Texting intervention prevents teen pregnancy among lesbian and bisexual girls, finds study

A new texting intervention that University of British Columbia researchers helped develop is more effective at promoting healthy sexual decision-making and reducing pregnancies among sexual minority teens than most existing interventions in the U.S.

Girl2Girl, developed and tested by the Center for Innovative Public Health Research (CIPHR) in San Clemente, Calif., in partnership with UBC's Stigma and Resilience Among Vulnerable Youth Center, is the first texting-based intervention specifically aimed at lesbian and bisexual teens.

"For more than 30 years, research in the U.S., Canada, and other countries has shown lesbian and bisexual girls have higher risk for teen pregnancy than their heterosexual peers," said Dr. Michele Ybarra (she/her), executive director of CIPHR and lead author of the study.

"Yet existing sexual health education and teen pregnancy prevention programs haven't addressed their unique needs. Girl2Girl was designed to share the knowledge, motivation and skills they need to make safe and healthy decisions."

In a large randomized trial, outlined in a paper published today in Pediatrics, the intervention's positive effects on behaviors lasted 12 months or more. The trial included 948 cisgender lesbian and bisexual girls across the U.S. ages 14 to 18 from a diversity of backgrounds. The participants were randomized to receive either five weeks of text messages every day about sexual health information tailored to their needs, or five weeks of text messages about nutrition, exercise and other health promotion.

"Girl2Girl puts information literally in the palm of their hands," noted Dr. Ybarra. "It makes it more available to teens in rural and remote regions where sexual-health services might be limited, and it is tailored to the real-world knowledge that lesbian, bisexual and queer girls need that might not be covered in sex education."

The researchers found that those who received the tailored sexual-health information had increased use of condoms and contraception five months after starting the program—surpassing the outcomes of many teen-pregnancy prevention programs and most e-health interventions. More notably, researchers found that these healthy behaviors were sustained 12 months after completing the program.

"The follow-up for most e-health interventions and teen pregnancy prevention programs is pretty short," explained co-author Dr. Elizabeth Saewyc (she/her), UBC professor of nursing. "It's rare to have data for even six months after the program. But we followed girls a full 12 months after the intervention ended, and we saw continued positive health behaviors."

Although there were too few pregnancies during that time in the Girl2Girl and control groups to see statistically significant differences, the changes in behaviors leading to pregnancy offered promising evidence that this program helps long-term health behavior changes, Dr. Saewyc noted, adding that the intervention could benefit Canadian teens as well.

"Teen pregnancy is much lower in Canada than the U.S., but our research finds lesbian and bi girls are still at twice the risk as heterosexual girls. Other sexual health issues, such as sexually transmitted infections, remain a concern here in Canada," she said.

"Most young people in Canada have mobile phones, and an intervention that reaches them, and can be adapted to our Canadian context, can help ensure we close the gap in sexual health outcomes for all young people."