Enhancing Wellbeing of Adolescents via Persuasive eHealth Technology in ePublic Sexual Health

Background: Nowadays adolescents primarily use modern, often web-based technology, such as social media and mobile applications to find the answers on all kinds of questions about their health and healthcare services (Kulyk et al., 2013; van Velsen et al., 2013). National program Sense in the Netherlands provides free public counselling young adults under 25 years and aims at supporting their sexual health. Current program consist of the national website, chat & email services as well as face-to-face consultations and the regional Municipal Health Services. Evaluations among the high-risk adolescents show that the use of the existing tools and services is limited due to the lack of awareness of this free health service and the lack of anonymity. In addition, high-risk adolescents with low education and immigrants have special needs. In order to provide optimal healthcare services for high-risk and hard to reach adolescents, it is important to actively involve youth as potential clients as well as sexual care providers throughout the whole design process of new technology and services. Topic: Assistive technologies for cognitive support and wellbeing Objective: The purpose of the Sense eHealth project is to optimize and enhance existing public sexual health counselling services with eHealth technology and social media, as well as to find new forms of eHealth services for hard to reach and high-risks adolescents. This research focuses on finding out which design elements in various modern forms of eHealth technology actually motivate high-risk adolescents? The optimal goal is to promote healthier lifestyle by increasing awareness among high-risk and hard to reach adolescents with various cultural backgrounds. Methods: A holistic eHealth approach, namely the CeHRes roadmap is used to identify how sexual health can be improved from the perspective of adolescents and different stakeholders, such as public health care professionals, youth experts and non-governmental organizations. The results presented on this poster focus on the contextual inquiry and value specifications phases, which investigate current practices, needs and expectations for enriching sexual healthcare services via eHealth technology and social media. The main stakeholders and users are adolescents and various public healthcare providers. Nine semi-structured interviews, six focus groups and field observations were conducted with 55 participants. High risk adolescents, sexual care professionals, youth experts as well as designers and technology developers participated in the study. High risk adolescents in focus groups were discussing their impressions and opinions about the existing Sense media, such as a serious game, Facebook page, mobile application and a promotion movie via Youtube. Participants were also asked their opinion about the new design ideas, such as personal virtual coach and a serious game on Facebook. An interview protocol and a demographic questionnaire were used. All interview sessions as well as focus groups were audio recorded with participants’ permission. During the data analysis, audio files were fully transcribed, analysed, coded and categorized. In order to validate the coding and avoid bias, two randomly selected audio recordings were also coded and compared by the second coder. In addition, additional analysis was performed on the influence of specific persuasive factors (Oinas-Kukkonen and Harjumaa, 2008) on the use of the various forms of new media. Results: Young adults are positive towards the use of new forms of eHealth technology for raising awareness about the public sexual care services. Trust in the provided information, anonymity, interactivity and entertaining fun elements are important defining factors for using the new forms of eHealth. Social media are widely used by adolescents and well suited as a promotion channel for the efficient distribution of public eHealth services like Sense to a broad and high-risk group. Due to the lack of anonymity in social networks, they are less suitable for offering support on the sexual domain. Adolescents give preference to mobile versus internet applications due to the anonymity, higher privacy and low-threshold. Combining various advantages of interactive media and social networks in a new anonymous applications on a private platform has a lot of potential in reaching the high-risk adolescents with information on public health services, health lifestyle and wellbeing. The results suggest a stepped blended care approach that is tailored to meet the needs of various user profiles with various types of sexual health questions. Conclusions: The integration of web based eHealth services like chat, mobile application, email, website with the traditional face-to-face counselling can provide easier access to low-threshold sexual health counselling on-demand for adolescents. The broad range of sexual care services not only promises to increase awareness of various sexual health services among hard to reach high-risk adolescents, but also offers a more cost effective way to provide optimally suited care for every individual client.