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Abstract

Background:

Digital knowledge translation (KT) interventions play a crucial role in advancing adolescent sexual and reproductive health (ASRH). Despite the extensive literature on their effectiveness, there’s a lack of synthesized evidence on the efficacy of digital KT tools for adolescent ASRH globally.

Objectives:

This review aimed to systematically identify and map existing empirical evidence on digital KT tools targeting ASRH outcomes and identify research gaps.

Design:

The review employed an evidence gap-map (EGM) approach following 2020 PRISMA reporting guidelines.

Data sources and methods:

A comprehensive literature search was conducted across databases including Medline, EMBASE, Global Health, CINAHL, Scopus, and Cochrane. Covidence software was used for data management. EPPI-Mapper software was used to synthesize findings and develop a graphical EGM.

Results:

The EGM comprises 68 studies: 59 experimental and 9 systematic reviews, predominantly from African (19 studies) and American regions (22 studies), with limited research from the Eastern Mediterranean and South East Asian regions. It examines digital KT tools’ influence on sexual and reproductive health (SRH) outcomes, identifying research gaps. Websites are extensively studied for their impact on adolescent behavior, knowledge, attitude, and self-efficacy, yet research on their effects on ASRH and health services access is limited. Similarly, mobile apps and short message service (SMS)/text messages impact various aspects of SRH outcomes, but research on their effects on health services utilization is insufficient. Interventions like digital pamphlets and gaming lack exploration in health service access. OTT media and social media need further investigation. Mass media, including radio, television, and podcasts, are largely unexplored in adolescent SRH outcomes. Topics such as menstrual hygiene, abortion, and sexual and intimate partner violence also lack research.

Conclusion:

The review underscores the dominance of certain KT tool interventions like SMS and websites. Despite advancements, research gaps persist in exploring diverse digital platforms on underrepresented outcomes globally. Future research should expand exploration across digital platforms and broaden the scope of outcome measures.

Trial registration:

The protocol is registered with PROSPERO (CRD42022373970).

Keywords

adolescents sexual and reproductive health digital tools knowledge translation evidence gap-map

Introduction

According to the World Health Organization (WHO) 2023, adolescence is a crucial phase typically ranging from aged 10 to 19 years, marked by significant physical, emotional, cognitive, and social changes.¹ Adolescents experience rapid changes in their physical and psychosocial development including pubertal changes and increased demand for independence, self-discovery, and the formation of one’s identity.^1,2 Adolescents are more prone to acquiring sexually transmitted infections (STIs) and facing unexpected pregnancies, as a result of various factors, such as behavioral and social aspects.^1,3 According to the Centre for Disease Control and Prevention (2021), 26 million new cases of STIs were reported in the year 2018 and almost half of the new STIs cases were among youth (15–24 years).⁴ The most common contributing factor to these infections is limited knowledge about sexual health, including how STIs are transmitted and prevented.⁵ In addition, adolescents may face barriers in accessing sexual health services, and contraceptive use, including concerns about confidentiality, stigma, lack of awareness about available services, and judgmental attitudes of healthcare professionals.^5,6 As a result, they engage in risky sexual behaviors, such as unprotected sex or having multiple sexual partners, which increases their vulnerability to STIs.^6,7

Adolescents’ sexual and reproductive health (ASRH) needs and issues are a critical aspect of their overall health and well-being. Evidence reports that adolescents are not equipped with specific sexual and reproductive health (SRH) education.^7,8 Therefore, it is imperative to utilize evidence-based innovative and novel approaches to address educational needs among this population. Among the others, comprehensive sexuality education and access to reproductive health services remain a priority for healthy sexual development.^1,9 Open and non-judgmental communication, along with the provision of accurate information and accessible services, plays a vital role in supporting adolescents in making informed decisions about their sexual health. Bridging the gap between research and practice ensures that valuable insights and evidence contribute to informed decision-making, policy development, and improvements in professional practices—a process called knowledge translation (KT).¹⁰

KT is particularly crucial in fields where evidence-based decision-making is essential. This process involves developing and employing strategies and tools to integrate research findings into practice.¹⁰ There are several digital KT tools such as mobile phones, websites, mobile apps, short message service (SMS)/text messages, YouTube, Facebook, Twitter, Instagram, WeChat, and other social media platforms that have been identified as useful public health tools, particularly to promote SRH among adolescents.^8,9,11,12 Several studies reported the positive use of digital tools in addressing SRH for adolescents; these include: maintaining privacy, anonymity,^12–14 and convenience,¹⁵ making it a valuable way to provide accurate information about sexual health to adolescents.^6,8,9,16 Other studies reported text messaging through mobile phone technology to increase awareness of adolescents to prevent STIs/HIV and improve safe sexual practices,^17–19 and chatbots—a user-friendly digital tool for adolescents to maintain confidentiality of their queries related to topics around sex and sexual activities.²⁰

Although there is sufficient evidence available on the effectiveness of digital tools in addressing adolescent SRH, there is a lack of synthesis of literature on the available digital or mHealth KT tools. Also, there is a lack of evidence on which digital KT tools prove to be more reliable and effective sources of SRH information for adolescents. Therefore, this review aimed to synthesize current and available evidence on the usefulness of digital KT tools to improve ASRH.

Study aims and objectives: This review aimed to identify, map, and describe existing empirical evidence on the digital KT tools designed to enhance awareness of SRH among adolescents globally. The specific objectives of this evidence gap-map (EGM) are to:

identify, assess, and report on empirical studies that describe the development, implementation, and/or evaluation of adolescent SRH digital KT tools;

identify current uses, purposes, and methods in the development of digital KT tools;

describe the characteristics of digital KT tools studies: such as target population, sample size, age of the participants, sex/gender, and regions

identify research gaps in the literature

Methods

The study is conducted in alignment with standard methodologies for the development of EGM as detailed in our previously published protocol.²¹ An EGM is an emerging process that presents visual representations that highlight the existing evidence on a specific subject, illustrating where research has been conducted and where there are gaps in knowledge.²¹ This review followed a priori-developed²² and is registered with PROSPERO (CRD42022373970). The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines have been followed to ensure comprehensive and transparent reporting of the research process.²³ We followed the below-mentioned specific eligibility criteria to include studies in the EGM.

Topics of interest: We included studies reported digital KT tools on SRH topics such as knowledge, attitude, and efficacy of SRH, pregnancy and birth, abortion, HIV, AIDS, and other STIs testing and their incidence, sexual and intimate partner violence, sexual behavior, menstrual hygiene, family planning and contraception use, communication and support related to SRH, and access to SRH services.

Population: We included studies conducted on adolescents aged between 10 and 19 years. We also included studies if they included mixed population inclusive of adolescents age group.

Exposure/Intervention: We included studies assessing digital KT tools for disseminating SRH information to adolescents. These KT tools included websites, mobile apps, SMS/text messages, digital pamphlets, brochures, digital storytelling and gaming, podcasts, mass media such as radio messages or videos on television, social media such as Instagram TikTok, Facebook, Twitter, YouTube, and OTT platforms such as Netflix, Prime, YouTube, online films, and videos.

Comparison: We included studies comparing the above-mentioned KT tools with no interventions, the standard of care, or other interventions such as self-directed learning, traditional teaching (lecture), reminders, educational website, and controlled messages.

Setting: We included studies conducted globally regardless of the settings (healthcare organizations, community, educational setting, etc.) or context of its conduct.

Timeframe and language: Studies and reports published from 2010 onward were included in the review to capture current advancements and practices in the field. Due to language limitations of researchers, literature published only in the English language was considered to be included in the review.

Types of studies: We included experimental studies (randomized/cluster randomized and non-randomized controlled trials, including quasi-randomized, controlled before-after, and interrupted time series), and observational studies, that is, including prospective cohort and case-control studies. The experimental and observational studies are only included in the presence of control/comparison arms. Studies with a historical control arm were excluded to focus on contemporary practices. Studies such as cross-sectional studies, case reports, series, editorials, and commentaries were excluded from this review. We included systematic reviews; however, following consistent criteria with the primary studies, systematic reviews with no comparison arm were excluded from this review. None of the scoping reviews was found relevant to be included in this review. Other types of reviews such as narrative reviews were excluded based on inconsistent and incomprehensive search strategies used in those reviews and lack of methodological robustness.

The search strategy for this review is reported in adherence to the PRISMA for Searching (PRISMA-S) extension²⁴ (Appendix A). The search strategy was developed by an experienced health sciences librarian at the University of Alberta (MK) in consultation with the research team. The following databases were searched individually from inception to present: Medline (1946–present), EMBASE (1974–present), and Global Health (1910–present) via OVID; Cumulative Index to Nursing and Allied Health Literature (CINAHL, 1936–present) via EBSCOhost; Scopus (1976–present); and Cochrane Library (1993–present) via Wiley. The search strategy was derived from four main concepts: (1) adolescents, teenagers, or young adults; (2) SRH or health services including vocabulary related to contraception, family planning, pregnancy, STIs, and gender-based violence; (3) digital communication tools such as websites, online messaging, smartphones, mobile applications, social media, podcasts, television, or digital information; (4) KT including vocabularies such as information dissemination, research innovation, knowledge transfer, implementation science, research into practice, knowledge into practice, and evidence-based practice. Bibliographic databases were searched using a combination of natural language (keywords) and subject headings, such as Medical Subject Headings (MeSH), wherever they are available. Items such as books, book chapters, editorials, conference materials, and opinion pieces were removed from the results and a publication date limit of 2010–present was applied. A preliminary search for OVID Medline was developed and executed in October 2022 to determine the feasibility of this project and test the scope. An updated search was completed in October 2023 for this review. Covidence web-based software was used for the deduplication of database search results and for facilitating the title/abstract screening and full-text screening phases.

All the studies identified from the databases were imported to Covidence (an online screening software), and two independent reviewers completed the first level (title/abstract) (SI, KR) and second-level of screening (full-text) (AH, KR). Disagreements were resolved by consensus among the two reviewers. The reference list of all the included studies was scanned and searched to include any relevant study that may have been missed during searching of databases. For data extraction, we used a standardized data extraction form to extract descriptive data from all studies meeting our inclusion criteria. Data extracted from each study include bibliographic details, KT tool types and descriptions, outcome types and descriptions, study design, context/geographical information, and details on the outcome and quality of the included studies. Two review authors independently extracted the data (SI, AH), and discrepancies were resolved through discussion until consensus was achieved or by consulting a third reviewer (SM) if required. The PRISMA chart was used to document inclusion and exclusion decisions and ensure transparency and rigor in the reporting of the studies (Appendix A).

Data from the review is visually synthesized in an EGM using EPPI-Mapper, a tool developed by the EPPI-Centre at University College London (UCL). The 2D graphical EGM is presented with an accompanying narrative. Rows of the EGM list digital KT strategies and columns components of outcomes and other relevant data coding. Each cell shows the number and quality of evidence for digital KT strategies. We conducted the quality assessment of the included studies using tool ROB2 developed by the Cochrane Collaboration, for randomized control trials (RCTs), ROB1 for quasi-experimental studies, and AMSTAR2 for systematic reviews.^25,26 The EGM identified areas with high-quality, evidence-based digital KT tools and areas where few or no KT tools exist (for targeted KT tool development and research/policy prioritization).

Results

We identified 18,060 studies from electronic databases and finally included 68 studies in the EGM. The PRISMA study flow chart for the study is shown in Appendix A. Out of the 68 included studies, 59 were primary effectiveness studies and 9 were systematic reviews. The majority of primary studies conducted were RCTs (48 studies).^27–74 Four studies were clustered RCTs,^75–78 seven were quasi-experimental studies,^79–85 and nine were review articles.^{7–9,12,14,16,17,20,86}

The majority of the evidence comes from African (19 studies),^{31,35,36,42–44,48,56,57,61,62,69,70,72,75,80–82,84} and American regions (22 studies).^{27,29,30,32–34,38,40,45–47,49,50,53,58–60,63–65,74,77} Eight studies were based in European^{28,37,39,41,51,55,66,76} and eight in Western pacific region,^{54,67,68,71,73,78,79,83} while only one from Eastern Mediterriean⁵² and one from South East Asian region.⁸⁵

The evidence base from 59 studies (excluding review articles) was concentrated in 23 countries. The highest evidence comes from African and American regions, with the United States having the highest evidence among other countries (18 studies),^{27,29,32,33,38,40,45,47,49,50,53,59,60,63–65,74,77}, followed by Kenya with 7 studies.^{42,43,48,56,62,69,84} European region displays a varied range of evidence among countries, with the United Kingdom having the highest (four studies),^28,37,66,76 while Western pacific region showcases a mix of low-to-moderate counts across its listed countries, with China having the most evidence (four studies; Figure 1).^68,71,73,78 Among nine review studies, six studies focused on a global perspective,^{9,12,14,16,20,86} while two targeted low and middle-income countries,^7,17 and one specifically centered on Sub-Saharan Africa⁸.

Figure 1.

Evidence by region and country.

This EGM is comprised of data from 43,382 participants in 59 primary studies. Sample sizes ranged from 50 to 8999 participants.^29,33 Of the 59 primary studies, 22 studies had only female participants,^{29,31,39–41,43,46,47,49,52,59–61,65,66,70,71,74,75,77,78,84} 2 studies only had male participants,^38,56 5 studies had males who had sex with male participants (MSM),^{34,45,53,63,67} and the remaining 30 studies had both male and female participants^{27,28,30,32,33,35–37,42,44,48,50,51,54,55,57,58,62,64,68,69,72,73,76,79–83,85} (refer to Appendices B and C).

In terms of quality appraisal, the majority of studies included were rated moderate quality with some concerns (31 studies)^{20,28,30,34,38,39,41–45,47,49,50,53,58,62–64,67,69–73,75,77,79,80,82,85} largely due to inadequate reporting of methodological details. Sixteen studies had low quality with high risks,^{7,9,12,14,17,27,32,33,35,48,59,65,68,74,81,86} and 21 were of good quality that had a low risk^{8,16,29,31,36,37,40,46,51,52,54–57,60,61,66,76,78,83,84} (Figure 2).

Figure 2.

Quality appraisal of studies.

A 2D graphical EGM was developed on EPPI-Mapper with a bubble map view consisting of rows and columns. Rows were types of KT tools divided into broad categories like website, mobile app, SMS/text messages, digital technology (pamphlet/brochure/storytelling/gaming), OTT media (Netflix, Prime, YouTube, online film, video), social media (Facebook, Instagram, WhatsApp, TikTok, Snapchat, LinkedIn), mass media (radio and television), and podcast. The columns encompass outcome categories grouped into broader categories, each with subcategories such as adolescent behaviors (sexual behavior, menstrual hygiene, contraception and prevention, communication, and support-seeking), adolescent knowledge, attitude and empowerment (knowledge and awareness, attitudes, self-efficacy), adolescent SRH outcomes (pregnancy and birth, abortion, HIV testing and incidence, sexual and intimate partner violence), and health services (accessing and utilizing services). The quality appraisals are highlighted by color codes: green for low risk of bias/high-quality, yellow for some concerns of bias/moderate quality, and red for high risk of bias/low-quality assessments. More detailed and dynamic versions that enable filtering by each specific subgroup with linked study references and additional study characteristics are available at the link here OR

The EGM examined how different digital mediums affect adolescent SRH outcomes based on available studies. While most of the studies examined individual digital KT tools separately within a specific study, few studies explored the combined effects of multiple tools in a single study. Similarly, in some instances, certain studies reported more than one piece of SRH information. Websites wield significant influence over adolescent behavior, as evidenced by 12 studies,^{8,16,17,30,39,45,50,65,66,71,74,81} while impacting knowledge, attitude, and self-efficacy in 16 studies.^{8,16,17,30,33,39,50,53,54,65,66,71,74,78,81,83} However, only four studies have delved into their effects on adolescent SRH outcomes^16,50,54,67 and merely two have investigated their impact on health services access and utilization.^53,54 Mobile apps have exhibited impacts on adolescent behavior (14 studies),^{7,17,32,40,49,51,55,62,63,68,69,75,77,82} knowledge, attitude and self-efficacy (13 studies),^{7,17,32,40,48,49,51,62,68,69,77,82,85} adolescent SRH outcomes (4 studies),^32,55,63,82 and healthcare access and utilization (only 1 study).⁷ SMS/text messages have emerged as highly influential, affecting adolescent behavior (22 studies),^{7–9,12,17,20,27–29,37,38,42,43,49,51,52,56,60,70,72,84,86} knowledge, attitude and self-efficacy (16 studies),^{7,8,12,17,38,42,49,51,52,58,60,61,70,73,79,86} SRH outcomes (13 studies),^{9,12,28,31,37,38,42,52,60,61,72,84,86} and to some extent, health services access and utilization (4 studies).^7,29,38,52 Interventions involving digital technology like digital pamphlets, brochures, storytelling, and gaming have limited research but exhibit an impact on behavior (3 studies),^64,80,81 and knowledge and attitude (6 studies),^{35,44,57,64,80,81} necessitating further exploration in terms of adolescent SRH outcomes and health services utilization.

Areas with less exploration in digital technology include OTT media and social media. There is a moderate amount of research on the influences of OTT media on adolescent behavior (five studies)^{9,29,46,47,76} and knowledge and attitude (four studies),^34,47,57,76 with limited studies on effects on adolescent SRH outcomes (three studies)^9,34,76 and healthcare access (two studies).^29,59 There are also few studies on the impacts of social media on adolescent behavior (four studies),^9,14,27,86 knowledge and attitude (four studies),^14,36,41,86 and SRH outcomes (three studies),^9,14,86 yet none explore its impact on healthcare access and utilization. Moreover, research on the effects of mass media, such as radio and television, on adolescent SRH behavior (one study),⁸¹ knowledge, attitude and self-efficacy, remains lacking (one study),⁸¹ with no studies focusing on adolescent SRH outcomes and health service access, indicating an unexplored area. Notably, within the outcome category, the EGM revealed that subcategories like menstrual hygiene (one study),⁸² abortion (three studies),^12,31,52 and sexual and intimate partner violence (two studies)^9,42 were less explored (Figure 3 or click here).

Figure 3.

Evidence gap-map.

Discussion

To the best of our knowledge, this is the first comprehensive evidence map focused on digital KT tools for adolescent SRH. The findings substantiate the diverse and impactful role of digital KT tools in shaping adolescent SRH knowledge, attitudes, and behaviors, underscoring their significance in promoting informed decision-making and positive SRH outcomes among adolescents. Websites emerge as essential platforms offering accessible and influential avenues for adolescents seeking SRH information and behavior. These websites serve as easily accessible, user-friendly, and potentially influential mediums, catering to adolescents seeking information regarding their sexual and reproductive well-being.⁹ Consistent with prior reviews, these online platforms serve as conduits for disseminating crucial knowledge, shaping attitudes, and potentially modifying behaviors related to SRH.^9,16,17 Within the evolving digital landscape, mobile apps have emerged as exemplars of innovation and adaptability in addressing adolescent SRH outcomes. These applications present interactive, captivating, and tailored content, serving as an effective means to engage adolescents. These findings align with the literature highlighting the potential of well-designed, evidence-based mobile apps to deliver customized content and interactive features.^6,12

Moreover, the review underscores the profound influence of SMS/text messages as powerful tools in the domain of adolescent SRH. Supported by extensive literature, these text-based interventions play a significant role in shaping adolescents’ understanding and attitudes toward SRH-related knowledge and behaviors.^9,17,20 Additionally digital interventions, such as pamphlets, brochures, storytelling, and gaming, exhibit promise in engaging and educating adolescents on SRH matters. Consistent with prior literature, these digital interventions showcase effectiveness in influencing SRH-related knowledge and behaviors among adolescents.^33,34,37

Our synthesis of the existing EGM highlights the significant gap in understanding the landscape of available digital KT options and their impact on adolescent SRH information. Despite the increasing prevalence of digital platforms, such as social media, OTT media, and technology-driven interventions like radio/TV and podcasts,⁸⁷ their effects on adolescent SRH outcomes remain relatively underexplored. Investigating the influence of these platforms is crucial, as they serve as pervasive sources of information and influence adolescents, shaping their attitudes and behaviors related to SRH.⁸⁸ Furthermore, parental consent may affect the accessibility and effectiveness of these digital KT interventions, particularly on sensitive topics. Some families may have reservations about certain SRH subjects, potentially limiting adolescents’ opportunities to seek and obtain critical information, thereby impacting their informed decision-making.

EGM revealed that the outcomes related to abortion, and sexual and intimate partner violence, were least explored. The lack of work in these areas is a concern for several reasons. First, neglecting outcomes related to abortion, and sexual and intimate partner violence overlooks critical components of comprehensive SRH.^8,14,89 Second, abortion and intimate partner violence are often stigmatized and surrounded by societal taboo.^8,32,52 Digital KT tool options have the potential to provide a more discreet and accessible platform for individuals seeking support in these areas. Neglecting these topics may perpetuate stigma and discourage individuals from seeking help.^74,75 By incorporating these dimensions into the discourse, we can enrich our understanding of how digital interventions can comprehensively address the multifaceted aspects of adolescent SRH, fostering more effective strategies for promoting the ASRH.

The EGM further underscores a concerning scarcity of work on menstrual hygiene within the context of digital interventions for adolescent SRH. This lack of focus on menstrual hygiene is problematic due to the reason that menstrual hygiene is an integral component of SRH and rights,^8,89 and the omission of KT tools in this area poses a significant gap in our understanding of how digital KT tools can address the unique challenges faced by adolescents in managing menstrual health.

The variation in different numbers of studies in different states in different regions and countries might be due to a high prevalence of SRH issues, the presence of digital technology, and/or the capacity to undertake research in these countries and regions.⁹⁰ There is a need to conduct research and introduce digital technology, potentially in all regions and countries, to understand its impact on ASRH. Key considerations for policy, practice, and research are summarized in Table 1 and discussed subsequently.

Table 1.

Key policies, practice, and research considerations.

1. Policies should be enacted to encourage and support research initiatives in underrepresented regions (South East and Eastern Mediterranean region) to rectify the current geographical imbalance in understanding the impacts of digital interventions on adolescent health. This would promote a more comprehensive global understanding.

2. Future funding should prioritize the development and implementation of neglected mediums like radio and podcasts, ensuring tailored, culturally sensitive approaches for effective engagement with diverse adolescent populations.

3. We recommend the integration of highly impactful digital mediums such as SMS/text messages, mobile applications, and websites within healthcare systems is necessary to expedite the improvement of adolescent SRH outcomes.

4. The significance of essential areas like menstrual hygiene, abortion, and sexual and intimate partner violence, prioritizing research focused on recognizing and comprehending the influence of digital KT interventions on these crucial aspects should be encouraged.

5. Active promotion and incentivization of international collaborations among researchers and institutions across regions should be undertaken to facilitate knowledge exchange and the sharing of best practices.

6. The sustainability and scaling up of these KT tools in different contexts will not only enhance the impact of digital interventions on adolescent SRH health but also economize research funds. Therefore, there is a critical need to evaluate the scalability of these tools in varied settings to ensure their effective implementation.

The strength of this study is the methodological rigor with which it was performed, which included an extensive search strategy, a comprehensive summary of the results, and an independent assessment of each stage of the study selection process. Moreover, this review provided a holistic, prescriptive model that can be used to scale up the available KT tools in international contexts, and simultaneously leverage significant economies of scale.

Limitations

Certain limitations of this review warrant acknowledgment. Some articles were excluded for not being written in the English language and no full-text article availability, which may have resulted in studies exploring the impact on a broader range of outcomes being missed. The focus on effectiveness limited our selection to experimental and quasi-experimental studies, omitting cross-sectional, qualitative studies, and gray literature. Further 48% of studies are of moderate-quality evidence. This suggests that findings should be interpreted with caution in light of moderate-quality review evidence.

Conclusion

The EGM has illuminated the multifaceted landscape of research and knowledge gaps surrounding available digital tools for disseminating knowledge in ASRH. This overview has underscored the geographical disparities in digital tool accessibility, their varying impacts on different facets of SRH, research capacities, and essential study characteristics. Furthermore, the analysis has emphasized the dominance of specific interventions while highlighting persistent research voids in exploring diverse digital platforms and less-represented outcome areas globally. It is imperative that future research endeavors focus on broadening the investigation into various digital platforms and expanding the range of measured outcomes to ensure a more comprehensive understanding and advancement in other critical domains of ASRH. By offering policymakers, healthcare providers, and researchers the ability to gauge evidence accessibility and reliability, EGMs serve as invaluable tools in shaping decisions regarding future research funding.

Footnotes

Appendix

Appendix C.

Extraction table for review studies.

Sr. no	Author and year	Objective/aim/purpose	Country/setting	Target population	Total number of studies	Study design	KT tool	Intervention	Outcomes	Quality assessment
1	Martin (2020)⁹	To describe existing published studies on online participatory intervention methods used to promote the sexual health of adolescents and young adults	Global	Adolescents and young adults aged between 10 and 24 years	n = 60	Systematic review	Facebook, YouTube, MySpace, Twitter, Flickr, Tumblr, Instagram, WeChat	• Information dissemination with participatory components (games, quizzes, discussions) • Online community/discussion • Participation in activities only (including games) • Participatory educational sessions • Personalized assistance	• Sexual health promotion • HIV/sexually transmitted infection prevention specifically • Sexual violence prevention • Hepatitis B virus and hepatitis C virus testing promotion • Improve HIV care linkage • Observe peer influence in sexual situations only	High risk
2	Feroz (2021)⁷	To identify a range of different mHealth solutions that can be used for improving young people SRH in LMICs and highlight facilitators and barriers for adopting mHealth interventions designed to target SRH of young people	LMICs	Young people (adolescents and youth) aged 10–24 years	n = 15)	Systematic review	Mobile phones	The most reported use of mHealth was for client education and behavior change communication followed by financial transactions and incentives	• Access to SRH services • Behavior change communication • SRH outcomes • Factors facilitating and impeding uptake of mHealth interventions for young people SRH	High risk
3	Onukwugha (2022)⁸	To describe mHealth intervention components, assesses their effectiveness, acceptability, and cost in improving adolescent’s uptake of SRH services in SSA	SSA	Adolescents aged 10–19 years and young people aged 10–24 years	n = 10	Systematic review	• SMS An interactive web-based peer support platform	The interventions focused on shaping knowledge and increasing the use of reproductive health interventions or services. Two studies evaluated SRH knowledge,^29,35 four assessed contraceptive use/birth control,^29,33,34,39 three examined pregnancy and fertility intentions.^29,33,34 One focused on facility childbirth delivery,³³ two on EBF,^33,34 four on HIV ART adherence,^31,32,37,38 and two on sexual behavior^29,34	• SRH knowledge • Sexual health behavior. • Contraceptive/birth control access and use • ART adherence	Low risk
4	Guse (2012)¹⁴	To summarize the currently published evidence-based on the effectiveness of new digital media-based sexual health interventions for adolescents aged 13–24 years	Global	Adolescents aged 13–24 years	n = 10	Systematic review	Internet	The shortest program was a single e-mail and the longest consisted of 24 45-min sessions administered over 2 years. Two of the interventions were delivered to adolescents in rural settings. Two of the interventions enrolled HIV-positive youth, and one enrolled youth with substance use disorders	• Youth behaviors, including initiation of vaginal sex recent sexual intercourse, frequency of sex, number of sexual partners, condom use, and sex while under the influence of drugs or alcohol • Adherence to medication. among young HIV-positive participants and alterations to public profiles on an SNS • Attitudes, self-efficacy, and intentions regarding sexual abstinence • Knowledge-based outcomes pertaining to HIV/ STIs, condoms, pregnancy, and emergency contraception	High risk
5	Saragih (2021)¹⁶	To explore the meta-effects of telehealth interventions on self-efficacy of using condoms, condom use practices, and sexually transmitted infection testing behaviors among adolescents	Global	Adolescent population aged 13–24 years old	n = 15	Systematic review and meta-analysis of randomized controlled studies	Web-based and game-based interventions	The telehealth interventions were designed to influence knowledge, attitudes, norms, self-efficacy, and behaviors; a range of sexual health and general health topics were addressed, including substance use, safer sex strategies, sexual risk behaviors, and risk-reducing behaviors including condom use, STI testing practices, and contraceptive options. A variety of professionals delivered the telehealth interventions, including clinicians (n = 3), a school nurse (n = 1), researchers in tropical medicine (n = 2 studies), a public health researcher (n = 1 study), a social worker (n = 1 study), and psychologists (n = 4 studies). The frequency of intervention delivery was most often weekly, with each session lasting 20–45 min, and the sessions occurring over a 3-week to 6-month period of time	• Knowledge, attitude, self-efficacy for condom use, and sexual behavior • Being screened/tested for sexual transmitted infections	Low risk
6	Nwaozuru (2021)¹⁷	To summarize what is known, and what we need to know about implementing mhealth interventions for HIV/STI prevention targeting young people in LMICs	LMICs	Young people aged 10–24 years	n = 11	Systematic review and meta-analyses	Mobile phones, SMS	The mHealth components across the six interventions were delivered using three modalities: (1) as mobile applications, (2) as phone-based SMSs, and (3) as web-based application. Specifically, two interventions used mobile phone applications to provide HIV/STI prevention services and information. One of the interventions was delivered as a narrative-based game for android smartphones³³ and one used WeChat—a messaging mobile application	• Acceptability, appropriateness, and feasibility • Condom use and sexual and reproductive health knowledge. • Sexual intercourse after male circumcision	High risk
7	Handschuh (2019)²⁰	To synthesize research examining the association between adolescent sexing and sexual activity	Global	Adolescents 10–19 years of age	n = 6	Systematic review and meta-analysis	Mobile phones, SMS	Sexting as sending either a written message or an image, one differentiated between sending a message and sending an image	• Sexual behavior	Some concerns
8	Jones (2014)⁸⁶	To examine the effectiveness of social media and text messaging interventions designed to increase STD knowledge, increase screening/testing, decrease risky sexual behaviors, and reduce the incidence of STDs among young adults aged 15 through 24 years	Global	Young adults 15–24 years	n = 11	Systematic review	SMS messaging and e-mail communications	Intervention modes included SMS messaging via text, e-mail communications, and internet-based health education programming	• STD knowledge: Significant increases in STD knowledge, including increased understanding of sexual protection methods and transmission • STD screening/testing • Increases in STD testing among participants after the intervention • Sexual risk behavior: Sexual risk behaviors were examined in 10 studies • Self-efficacy/intention • Significant increases in condom use self-efficacy and intention	High risk
9	L’Engle (2016)¹²	To assess strategies, findings, and quality of evidence on using mobile phones to improve ASRH by using the mERA checklist recently published by the World Health Organization mHealth Technical Evidence Review	Global	Adolescents aged 10–24 years	n = 35	Systematic review	Mobile phones	mHealth intervention programs where mobile phones were used to address ASRH	• Knowledge and STI testing • Increased sexual health knowledge and awareness, lower rates of unprotected sex and higher rates of condom use, and greater STI testing • Adolescents commonly asked about sexual acts and practices, physical and sexual development, abortion, and contraception and unplanned pregnancy. Confidentiality: Adolescents y liked the confidentiality of mobile phone communication and found the SRH content simple to understand, informative, and easily shared • HPV vaccine: Increased HPV vaccination through vaccination reminders sent via SMS to parents or teens	High-risk

ART, antiretroviral therapy; ASRH, adolescent sexual and reproductive health; EBF, exclusive breastfeeding; HPV, human papillomavirus; LMIC, low- and middle-income country; mERA, mHealth Evidence Reporting and Assessment; SMS, short message service; SNS, Social Networking Site; SRH, sexual and reproductive health; SSA, Sub-Saharan Africa; STD, sexually transmitted disease; STI, sexually transmitted infection.

Acknowledgements

We acknowledge the University of Alberta for their institutional support.

Declarations

ORCID iDs

Amber Hussain

Komal Abdul Rahim

References

World Health Organization. Adolescents health, https://www.who.int/health-topics/adolescent-health/#tab=tab_1 (n.d., accessed 18 December 2023).

Kuzma

Peters

RM.

Adolescent vulnerability, sexual health, and the NP’s role in health advocacy. J Am Assoc Nurse Pract 2016; 28(7): 353–361.

Hensel

Nance

Fortenberry

JD.

The association between sexual health and physical, mental, and social health in adolescent women. J Adolesc Health 2016; 59(4): 416–421.

Centers for Disease Control and Prevention. Adolescents and school health, https://www.cdc.gov/healthyyouth/sexualbehaviors/index.htm (2019, accessed 18 December 2023).

Leichliter

Copen

Dittus

PJ.

Confidentiality issues and use of sexually transmitted disease services among sexually experienced persons aged 15–25 years—United States, 2013–2015. MMWR Morb Mortal Wkly Rep 2017; 66(9): 237–241.

Meherali

Salami

Okeke-Ihejirika

, et al. Barriers to and facilitators of South Asian immigrant adolescents’ access to sexual and reproductive health services in Canada: a qualitative study. Can J Hum Sex 2021; 30(3): 329–338.

Feroz

Ali

Khoja

, et al. Using mobile phones to improve young people sexual and reproductive health in low and middle-income countries: a systematic review to identify barriers, facilitators, and range of mHealth solutions. Reprod Health 2021; 18(1): 9.

Onukwugha

Smith

Kaseje

, et al. The effectiveness and characteristics of mHealth interventions to increase adolescent’s use of Sexual and Reproductive Health services in Sub-Saharan Africa: a systematic review. PLoS One 2022; 17(1): e0261973.

Martin

Cousin

Gottot

, et al. Participatory interventions for sexual health promotion for adolescents and young adults on the internet: systematic review. J Med Internet Res 2020; 22(7): e15378.

10.

Meijers

van der Kwaak

Aqel

, et al. Using a Rapid knowledge translation approach for better sexual and reproductive health and rights in Bangladesh, Burundi, Indonesia, and Jordan. Glob Health Sci Pract 2022; 10(2): e2100461.

11.

Crutzen

Peters

GJY

Portugal

, et al. An artificially intelligent chat agent that answers adolescents’ questions related to sex, drugs, and alcohol: an exploratory study. J Adolesc Health 2011; 48(5): 514–519.

12.

L’Engle

Mangone

Parcesepe

, et al. Mobile phone interventions for adolescent sexual and reproductive health: a systematic review. Pediatrics 2016; 138(3): e20160884.

13.

Cornelius

St. Lawrence

Howard

, et al. Adolescents’ perceptions of a mobile cell phone text messaging-enhanced intervention and development of a mobile cell phone-based HIV prevention intervention. J Spec Pediatr Nurs 2012; 17(1): 61–69.

14.

Guse

Levine

Martins

, et al. Interventions using new digital media to improve adolescent sexual health: a systematic review. J Adolesc Health 2012; 51(6): 535–543.

15.

Chen

Mangone

ER.

A systematic review of apps using mobile criteria for adolescent pregnancy prevention (mCAPP). JMIR Mhealth Uhealth 2016; 4(4): e122.

16.

Saragih

Imanuel Tonapa

Porta

, et al. Effects of telehealth interventions for adolescent sexual health: a systematic review and meta-analysis of randomized controlled studies. J Telemed Telecare 2024; 30(2): 201–214.

17.

Nwaozuru

Obiezu-Umeh

Shato

, et al. Mobile health interventions for HIV/STI prevention among youth in low- and middle-income countries (LMICs): a systematic review of studies reporting implementation outcomes. Implement Sci Commun 2021; 2(1): 126.

18.

Buchanan

CRM

Tomaszewski

Chung

S-E

, et al. Why didn’t you text me? Poststudy trends from the DepoText Trial. Clin Pediatr (Phila) 2018; 57(1): 82–88.

19.

Reback

Fletcher

Kisler

KA.

Text messaging improves HIV care continuum outcomes among young adult trans women living with HIV: Text Me, Girl!

AIDS Behav 2021; 25(9): 3011–3023.

20.

Handschuh

La Cross

Smaldone

Is sexting associated with sexual behaviors during adolescence? A systematic literature review and meta-analysis. J Midwifery Womens Health 2019; 64(1): 88–97.

21.

Snilstveit

Vojtkova

Bhavsar

, et al. Evidence & Gap Maps: a tool for promoting evidence informed policy and strategic research agendas. J Clin Epidemiol 2016; 79:120–129.

22.

Meherali

Bhaumik

Idrees

, et al. Digital knowledge translation tools for disseminating sexual and reproductive health information to adolescents: protocol for an evidence gap map review. JMIR Res Protoc 2024; 13: e55081.

23.

Page

McKenzie

Bossuyt

, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71.

24.

Tricco

Lillie

Zarin

, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 2018; 169(7): 467–473.

25.

Sterne

JAC

Savović

Page

, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898.

26.

Shea

Reeves

Wells

, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 2017; 358: j4008.

27.

Bourdeau

Miller

Byrnes

, et al. Efficacy of a web-based intervention (Smart Choices 4 Teens) for facilitating parent-adolescent communication about relationships and sexuality: randomized controlled trial. JMIR Pediatr Parent 2021; 4(2): e19114.

28.

Brown

Tan

Guerra

, et al. Using behavioural insights to increase HIV self-sampling kit returns: a randomized controlled text message trial to improve England’s HIV self-sampling service. HIV Med 2018; 19(9): 585–596.

29.

Chernick

Santelli

Stockwell

, et al. A multi-media digital intervention to improve the sexual and reproductive health of female adolescent emergency department patients. Acad Emerg Med 2022; 29(3): 308–316.

30.

Chong

Gonzalez-Navarro

Karlan

, et al. Do information technologies improve teenagers’ sexual education? Evidence from a randomized evaluation in Colombia. World Bank Econ Rev 2020; 34(2): 371–392.

31.

Constant

de Tolly

Harries

, et al. Mobile phone messages to provide support to women during the home phase of medical abortion in South Africa: a randomised controlled trial. Contraception 2014; 90(3): 226–233.

32.

Cordova

Munoz-Velazquez

Mendoza Lua

, et al. Pilot study of a multilevel mobile health app for substance use, sexual risk behaviors, and testing for sexually transmitted infections and HIV among youth: randomized controlled trial. JMIR Mhealth Uhealth 2020; 8(3): e16251.

33.

Cortese

Lustria

MLA

. Can tailoring increase elaboration of health messages delivered via an adaptive educational site on adolescent sexual health and decision making? J Am Soc Inf Sci Technol 2012; 63(8): 1567–1580.

34.

Del Río-González

Zea

Calabrese

, et al. Development and evaluation of an online education-entertainment intervention to increase knowledge of HIV and uptake of HIV testing among Colombian men who have sex with men (MSM). Int J Environ Res Public Health 2021; 18(4): 1811.

35.

Dike

Ebizie

Njoku

, et al. Improving knowledge and perception of HIV/AIDS among English language speaking children in rural areas through educational digital storytelling. Medicine (Baltimore) 2021; 100(50): e28058.

36.

Ezegbe

Eseadi

Ede

, et al. Efficacy of rational emotive digital storytelling intervention on knowledge and risk perception of HIV/AIDS among schoolchildren in Nigeria. Medicine (Baltimore) 2018; 97(47): e12910.

37.

Free

McCarthy

French

, et al. Can text messages increase safer sex behaviours in young people? Intervention development and pilot randomised controlled trial. Health Technol Assess 2016; 20(57): 1–82.

38.

Gerend

Madkins

Crosby

, et al. Evaluation of a text messaging-based human papillomavirus vaccination intervention for young sexual minority men: results from a pilot randomized controlled trial. Ann Behav Med 2021; 55(4): 321–332.

39.

Gil-Llario

Ballester-Arnal

Giménez-García

, et al. Effectiveness of HIV prevention for women: what is working? AIDS Behav 2014; 18(10): 1924–1933.

40.

Gilliam

Martins

Bartlett

, et al. Development and testing of an iOS waiting room “app” for contraceptive counseling in a Title X family planning clinic. Am J Obstet Gynecol 2014; 211(5): 481.e1–481.e8.

41.

Gonenc

Alan Dikmen

Golbasi

The effect of WhatsApp-based and conventional education methods on sexual myths and sexual health knowledge: a comparative intervention study in midwifery students. Int J Sex Health 2021; 33(3): 326–341.

42.

Gonsalves

Njeri

Schroeder

, et al. Research and implementation lessons learned from a youth-targeted digital health randomized controlled trial (the ARMADILLO study). JMIR Mhealth Uhealth 2019; 7(8): e13005.

43.

Green

Augustine

Naanyu

, et al. Developing a digital marketplace for family planning: pilot randomized encouragement trial. J Med Internet Res 2018; 20(7): e10756.

44.

Haruna

Chu

, et al. Improving sexual health education programs for adolescent students through game-based learning and gamification. Int J Environ Res Public Health 2018; 15(9): 2027.

45.

Horvath

Bauermeister

JA.

eHealth literacy and intervention tailoring impacts the acceptability of a HIV/STI testing intervention and sexual decision making among young gay and bisexual men. AIDS Educ Prev 2017; 29(1): 14–23.

46.

Hylton-Kong

Steiner

Bailey

, et al. Debunking myths about contraceptive safety among women in Kingston, Jamaica: pilot randomized controlled trial. Contraception 2021; 103(5): 356–360.

47.

Jones

Hoover

Lacroix

LJ.

A randomized controlled trial of soap opera videos streamed to smartphones to reduce risk of sexually transmitted human immunodeficiency virus (HIV) in young urban African American women. Nurs Outlook 2013; 61(4): 205–215.e3.

48.

Macharia

Pérez-Navarro

Sambai

, et al. An Unstructured Supplementary Service Data-based mHealth app providing on-demand sexual reproductive health information for adolescents in Kibra, Kenya: randomized controlled trial. JMIR Mhealth Uhealth 2022; 10(4): e31233.

49.

Manlove

Whitfield

Finocharo

, et al. Lessons learned from replicating a randomized control trial evaluation of an app-based sexual health program. Int J Environ Res Public Health 2021; 18: 3305.

50.

Marsch

Guarino

Grabinski

, et al. Comparative effectiveness of web-based vs. educator-delivered HIV prevention for adolescent substance users: a randomized, controlled trial. J Subst Abuse Treat 2015; 59: 30–37.

51.

McCarthy

Ahamed

Kulaeva

, et al. A randomized controlled trial of an intervention delivered by mobile phone app instant messaging to increase the acceptability of effective contraception among young people in Tajikistan. Reprod Health 2018; 15(1): 28.

52.

McCarthy

Zghayyer

Stavridis

, et al. A randomized controlled trial of an intervention delivered by mobile phone text message to increase the acceptability of effective contraception among young women in Palestine. Trials 2019; 20(1): 228.

53.

McRee

Shoben

Bauermeister

, et al. Outsmart HPV: acceptability and short-term effects of a web-based HPV vaccination intervention for young adult gay and bisexual men. Vaccine 2018; 36(52): 8158–8164.

54.

Mortimer

Rhee

Guy

, et al. A web-based personally controlled health management system increases sexually transmitted infection screening rates in young people: a randomized controlled trial. J Am Med Inform Assoc 2015; 22(4): 805–814.

55.

Nielsen

De Costa

Gemzell-Danielsson

, et al. The MOSEXY trial: mobile phone intervention for sexual health in youth—a pragmatic randomised controlled trial to evaluate the effect of a smartphone application on sexual health in youth in Stockholm, Sweden. Sex Transm Infect 2021; 97(2): 141–146.

56.

Odeny

Bailey

Bukusi

, et al. Effect of text messaging to deter early resumption of sexual activity after male circumcision for HIV prevention: a randomized controlled trial. J Acquir Immune Defic Syndr 2014; 65(2): e50–e57.

57.

Ofoegbu

Otu

Christopher

, et al. Impact of an educational digital storytelling intervention on HIV risk perception among Nigerian adolescents. J Int Med Res 2020; 48(1): 030006051985463.

58.

Perez-Lu

Guerrero

Cárcamo

, et al. The ARMADILLO text message intervention to improve the sexual and reproductive health knowledge of adolescents in Peru: results of a randomized controlled trial. PLoS One 2022; 17(2): e0262986.

59.

Riese

Houck

Abdullahi

, et al. An electronic sexual health module for hospitalized adolescent girls. Hosp Pediatr 2019; 9(11): 880–887.

60.

Rinehart

Leslie

Durfee

, et al. Acceptability and efficacy of a sexual health texting intervention designed to support adolescent females. Acad Pediatr 2020; 20(4): 475–484.

61.

Rokicki

Fink

Assessing the reach and effectiveness of mHealth: evidence from a reproductive health program for adolescent girls in Ghana. BMC Public Health 2017; 17(1): 969.

62.

Sabben

Mudhune

Ondeng’e

, et al. A smartphone game to prevent HIV among young Africans (Tumaini): assessing intervention and study acceptability among adolescents and their parents in a randomized controlled trial. JMIR Mhealth Uhealth 2019; 7(5): e13049.

63.

Schnall

Kuhns

Pearson

, et al. Preliminary results from a pragmatic clinical trial of MyPEEPS mobile to improve HIV prevention behaviors in young men. Stud Health Technol Inform 2020; 270: 1365–1366.

64.

Shegog

Peskin

Markham

, et al. It’s your game-tech: toward sexual health in the digital age. Creat Educ 2014; 5(15): 1428–1447.

65.

Starosta

Cranston

Earleywine

Safer sex in a digital world: a Web-based motivational enhancement intervention to increase condom use among college women. J Am Coll Health 2016; 64(3): 184–193.

66.

Stephenson

Bailey

Blandford

, et al. An interactive website to aid young women’s choice of contraception: feasibility and efficacy RCT. Health Technol Assess 2020; 24(56): 1–44.

67.

Tan

RKJ

Koh

, et al. Effect of a popular web drama video series on HIV and other sexually transmitted infection testing among gay, bisexual, and other men who have sex with men in Singapore: community-based, pragmatic, randomized controlled trial. J Med Internet Res 2022; 24(5): e31401.

68.

Tang

Zheng

Zhang

, et al. Evaluation of an AIDS educational mobile game (AIDS Fighter · Health Defense) for young students to improve AIDS-related knowledge, stigma, and attitude linked to high-risk behaviors in China: randomized controlled trial. JMIR Serious Games 2022; 10(1): e32400.

69.

Winskell

Sabben

Akelo

, et al. A Smartphone game-based intervention (Tumaini) to prevent HIV among young Africans: pilot randomized controlled trial. JMIR Mhealth Uhealth 2018; 6(8): e10482.

70.

Wirsiy

Atuhaire

Ngonzi

, et al. A randomized controlled trial on mobile phone text messaging to improve sexo-reproductive health among adolescent girls in Cameroon. Contracept Reprod Med 2022; 7(1): 12.

71.

Wong

JYH

Zhang

, et al. An interactive web-based sexual health literacy program for safe sex practice for female Chinese university students: multicenter randomized controlled trial. J Med Internet Res 2021; 23(3): e22564.

72.

Ybarra

Agaba

Nyemara

A pilot RCT evaluating InThistoGether, an mHealth HIV prevention program for Ugandan youth. AIDS Behav 2021; 25(10): 3437–3448.

73.

Zha

Mahat

Qureshi

, et al. Utilising a WeChat intervention to improve HIV and AIDS education among college students in China. Health Educ J. 2021;80(8):1002–1013.

74.

Widman

Golin

Kamke

, et al. Sexual assertiveness skills and sexual decision-making in adolescent girls: randomized controlled trial of an online program. Am J Public Health 2018; 108(1): 96–102.

75.

Babalola

Loehr

Oyenubi

, et al. Efficacy of a digital health tool on contraceptive ideation and use in Nigeria: results of a cluster-randomized control trial. Glob Health Sci Pract 2019; 7(2): 273–288.

76.

Lohan

Aventin

Clarke

, et al. Can teenage men be targeted to prevent teenage pregnancy? A feasibility cluster randomised controlled intervention trial in schools. Prev Sci 2018; 19(8): 1079–1090.

77.

Tebb

Rodriguez

Pollack

, et al. Improving contraceptive use among Latina adolescents: a cluster-randomized controlled trial evaluating an mHealth application, Health-E You/Salud iTu. Contraception 2021; 104(3): 246–253.

78.

Zhang

Chen

Zhou

, et al. Impact of web-based health education on HPV vaccination uptake among college girl students in Western and Northern China: a follow-up study. BMC Womens Health 2022; 22(1): 46.

79.

Ujang

Sutan

The effects of short health messages intervention in improving knowledge and attitude on sexual and reproductive health among late adolescents at colleges in Malaysia. Open J Prev Med 2018; 8(8): 207–228.

80.

Haruna

Okoye

Zainuddin

, et al. Gamifying sexual education for adolescents in a low-tech setting: quasi-experimental design study. JMIR Serious Games 2021; 9(4): e19614.

81.

Musiimenta

A controlled pre-post evaluation of a computer-based HIV/AIDS education on students’ sexual behaviors, knowledge and attitudes. Online J Public Health Inform 2012; 4(1): ojphi.v4i1.4017.

82.

Nalwanga

Nuwamanya

Nuwasiima

, et al. Utilization of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda. Reprod Health 2021; 18(1): 95.

83.

Nik Farid

Mohd Arshad

MFB

Yakub

, et al. Improving Malaysian adolescent sexual and reproductive health: an internet-based health promotion programme as a potential intervention. Health Educ J 2018; 77(7): 837–848.

84.

Njuguna

Ngure

Mugo

, et al. The effect of human immunodeficiency virus prevention and reproductive health text messages on human immunodeficiency virus testing among young women in rural Kenya: a pilot study. Sex Transm Dis 2016; 43(6): 353–359.

85.

Turah

Anggraen

Setiawati

The effect of an android application on adolescent’s knowledge and attitudes toward premarital sex. Ann Trop Med Public Health 2019; 22(11): 150–157.

86.

Jones

Eathington

Baldwin

, et al. The impact of health education transmitted via social media or text messaging on adolescent and young adult risky sexual behavior: a systematic review of the literature. Sex Transm Dis 2014; 41(7): 413–419.

87.

United Nations Educational, Scientific and Cultural Organization (UNESCO). Comprehensive sexuality education: for healthy, informed and empowered learners, https://www.unesco.org/en/health-education/cse (2023, accessed 10 December 2023).

88.

Huang

Kumar

Cheng

, et al. Applying technology to promote sexual and reproductive health and prevent gender based violence for adolescents in low and middle-income countries: digital health strategies synthesis from an umbrella review. BMC Health Serv Res 2022; 22(1): 1373.

89.

Liberty

Samuelson Bannow

Matteson

, et al. Menstrual technology innovations and the implications for heavy menstrual bleeding. Obstet Gynecol 2023; 141(4): 666–673.

90.

Adler

Biggs

Kaller

, et al. Changes in the frequency and type of barriers to reproductive health care between 2017 and 2021. JAMA Netw Open 2023; 6(4): e237461.

Digital knowledge translation tools for sexual and reproductive health information to adolescents: an evidence gap-map

Abstract

Background:

Objectives:

Design:

Data sources and methods:

Results:

Conclusion:

Trial registration:

Keywords

Introduction

Methods

Results

Discussion

Limitations

Conclusion

Footnotes

Appendix

Acknowledgements

Declarations

ORCID iDs

References