Health‐E You/Salud iTu: Pre-visit mobile health app for male adolescents to promote adolescent‐centered sexual & reproductive healthcare receipt

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ABSTRACT While preventive care guidance recommends primary care providers deliver sexual and reproductive health (SRH) care to male adolescents (ages 12 and older), males’ SRH care receipt is poor. Clinic-based interventions can be valuable SRH promotion tools for adolescents. However, they have mainly focused on pregnancy prevention for females, single topics (STIs, HIV) rather than the recommended SRH care package, or specific male groups (e.g., men who have sex with men) rather than inclusive of the diversity of males encompassing the full range of gender identities, sexual orientation, race/ethnicity, and risk behaviors. Computer-based approaches make it easier to consistently provide evidence-based SRH, in multiple languages, tailored to the diverse needs of all adolescents. Using such approaches before the clinic visit can also help overcome providers’ barriers, such as time constraints, to improve SRH care. Yet, we are not aware of any computer-based strategy to promote recommended SRH care for diverse groups of males. Neglecting males in evidence-based SRH care fails to meet their own needs, and compromises their partners’ health. Health-E You/Salud iTu is a pre-visit, individually tailored, interactive, web-based mobile intervention shown to improve contraceptive knowledge and use among adolescent females 6 months later and prime and extend providers’ ability to deliver individually tailored contraceptive care to female patients. We will adapt the current Health-E You for male adolescents to assess their SRH needs; provide interactive, individually tailored, evidence-based SRH information; support SRH decision-making and visit priorities; and support providers’ ability to individually tailor recommended SRH care. We will then evaluate its acceptability, usability, satisfaction, and efficacy on SRH care receipt and method use among diverse groups of male adolescents presenting for care at school-based health centers (SBHCs), by leveraging the infrastructure of a current PCORI-funded trial with 28 SBHCs in 11 states focused on assigned females sex at birth. It will also support providers in delivering the recommended SRH care package for males. In this R01 proposal, we propose to (1) adapt Health-E You as a pre-visit, individually tailored, interactive, SRH care tool for use with diverse groups of male adolescents employing a Youth-Centered Health Design Process with input from an advisory board of male adolescents and providers; (2) ensure its acceptability, usability, and satisfaction among male adolescent patients and providers in SBHCs using an iterative design approach; and (3) test its efficacy to improve sexually active male adolescent patients’ knowledge, self-efficacy, beliefs, and behaviors related to SRH care after the visit and method use 2 months later. The current proposal would be the first to examine the acceptability, usability, satisfaction, and efficacy of a pre-visit, computer-based intervention to engage sexually active male adolescent patients in SRH care and method use, where currently no such strategy exists.