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Table 2 Characteristics of included 6 interventions across 11 articles included in the review

From: Mobile health interventions for HIV/STI prevention among youth in low- and middle-income countries (LMICs): a systematic review of studies reporting implementation outcomes

Author(s), Year

Country/study setting/study design

Participants (sample size, gender, age)

Implementation/study objective

Intervention description (features, duration)

Primary outcomes

Main results

Lou et al. 2006 [36]

Country: China

Setting: School-based (two high schools and four colleges)

Study design: Quasi-experimental (non-randomized intervention and control groups)

Sample size: 1337 participants (624 in the intervention group, and 713 in the control group)

Gender: Males and Females

Age: 14–24 years

To examine intervention effect on adolescent and young people HIV/STI-related knowledge and changes inattitudes and behaviors

Intervention group: participants received access to a web-based intervention that offered sexual and reproductive health knowledge, service information, counseling, and discussion.

Control group: No special sexual education was provided. Received their usual care

mHealth Component: Web application

Duration: 10 months

HIV and STI knowledge, attitude score, and proportion of sex-related behaviors

The median scores of the overall knowledge on each specific aspect of reproductive health such as reproduction, contraception, condom, sexually transmitted infections (STIs), and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) were significantly higher in the intervention group compared with those in the control group at post-intervention (p < 0.0001)

Odeny et al., 2012 [38];

Odeny et al. 2014 [34]

Country: Kenya

Setting: Clinic-based

Study design: Two-arm parallel-group RCT

Sample size: 1200 participants (600 in the intervention group, and 600 in the control group)

Gender: Males only

Age: 18–20 years

To examine the effect of text messaging to deter resumption of sex before 42 days post-circumcision, and post-operative clinic visit after circumcision

Intervention group: participants received usual care (which consisted of HIV testing and counseling, screening and treatment for STIs, condom promotion and provision, risk reduction, and safe sex counseling, the male circumcision procedure and post-operative review) and SMS about post-operative care, appointment reminders and healthy sex behaviors (including abstinence) for the first 7 days and on days 8, 14, 21, 28, 35, 41, and 42 post-procedure Control group: participants received usual care (which consisted of HIV testing and counseling, screening and treatment for sexually transmitted infections, condom promotion and provision, risk reduction, and safe sex counseling, the MC procedure, and postoperative review) only

mHealth Component:

SMS

Duration: 2 months

Health-seeking behavior of clinic attendance

Increase in sexual and reproductive health clinic visits among participants in the intervention groupcompared to those in the control group

Rokicki et al. 2017 [15]; Rokicki & Fink, 2017 [14]

Country: Ghana

Setting: School-based

Study design: RCT

Sample size: 498 participants (10 schools in the intervention group consisting of 205 participants, and 12 schools in the control group consisting of 291 participants)

Gender:Females only

Age: 14-24 years

To assess the reach of the intervention among the target population and intervention effect on sexual and reproductive health knowledge

Intervention group: Participants received an interactive mobile phone quiz game where participants could win mobile phone credit by texting correct answers to SRH questions. The messages focused on pregnancy prevention and contained information on topics of reproductive anatomy, pregnancy, STIs, and contraception including male and female condoms, birth control pills, and emergency contraception.

Control group: Received one message each week with information about malaria

mHealth Component:

SMS

Duration: 12 weeks

Increase in sexual and reproductive health knowledge

81% of participants engaged with the mHealth intervention. The intervention was effective at increasing knowledge of sexual reproductive health across all strata. Higher levels of engagement were associated with higher knowledge scores up to a year later.

Participants in the intervention group who were sexually active reported lower odds of self-reported pregnancy from baseline to 15 months

Winskell et al. 2018 [33];

Sabben et al. 2019 [44]

Country:

Kenya

Setting: Community-based (participants were recruited from schools)

Study design: RCT

Sample size: 60 participants (30 participants in the intervention group and 30 participants in the control group)

Gender: Males and Females

Age: 11–14 years

The determine the influence of the intervention on increased age of sexual debut and condom use at sexual debut

Intervention group: participants receivedTumaini, a narrative-based game for android smartphones. The game comprisesapproximately 12 h of discrete gameplay and is designed to be replayed so that players can observe the outcomes of the different decisions. The game was designed to increase age and condom use at first sex by increase knowledge about sexual health and HIV; building risk-avoidance and risk-reduction skills and related self-efficacy; challenging HIV stigma and harmful gender norms and attitudes; fostering future orientation, goal setting, and planning, and promoting dialog with adult mentors

Control group: Received standard of care, no additional intervention beyond any existing sex education from family, school, and peers

mHealth Component:

Mobile application

Duration: 16 days over 3-week school holiday period

Increase condom use at sexual debut, increase sexual health-related knowledge

Participants in the intervention arm showed significant gains in sexual health-related knowledge and self-efficacy compared to participants in the control arm at 6-week postintervention completion

Ybarra et al. 2012 [39]; Ybarra et al. 2013 [40]; Ybarra et al. 2014 [35]

Country: Uganda

Setting: School-based

Study design: RCT

Sample size: 366 participants (183 participants in the intervention group and 183 participants in the control group)

Gender: Males and females

Age: 12 years and older

To increase abstinence and/or condom use

Intervention group: Participants received CyberSenga five 1-h online modules (+ booster module), tailored for gender and culture. The topics covered included (1) information about HIV (e.g., what is HIV and how is it prevented), (2) decision making and communication (e.g., steps to solving a problem; strategies for communicating your solution to others assertively), (3) motivations to be healthy (e.g., reasons why adolescents choose to be abstinent versus to have sex), (4) how to use a condom to be healthy (e.g., demonstration of correct condom use, testimonials from people similar to the participants who used condoms), (5) healthy relationships (e.g., components of healthy relationships; strategies to address coercive gifts), and (6) review.

Control group: Participants received “treatment as usual” (i.e., school-delivered sexuality programming)

mHealth Component:

Web application (Website)

Duration: 12 weeks

Increase condom use, promote abstinence at 3-month post-intervention

At 3-month post-intervention:

Abstinence–intervention versus comparison group: 81% vs. 74%, p = 0.08); unprotected sex—no difference.

At 6-month post-intervention: no significant differences in the main outcomes. Abstinence, I booster group vs. I no booster vs. C: (80% vs. 57% vs. 55%).

Zhu et al. 2019 [37]

Country: China

Setting: Community (recruited through WeChat)

Study design: RCT

Sample size: 100 participants (50 participants in the intervention group and 50 participants in the control group)

Gender: Males only

Age: 18–29 years

To examine preliminary effects of interventions on HIV testing, and use of the HIVST kits, and condom use

Intervention group: participants received two oral HIVST kits and access to WeTest, a WeChat group that provided app-based messages and referrals to health services related to HIV.

Control group: Participants received two oral HIVST kits only

mHealth Component:

Mobile application

Duration: 4 weeks

HIV testing, condom use

Participants in the intervention group had significantly higher rates of HIV testing (adjusted rate ratio RR=1.99, 95% confidence interval (CI) 1.07–3.84) and higher rates of testing via oral HIVST (adjusted RR=2.17, 95% CI 1.08–4.37) compared to participants in the control group.