A Contextual Approach to Inform a Mobile Health Application for Adolescent Health
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ORIGINAL PAPER
A Contextual Approach to Inform a Mobile Health Application for Adolescent Health Kim L. Larson 1 Sharon M. Ballard1 Danny F. Ellis1 Josh G. Peery1 Julie E. Cary2 Rebecca L. Levy1 Taylor B. Nelson1 Lauren B. Scroggs1 ●
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Accepted: 3 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Adolescents from rural, resource poor regions of the United States have disproportionately higher rates of drug and alcohol misuse, which may lead to increased sexual risk behaviors. Adolescents living in both urban and rural areas are major users of smartphones as a source for health information. Yet, the quality and accuracy of some Internet sites tend to be unreliable. The purpose of this study was to explore the perceptions and attitudes of adolescents from a rural region in the southeastern United States regarding health and social concerns to inform the development of a risk reduction application for smartphone use. This study used a qualitative descriptive design guided by the Theory of Triadic Influence. The research team was composed of community partners, faculty, and students from a mid-Atlantic university. Forty-nine adolescents (18 boys and 31 girls) participated in one of five mixed-gender focus groups; they were predominantly Black and Latino, with a mean age of 13.8. Content and thematic analysis led to three interrelated themes: Family as Nexus, Unlevel Playing Field, and Threats to Safety and Security. Structural (racism and bullying) and proximal (neighborhood, family and peers) determinants of health were congruent with other recent reports. Snapchat and Instagram were the most popular social media platforms used. Using a contextual approach, we analyzed the daily experiences of ethnic minority adolescents to inform the development of a risk reduction mobile health application. Community-academic partnerships with engaged youth can assist in smartphone application development and beta testing. Keywords Adolescents Risk behaviors Mobile application Focus groups Contextual elements ●
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Highlights The Theory of Triadic Influence illustrated contexts of adolescent decision-making. ● Adolescents made decisions in the contexts of racism, poverty, and violence. ● Contextual elements provided a holistic approach to mobile health applications. ●
Reducing substance misuse and sexual risk behaviors among adolescents is paramount to ensuring their health and well-being. Substance misuse, defined by substance use at high doses or in inappropriate situations causing individual harm (McLellan 2017), has been associated with
* Kim L. Larson [email protected] 1
East Carolina University, 2205W. 5th St., Greenville, NC 27889, USA
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Boys & Girls Club of Coastal Plain, 621W. Fire Tower Rd., Greenville, NC, USA
sexual risk behaviors. Sexual risk behaviors specific to adolescents include sexual coercion, multiple sexual partners, and inadequate access to contraception and reproductive health services (Kovar 2018; Zhao et al.
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