Mobile Phone Interventions for Adolescent Sexual and Reproductive Health: A Systematic Review

Abstract

Context: Interventions for adolescent sexual and reproductive health (ASRH) are increasingly using mobile phones but may not effectively report evidence.

Objective: To assess strategies, findings, and quality of evidence on using mobile phones to improve ASRH by using the mHealth Evidence Reporting and Assessment (mERA) checklist recently published by the World Health Organization mHealth Technical Evidence Review Group.

Data sources: Systematic searches of 8 databases for peer-reviewed studies published January 2000 through August 2014.

Study selection: Eligible studies targeted adolescents ages 10 to 24 and provided results from mobile phone interventions designed to improve ASRH.

Data extraction: Studies were evaluated according to the mERA checklist, covering essential mHealth criteria and methodological reporting criteria.

Results: Thirty-five articles met inclusion criteria. Studies reported on 28 programs operating at multiple levels of the health care system in 7 countries. Most programs (82%) used text messages. An average of 41% of essential mHealth criteria were met (range 14%-79%). An average of 82% of methodological reporting criteria were met (range 52%-100%). Evidence suggests that inclusion of text messaging in health promotion campaigns, sexually transmitted infection screening and follow-up, and medication adherence may lead to improved ASRH.

Limitations: Only 3 articles reported evidence from lower- or middle-income countries, so it is difficult to draw conclusions for these settings.

Conclusions: Evidence on mobile phone interventions for ASRH published in peer-reviewed journals reflects a high degree of quality in methods and reporting. In contrast, current reporting on essential mHealth criteria is insufficient for understanding, replicating, and scaling up mHealth interventions.