Abstract
Study Objective
Depressed young women are at increased risk for adverse outcomes related to sexual
behavior, including unintended pregnancy, HIV, and other sexually transmitted infections.
Brief sexual risk reduction interventions have not targeted depressed young women's
specific needs for affect management and impulse control.
Design, Setting, Participants, Interventions, and Main Outcome Measures
We interviewed depressed young women ages 15-23 years engaging in sexual risk behavior
about a proposed intervention approach. The approach was described as in-person counseling
and cognitive-behavioral skills training, followed by an ecological momentary intervention
(EMI) delivered via smartphone application for 4 weeks. The EMI would include reporting
multiple times a day on affective states, self-efficacy for safer sex behavior, and
sexual behavior, and receiving responsive messages to provide support and prompt use
of cognitive-behavioral skills. Participants provided their perspectives on comfort,
usability, burden, confidentiality, and potential efficacy of the EMI and recommended
message content. Interviews were audio-recorded, transcribed, and analyzed using thematic
analysis.
Results
Thematic saturation was reached with 16 interviews. Participants expressed positive
opinions about the EMI. They believed that reporting at random times would help them
to recognize their feelings, receiving the messages would be reassuring, and overall
the smartphone application would be experienced as therapeutic. They desired a high
degree of personalization of the message quality, style, and voice, and provided a
wide variety of message content.
Conclusion
Depressed young women believed that a flexible, personalized approach to mobile momentary
intervention for addressing the link between their symptoms and behavior would be
acceptable, supportive, and effective in reducing sexual risk.
Key Words
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Article info
Publication history
Published online: August 27, 2016
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
© 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
