BACKGROUND
Research suggests that lesbian and bisexual girls are between two and four times more likely to report having been pregnant than girls who identify as exclusively heterosexual. Despite this compelling evidence that sexual minority adolescent girls are at risk for teen pregnancy, programs tailored to the unique needs of LGB adolescents are nonexistent.
OBJECTIVE
Research suggests that lesbian and bisexual girls are between two and four times more likely to report having been pregnant than girls who identify as exclusively heterosexual. Despite this compelling evidence that sexual minority adolescent girls are at risk for teen pregnancy, programs tailored to the unique needs of LGB adolescents are nonexistent.
METHODS
Over a 12-month period between 2015 and 2016, three different formative activities were implemented to develop and refine the prevention program. Participants were 14-18 year-old cisgender females recruited nationally on Facebook and Instagram. First, focus groups (FGs) were conducted to gain teens’ ‘voice’ about how they talked about sexual situations (n=160). Next, content advisory teams (CATs) were convened to iteratively review a draft of the intervention messages and provide feedback on their tone, saliency, and understandability (n=82). Finally, once the content and assessments were finalized, a beta test was conducted to confirm the program functionality, the feasibility of the assessments, and the enrollment protocol (n=27).
RESULTS
Girls in the FGs were overwhelmingly positive about the idea of receiving text messages about sexual health, although privacy was a noteworthy concern. As such, important safe guards were built into the enrollment process (e.g., the provision of how-to guides to safe-guard one’s phone). Teens in the CATs found the content to be approachable, salient, and educational although many wanted the messages to be more gender inclusive. Messages were thusly updated to not assume people with penises were boys. Once the messages and study protocol were finalized, a beta test was conducted. None of the participants withdrew during the six-week intervention and between 71-86% provided weekly feedback, suggesting both the protocol and content were feasible to test at the national level in a subsequent RCT.
CONCLUSIONS
This careful step-by-step iterative approach resulted in a high level of feasibility and acceptability, with all randomized beta test participants successfully completing the program. Developed and refined with the input of diverse sexual minority adolescent girls from across the United States, Girl2Girl program is a promising approach to addressing sexual health and pregnancy prevention in this underserved but vulnerable population.
CLINICALTRIAL
NCT03029962
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