Impacts of Healthy U: A cluster-randomized control trial of a sexual health education app developed for justice-involved male youth

Purpose: Despite overall declines in teen pregnancy rates, teen pregnancies remain high among justice-involved youth. Justice-involved youth are disproportionately likely to engage in riskier sexual health behavior and simultaneously lack access to sexual health education programs. The study investigated the impact of Healthy U, a program specifically designed for male justice-involved youth. Healthy U is an app-based, self-paced fatherhood prevention program. Methods: The study employed a cluster-randomized control trial among four, male-serving residential facilities operated by a state juvenile justice agency. Within the facilities, living units were randomly assigned to either receive Healthy U or participate in business-as-usual conditions. Male youth, ages 14-19, participated in baseline surveys prior to treatment group participation in Healthy U, and completed surveys six months post-baseline. Results: Results indicated participation in Healthy U significantly and meaningfully increased positive attitudes toward condom use and negative attitudes toward sexual health behavior, as well as increased intentions to use condoms and birth control. No significant differences were found for knowledge about condom use. Conclusions: Results from this study indicate Healthy U, an app-based, self-paced program developed with and for male justice-involved youth, increased important non-behavioral sexual health-related outcomes. Currently, there is a noteworthy lack of sexual health programs developed specifically for justice-involved youth, regardless of gender. Thus, it is notable that Healthy U not only fills this gap but does so in an effective way.