Texting to Increase Contraceptive Initiation Among Adolescents in the Emergency Department

Abstract

PurposeTo evaluate the feasibility and acceptability of a text messaging intervention to increase contraception among adolescent emergency department patients. MethodsA pilot randomized controlled trial of sexually active females aged 14–19 receiving 3 months of theory-based, unidirectional educational and motivational texts providing reproductive health information versus standardized discharge instructions. Blinded assessors measured contraception initiation via telephone follow-up and health record review at 3 months. ResultsWe randomized 100 eligible participants (predominantly aged 18–19, Hispanic, and with a primary provider); 88.0% had follow-up. In the intervention arm, 3/50 (6.0%) participants opted out, and 1,172/1,654 (70.9%) texts were successfully delivered; over 90% of message failures were from one mobile carrier. Most (36/41; 87.7%) in the intervention group liked and wanted future reproductive health messages. Contraception was initiated in 6/50 (12.0%) in the intervention arm and in 11/49 (22.4%) in the control arm. ConclusionsA pregnancy prevention texting intervention was feasible and acceptable among adolescent females in the emergency department setting.