Reaching Out via Blended Care: Empowering High-Risk Adolescents via Tailored ePublic Sexual Health Services

Background: More and more adolescents primarily use online resources and mobile applications to find the answers on all kinds of questions about sexual health, such as first time sex, sexually transmitted infections (STD), pregnancy prevention and so on. Current Dutch national program for improving sexual health of young adults under 25 in Public Health Services is supported via a national website Sense.info. In addition, face-to-face sexual counselling is organized by designated Municipal Health Services. Evaluations among the target group of young adults show that the current use of the face-to-face counselling is limited due to the lack of awareness of this free health service and the lack of the lack of anonymity during the face-to-face contact with health care professionals. In addition, high-risk adolescents and nationals with foreign backgrounds have special needs in sexual health care services. In order to provide optimal sexual counselling services for high-risk and hard to reach adolescents, it is important to actively involve youth as potential clients as well as sexual care providers throughout the whole eHealth design process. Objective: The purpose of this study is to optimize and enhance existing public sexual health counselling services with eHealth and social media, as well as to find new forms of eHealth services for hard to reach and high-risks adolescents. The optimal goal is to promote healthier lifestyle by increasing awareness among high-risk and hard to reach adolescents with various cultural backgrounds. This paper presents the results of the contextual inquiry study on the current practices and needs of various users, as well as expectations and conditions for enriching sexual healthcare services via eHealth technology, mobile applications and social media. Methods: A holistic eHealth approach is used to identify how sexual health can be improved from the perspective of adolescents and different stakeholders, such as public health care professionals, youth experts and non-governmental organizations. Nine semi-structured interviews, two focus groups and one field observation were conducted with 27 sexual care professionals, youth experts as well as intervention developers and designers participated in the study. In addition, results include the analysis of previous studies on the needs of adolescents in sexual health counselling conducted earlier within the Dutch national Sense programme. Results: Online peer communities, mobile applications and social media networks are important outreach channels for adolescents. The results suggest a blended stepped care approach design to tailor eHealth services to various user profiles with various types of sexual health questions. The integration of the traditional face-to-face counselling with eHealth services like chat, email, website, mobile applications and social media can provide easier access to low-threshold anonymous sexual health counselling on-demand for diverse groups. Conclusions: The broad range of sexual care services not only promises to increase awareness of various sexual health services among hard to reach high-risk adolescents, but also offers a more cost effective way to provide optimally suited care for every individual client