of text messaging, social media, and email health interventions has successfully promoted young adult health specific to sexual health, including a potent method for providing private appointment(Chen, Fang, Chen, & Dai, 2008; Free et al., 2013)and medication reminders,health tips, andlinks to testing sites and other resources(Divecha, Divney, Ickovics, & Kershaw, 2012).Chlamydia education campaigns have increased testing rates by as much as 28% while also saving up to 46 hours of monthly staff time by sending test result notifications via text message(Menon-Johansson, McNaught, Mandalia, & Sullivan, 2006). Clinical use of electronic messaging has also decreased time between STI diagnosis and treatment(Menon-Johansson et al., 2006), and increased likelihood that patients return for all doses of the HPV vaccine(Kharbanda et al., 2011).A meta-analysis of 12 technology-based HIV prevention interventions found that information delivered electronically had a statistically significant effect on increasing condom use that was similar in efficacy to more traditional human-delivered interventions(Head, Noar, Iannarino, & Harrington, 2013; Noar, Black, & Pierce, 2009)
Patients receiving educational text messages about sexual health typically found them to be entertaining and informative, and often shared them with others(Gold et al., 2011).Those with secure email via electronic health records (EHRs) felt that it enhanced the quality of careand led to asking a question they wouldn’t otherwise have asked (Head et al., 2013; Noar et al., 2009).Further, among patients with EHRs,
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