Project Summary

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

This PCORI-funded implementation project is putting an app shown to increase teens’ knowledge, confidence, and use of birth control into practice at school-based health centers across the country.

Most teen pregnancies are unplanned and result from teens not using birth control, or not using it correctly or consistently. Contraceptive education and tailored support for decision making can help teens choose birth control that is right for them and prevent unplanned pregnancies.

What is the goal of this implementation project?

Clinicians like doctors or nurses can educate and counsel teens about birth control methods. But clinicians may lack the experience or time to offer in-depth services. A PCORI-funded research study found that Latina teens who used an interactive app called Health-E You/Salud iTuTM before visits at school-based health centers, or SBHCs, were more likely to use an effective birth control method than teens who received usual care. Teens who used the app also knew more about birth control and felt more confident in choosing and using a birth control method.

This project will expand the use of the app to SBHCs serving teens with diverse racial and ethnic backgrounds across the United States to increase teen use of effective birth control methods.

What will this project do?

The project team is working to make the app part of standard care in about 30 SBHCs across the United States. At these sites, teens receive a link to access the app when staff schedule their clinic appointment or at the time of their clinic visit. Teens can access the website that hosts the app from any device with internet access, such as a phone or tablet. They can use it either at home or in the clinic before their appointment.

The app, which is in English and Spanish, helps teens learn about different birth control methods using a game format. It also includes questions to help teens choose a birth control method that is a good fit for them. The app provides the SBHC clinician with a summary of information entered in the app prior to the visit. The summary includes the methods of birth control that the app recommended and the methods the teen is most interested in using.

The project team is training clinicians, medical assistants, managers, and receptionists at the clinic to support use of the app at the SBHCs as part of routine care. The team is also:

  • Creating materials, like manuals and trainings, to help SBHC staff learn about the app
  • Training SBHC staff to discuss results with teens
  • Providing ongoing technical support

What is the expected impact of this project?

This project will put the app in place at SBHCs in eight states and demonstrate what’s required for broader uptake.

The project will train more than 135 clinic staff to use the app and provide information about effective birth control to more than 16,000 teens from diverse racial and ethnic backgrounds. The project evaluation will assess how well the app is working as intended to increase teens’ knowledge about and use of effective birth control methods.

More about this implementation project:

Stakeholders Involved in This Project

  • National youth advisory board
  • School-Based Health Alliance
  • Clinic staff from all SBHCs who will serve as site champions
  • Representatives from SBHCs, federally qualified health centers, university health centers
  • Los Angeles Trust for Children’s Health
  • University of California San Francisco
  • University of California, Los Angeles
  • Representatives of state adolescent health authorities (coordinator for California Maternal, Child, and Adolescent Health Program)
  • California School-Based Health Alliance

Implementation Strategies

  • Adapt the program to work with existing sites’ resources and workflows, including different delivery approaches, including in-person, telehealth, and hybrid.
  • Create and support implementation teams at sites.
  • Provide sites with tools to support implementation, including implementation manuals and training webinars.
  • Provide educational materials to patients, as part of mobile app.
  • Train clinic staff, including clinicians, medical assistants, managers, and receptionists, to deliver the app and use the app dashboard.
  • Identify and prepare champions at sites, who will lead implementation efforts
  • Use a phased implementation approach, launching the program in three waves.
  • Provide technical assistance to sites.
  • Partner with national stakeholder organization to develop plans for further program scaleup.

Evaluation Outcomes

To document implementation:

  • Number and proportion of adolescents using the app (app data)
  • Provider use of reports (app data)
  • Acceptability, feasibility, and maintenance of app (interviews and surveys)

To assess healthcare and health outcomes:

  • Adolescents’ contraceptive knowledge
  • Clinician-adolescent communication
  • Adolescents’ perceived visit quality
  • Adolescents’ self-efficacy to select, discuss, and use contraception
  • Adolescents’ use of an effective, or more effective, contraceptive method (3 and 6-month follow up)
  • Adolescents’ satisfaction with contraceptive method chosen

Project Information

Kathleen Tebb, PhD
The Regents of the University of California, San Francisco
Implementation of Health-E You/Salud iTu to Promote Adolescent-Centered Contraceptive Care

Key Dates

March 2021
May 2025

Initial PCORI-Funded Research Study

This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Using an iPad App in School Health Centers to Support Latina Teens Making Choices about Birth Control -- The Health-E You/Salud iTu Intervention


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Last updated: March 15, 2024