Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE (Open Access)

A quasi-experimental text messaging trial to improve adolescent sexual and reproductive health and smoking knowledge in Indonesia

Alisa E. Pedrana A B H , Jamie Pina C , Retna S. Padmawati D E , Ririh Zuhrina D , Lutfan Lazuardi F , Megan S. C. Lim A B G , Margaret E. Hellard A B G and Yayi S. Prabandari D E
+ Author Affiliations
- Author Affiliations

A Disease Elimination, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia.

B Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic. 3004, Australia.

C Public Health Informatics Program, RTI International, Waltham, MA 02452, USA.

D Department of Health Behavior, Environment Health and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogjakarta 55281, Indonesia.

E Center of Health Behavior and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia.

F SIMKES – Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogjakarta 55281, Indonesia.

G Melbourne School of Population and Global Health, University of Melbourne, Vic. 3010, Australia.

H Corresponding Author. Email: alisa.pedrana@burnet.edu.au

Sexual Health 17(2) 167-177 https://doi.org/10.1071/SH18199
Submitted: 23 November 2018  Accepted: 9 September 2019   Published: 5 February 2020

Journal Compilation © CSIRO 2020 Open Access CC BY-NC-ND

Abstract

Background: To evaluate the feasibility and acceptability of a text message intervention to improve young people’s knowledge of sexual reproductive health (SRH) and harms related to smoking in Indonesia. Methods: A quasi-experimental short message service (SMS) trial of young people aged 16–24 years receiving twice weekly SMS over a 10-week intervention period. Pre- and post-online demographic and risk behaviour surveys were used to assess changes in knowledge. Among respondents who completed both surveys, we assessed changes in knowledge before and after SMS intervention using paired McNemar’s test and differences in mean knowledge score using a paired t-test. Results: In total, 555 eligible young people were enrolled into the SMS intervention; 235 (42%) completed a follow-up survey, of which 198 (84%) were matched to a baseline survey. Median age of participants was 19 years and the majority were female (63%). The mean knowledge score significantly increased between baseline and follow-up surveys for SRH questions [2.7, (95% CI 2.47, 2.94) vs 3.4 (95% CI 2.99, 3.81) (P = <0.01)] and smoking-related questions [3.8 (95% CI 3.66, 3.99) vs 4.1 (95% CI 3.99, 4.28) (P = 0.03)]. A majority of participants reported that the SMS intervention increased their knowledge (95%) and were a useful reminder (95%). Conclusions: An SMS intervention was feasible, acceptable and improved adolescents’ SRH knowledge and smoking knowledge in a low- to middle-income setting. SMS interventions targeting young people need to be scaled up, with the potential to explore additional topics around healthy lifestyle, nutrition and physical activity.

Additional keywords: adolescent health, health promotion, mobile phone.


References

[1]  World Bank Group. Data: Indonesia [updated 2017, World Development Indicators database]. Washington, DC: World Bank; 2016. Available online at: https://data.worldbank.org/country/indonesia [verified 5 December 2017].

[2]  Ministry of Health Republic of Indonesia. Indonesian health profile 2015. Jakarta, Indonesia: Ministry of Health Republic of Indonesia; 2016.

[3]  Statistics Indonesia (Badan Pusat Statistik—BPS), National Population and Family Planning Board Ministry of Health (Kementerian Kesehatan), and ICF International. Indonesia Demographic and Health Survey 2012. Jakarta, Indonesia: BPS, BKKBN, Kemenkes, and ICF International; 2013.

[4]  Utomo ID, McDonald P. Adolescent reproductive health in Indonesia: contested values and policy inaction. Stud Fam Plann 2009; 40 133–46.
Adolescent reproductive health in Indonesia: contested values and policy inaction.Crossref | GoogleScholarGoogle Scholar | 19662805PubMed |

[5]  Utomo ID, McDonald P, Reimondos A, Hull T, Utomo A. Reproductive health services for single young adults. Canberra: Australian Demographic and Social Research Institute, Australian National University; 2012. Available online at: https://chr.ui.ac.id/wp-content/uploads/downloads/2013/06/policy_brief_5_rh_service.pdf [verified 30 November 2019].

[6]  Masyarakat PTIK, Kesehatan BLKD. Global School-based students Health Survey (GSHS). Jakarta, Indonesia: Centers for Disease Control and Prevention; 2015.

[7]  World Health Organization. Adolescent pregnancy situation in South-East Asia Region. New Delhi, India: World Health Organization, Regional Office for South-East Asia; 2014.

[8]  Kennedy E, Gray N, Azzopardi P, Creati M. Adolescent fertility and family planning in East Asia and the Pacific: a review of DHS reports. Reprod Health 2011; 8 11
Adolescent fertility and family planning in East Asia and the Pacific: a review of DHS reports.Crossref | GoogleScholarGoogle Scholar | 21545708PubMed |

[9]  Smith-Hefner N. Reproducing respectability: sex and sexuality among Muslim Javanese youth. RIMA 2006; 40 143–72.

[10]  Statistics Indonesia (Badan Pusat Statistik—BPS), National Population and Family Planning Board (BKKBN), Ministry of Health (Kemenkes), and ICF International. Indonesia Demographic and Health Survey 2012: adolescent reproductive health. Jakarta, Indonesia: BPS, BKKBN, Kemenkes, and ICF International; 2013. Available online at: https://dhsprogram.com/pubs/pdf/FR281/FR281.pdf [verified 30 November 2019].

[11]  World Bank. Indonesia – reproductive health at a glance (English). Washington, DC: World Bank; 2011. Available online at: http://documents.worldbank.org/curated/en/307911468050028819/Indonesia-Reproductive-health-at-a-glance [verified 30 November 2019].

[12]  Amnesty International. Left without a choice: barriers to reproductive health in Indonesia. London, UK: Amnesty International Publications; 2010.

[13]  Situmorang A. Staying single in a married world: never-married women in Yogyakarta and Medan. Asian Popul Stud 2007; 3 287–304.
Staying single in a married world: never-married women in Yogyakarta and Medan.Crossref | GoogleScholarGoogle Scholar |

[14]  Purdy CH. Fruity, fun and safe: creating a youth condom brand in Indonesia. Reprod Health Matters 2006; 14 127–34.
Fruity, fun and safe: creating a youth condom brand in Indonesia.Crossref | GoogleScholarGoogle Scholar | 17101431PubMed |

[15]  Utomo ID, Vera H, Habsyah A. Study report incidence and social-psychological aspects of abortion in Indonesia: a community-based survey in 10 major cities and 6 districts. Depok, Indonesia: University of Indonesia Centre for Health Research; 2000.

[16]  World Health Organization. WHO report on the global tobacco epidemic 2017. Geneva, Switzerland: World Health Organization; 2017.

[17]  Beladenta A, Filippidis FT, Cadogan SL, Prabandari YS. The impact of Indonesia’s tobacco control policy on cigarette smoking among Indonesian adults: a longitudinal study. Tob Prev Cessation 2018; 4 A140
The impact of Indonesia’s tobacco control policy on cigarette smoking among Indonesian adults: a longitudinal study.Crossref | GoogleScholarGoogle Scholar |

[18]  Nichter M, Padmawati S, Danardono M, Ng N, Prabandari Y, Nichter M. Reading culture from tobacco advertisements in Indonesia. Tob Control 2009; 18 98–107.
Reading culture from tobacco advertisements in Indonesia.Crossref | GoogleScholarGoogle Scholar | 19033331PubMed |

[19]  Mackay J, Ritthiphakdee B, Reddy KS. Tobacco control in Asia. Lancet 2013; 381 1581–7.
Tobacco control in Asia.Crossref | GoogleScholarGoogle Scholar | 23642699PubMed |

[20]  Eriksen M, Mackay J, Schluger N, Gomeshtapeh FI, Drope J. The tobacco atlas, fifth edition. Atlanta: American Cancer Society and Vital Strategies; 2015. Available online at: https://ncdalliance.org/sites/default/files/resource_files/TA5_2015_WEB.pdf [verified 30 November 2019].

[21]  World Health Organization. Monitoring tobacco control among youth in countries of the South-East Asia Region: 2014. New Delhi, India: World Health Organization, Regional Office for South-East Asia; 2014.

[22]  Prabandari YS, Dewi A. How do Indonesian youth perceive cigarette advertising? A cross-sectional study among Indonesian high school students. Glob Health Action 2016; 9 30914
How do Indonesian youth perceive cigarette advertising? A cross-sectional study among Indonesian high school students.Crossref | GoogleScholarGoogle Scholar | 27578600PubMed |

[23]  Center for Health Research. Indonesian’s awareness on smoking health warning and its impact. Jakarta, Indonesia: The Collaborative Funding Program for Southeast Asia Tobacco Control Research Center for Health Research, University of Indonesia; 2009.

[24]  UNESCO Institute for Statistics. UNESCO eAtlas of literacy. Montreal, Canada: UNESCO Institute for Statistics; 2019. Available online at: http://uis.unesco.org/en/topic/literacy [verified 10 July 2019].

[25]  International Telecommunication Union. World Telecommunication/ICT Indicators Database online. 23rd Edition, 2019. Geneva: International Telecommunication Union; 2019. Available online at: http://handle.itu.int/11.1002/pub/81377c7d-en [verified 30 November 2019].

[26]  Bennett DA, Emberson JR. Text messaging in smoking cessation: the txt2stop trial. Lancet 2011; 378 6–7.
Text messaging in smoking cessation: the txt2stop trial.Crossref | GoogleScholarGoogle Scholar | 21722951PubMed |

[27]  Wright E, Fortune T, Juzang I, Bull S. Text messaging for HIV prevention with young Black men: formative research and campaign development. AIDS Care 2011; 23 534–41.
Text messaging for HIV prevention with young Black men: formative research and campaign development.Crossref | GoogleScholarGoogle Scholar | 21287416PubMed |

[28]  Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet 2010; 376 1838–45.
Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial.Crossref | GoogleScholarGoogle Scholar | 21071074PubMed |

[29]  Noordam AC, Kuepper BM, Stekelenburg J, Milen A. Improvement of maternal health services through the use of mobile phones. Trop Med Int Health 2011; 16 622–6.
Improvement of maternal health services through the use of mobile phones.Crossref | GoogleScholarGoogle Scholar | 21342374PubMed |

[30]  Krishna S, Boren SA, Balas EA. Healthcare via cell phones: a systematic review. Telemed J E Health 2009; 15 231–40.
Healthcare via cell phones: a systematic review.Crossref | GoogleScholarGoogle Scholar | 19382860PubMed |

[31]  Gold J, Aitken CK, Dixon HG, Lim MS, Gouillou M, Spelman T, et al. A randomised controlled trial using mobile advertising to promote safer sex and sun safety to young people. Health Educ Res 2011; 26 782–94.
A randomised controlled trial using mobile advertising to promote safer sex and sun safety to young people.Crossref | GoogleScholarGoogle Scholar | 21447750PubMed |

[32]  Lim MS, Hocking JS, Aitken CK, Fairley CK, Jordan L, Lewis JA, et al. Impact of text and email messaging on the sexual health of young people: a randomised controlled trial. J Epidemiol Community Health 2012; 66 69–74.
Impact of text and email messaging on the sexual health of young people: a randomised controlled trial.Crossref | GoogleScholarGoogle Scholar | 21415232PubMed |

[33]  Hou MY, Hurwitz S, Kavanagh E, Fortin J, Goldberg AB. Using daily text-message reminders to improve adherence with oral contraceptives: a randomized controlled trial. Obstet Gynecol 2010; 116 633–40.
Using daily text-message reminders to improve adherence with oral contraceptives: a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 20733446PubMed |

[34]  Hall AK, Cole-Lewis H, Bernhardt JM. Mobile text messaging for health: a systematic review of reviews. Annu Rev Public Health 2015; 36 393–415.
Mobile text messaging for health: a systematic review of reviews.Crossref | GoogleScholarGoogle Scholar | 25785892PubMed |

[35]  Ghorai K, Akter S, Khatun F, Ray P. mHealth for smoking cessation programs: a systematic review. J Pers Med 2014; 4 412–23.
mHealth for smoking cessation programs: a systematic review.Crossref | GoogleScholarGoogle Scholar | 25563359PubMed |

[36]  Ippoliti NB, L’Engle K. Meet us on the phone: mobile phone programs for adolescent sexual and reproductive health in low-to-middle income countries text. Reprod Health 2017; 14 11
Meet us on the phone: mobile phone programs for adolescent sexual and reproductive health in low-to-middle income countries text.Crossref | GoogleScholarGoogle Scholar | 28095855PubMed |

[37]  Gold J, Lim MS, Hocking JS, Keogh LA, Spelman T, Hellard ME. Determining the impact of text messaging for sexual health promotion to young people. Sex Transm Dis 2011; 38 247–52.
Determining the impact of text messaging for sexual health promotion to young people.Crossref | GoogleScholarGoogle Scholar | 20966830PubMed |

[38]  Statistics Indonesia (Badan Pusat Statistik—BPS), National Family Planning Coordinating Board (BKKBN), Indonesia Ministry of Health (Kemenkes), Macro International. Indonesia Demographic and Health Survey 2007. Calverton, MD, USA: BPS, BKKBN, Kemkes, and Macro International; 2008.

[39]  Tahlil T, Coveney J, Woodman RJ, Ward PR. Exploring recommendations for an effective smoking prevention program for Indonesian adolescents. Asian Pac J Cancer Prev 2013; 14 865–71.
Exploring recommendations for an effective smoking prevention program for Indonesian adolescents.Crossref | GoogleScholarGoogle Scholar | 23621253PubMed |

[40]  Violita F, Hadi EN. Determinants of adolescent reproductive health service utilization by senior high school students in Makassar, Indonesia. BMC Public Health 2019; 19 286
Determinants of adolescent reproductive health service utilization by senior high school students in Makassar, Indonesia.Crossref | GoogleScholarGoogle Scholar | 30857523PubMed |

[41]  Fauk NK, Merry MS, Sigilipoe MA, Putra S, Mwanri L. Culture, social networks and HIV vulnerability among men who have sex with men in Indonesia. PLoS One 2017; 12 e0178736
Culture, social networks and HIV vulnerability among men who have sex with men in Indonesia.Crossref | GoogleScholarGoogle Scholar | 28582451PubMed |

[42]  Statistics Indonesia (Badan Pusat Statistik—BPS). Indonesia young people statistics 2017. Jakarta, Indonesia: Statistics Indonesia (Badan Pusat Statistik—BPS); 2017.

[43]  National Population and Family Planning Board (BKKBN), Statistics Indonesia (Badan Pusat Statistik—BPS), Ministry of Health (Kementerian Kesehatan – Kemenkes), and ICF International. Indonesia Demographic and Health Survey 2017. Jakarta, Indonesia: BKKBN, BPS, Kemenkes, and ICF International; 2018.

[44]  Lim MS, Wright C, Hellard ME. The medium and the message: fitting sound health promotion methodology into 160 characters. JMIR Mhealth Uhealth 2014; 2 e40
The medium and the message: fitting sound health promotion methodology into 160 characters.Crossref | GoogleScholarGoogle Scholar | 25367387PubMed |

[45]  Haryanti RH, Hastuti TK, Hanim D. Short Message Service (SMS) Bunda: innovation policy to reduce maternal mortality in Brebes. KnE Soc Sci 2017; 2 69–75.
Short Message Service (SMS) Bunda: innovation policy to reduce maternal mortality in Brebes.Crossref | GoogleScholarGoogle Scholar |

[46]  O’Riordan DL, Nehl E, Gies P, Bundy L, Burgess K, Davis E, et al. Validity of covering-up sun-protection habits: association of observations and self-report. J Am Acad Dermatol 2009; 60 739–44.
Validity of covering-up sun-protection habits: association of observations and self-report.Crossref | GoogleScholarGoogle Scholar | 19278750PubMed |

[47]  Schroder KE, Carey MP, Vanable PA. Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports. Ann Behav Med 2003; 26 104–23.
Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports.Crossref | GoogleScholarGoogle Scholar | 14534028PubMed |