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Impact of text and email messaging on the sexual health of young people: a randomised controlled trial
  1. Megan S C Lim1,2,
  2. Jane S Hocking3,
  3. Campbell K Aitken1,2,
  4. Christopher K Fairley3,4,
  5. Lynne Jordan5,
  6. Jennifer A Lewis1,
  7. Margaret E Hellard1,2
  1. 1Centre for Population Health, Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia
  2. 2Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
  3. 3Melbourne School of Population Health, University of Melbourne, Australia
  4. 4Melbourne Sexual Health Centre, Carlton, Australia
  5. 5Family Planning Victoria, Box Hill, Australia
  1. Correspondence to Dr Margaret E Hellard, Macfarlane Burnet Institute for Medical Research and Public Health, Burnet Institute, Commercial Road, Melbourne 3004, Australia; hellard{at}


Objective To carry out a randomised controlled trial on the effect of a new method of health promotion—email and mobile phone text messages (short messaging service (SMS))—on young people's sexual health.

Methods 994 people aged 16–29 were recruited at a music festival to a non-blinded randomised controlled trial. Participants were randomised to either receive sexual health promotion messages (n=507) or the control group (n=487). The 12-month intervention included SMS (catchy sexually transmissible infections prevention slogans) and emails. Participants completed questionnaires at the festival at baseline and online after 3, 6 and 12 months. Outcomes were differences between the control and intervention groups in health-seeking behaviour, condom use with risky partners (new or casual partners or two or more partners within 12 months) and STI knowledge.

Results 337 (34%) completed all three follow-up questionnaires and 387 (39%) completed the final questionnaire. At 12 months, STI knowledge was higher in the intervention group for both male (OR=3.19 95% CI 1.52 to 6.69) and female subjects (OR=2.36 95% CI 1.27 to 4.37). Women (but not men) in the intervention group were more likely to have had an STI test (OR=2.51, 95% CI 1.11 to 5.69), or discuss sexual health with a clinician (OR=2.92, 95% CI 1.66 to 5.15) than their control counterparts. There was no significant impact on condom use. Opinions of the messages were favourable.

Conclusion This simple intervention improved STI knowledge in both sexes and STI testing in women, but had no impact on condom use. SMS and email are low cost, popular and convenient, and have considerable potential for health promotion.

Clinical trial registration number Australian Clinical Trials Registry - ACTRN12605000760673.

  • Cellular phone
  • electronic mail
  • health promotion
  • sexual behaviour
  • sexually transmitted diseases
  • adolescent
  • sexual health young

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  • Funding Australian Health Ministers Advisory Council Priority Driven Research Program, 2005. The funders had no role in study design; in collection, analysis, or interpretation of data; in the writing of the report; nor in the decision to submit the article for publication. The researchers are independent of the funders.

  • Competing interests None.

  • Ethics approval The study was registered with the Australian Clinical Trials Registry (ACTRN12605000760673 - and ethics approval was obtained from the Victorian Department of Human Services Human Research Ethics Committee (project #77/05).

  • Provenance and peer review Not commissioned; externally peer reviewed.