title: Enhancing a Teen Pregnancy Prevention Program with text messaging: engaging minority youth to develop TOP ® Plus Text.
abstract: OBJECTIVE
  To develop and pilot a theory-based, mobile phone texting component attractive to minority youth as a supplement to the Teen Outreach Program(®), a youth development program for reducing teen pregnancy and school dropout.
  
  
  METHODS
  We conducted iterative formative research with minority youth in multiple focus groups to explore interest in texting and reaction to text messages. We piloted a month-long version of TOP(®) Plus Text with 96 teens at four sites and conducted a computer-based survey immediately after enrollment and at the end of the pilot that collected information about teens' values, social support, self-efficacy, and behaviors relating to school performance, trouble with the law, and sexual activity. After each of the first three weekly sessions we collected satisfaction measures. Upon completion of the pilot we conducted exit interviews with twelve purposively selected pilot participants.
  
  
  RESULTS
  We successfully recruited and enrolled minority youth into the pilot. Teens were enthusiastic about text messages complementing TOP(®). Results also revealed barriers: access to text-capable mobile phones, retention as measured by completion of the post-pilot survey, and a need to be attentive to teen literacy.
  
  
  CONCLUSIONS
  Piloting helped identify improvements for implementation including offering text messages through multiple platforms so youth without access to a mobile phone could receive messages; rewording texts to allow youth to express opinions without feeling judged; and collecting multiple types of contact information to improve follow-up. Thoughtful attention to social and behavioral theory and investment in iterative formative research with extensive consultation with teens can lead to an engaging texting curriculum that enhances and complements TOP(®).
authors.affiliation: University of Colorado Denver, Denver, Colorado. Electronic address: sharon.devine@ucdenver.edu.
authors.forename: Sharon
authors.initials: S
authors.lastname: Devine
authors.affiliation: Colorado School of Public Health, Aurora, Colorado.
authors.forename: Sheana
authors.initials: S
authors.lastname: Bull
authors.affiliation: University of Colorado Denver, Denver, Colorado.
authors.forename: Susan
authors.initials: S
authors.lastname: Dreisbach
authors.affiliation: Denver Public Health, Denver Health and Hospital Authority, Denver, Colorado.
authors.forename: Judith
authors.initials: J
authors.lastname: Shlay
mesh_terms: D000293:Adolescent; D001741:Black or African American; D003120:Colorado; D003159:Community-Institutional Relations; D005260:Female; D017144:Focus Groups; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D054525:Minority Health; D010865:Pilot Projects; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D020377:Self Efficacy; D012944:Social Support; D012945:Social Values; D060145:Text Messaging
keywords: Adaptation; Health communication; Iterative formative research; Teen pregnancy; Text messaging