Now, the Boston Public Health Commission (BPHC) has incorporated these new media outlets into an ambitious campaign to educate teenagers about sexually transmitted infections, diseases such as chlamydia and gonorrhea, that affect one out of four sexually active teenagers in the U.S.
Health and new media experts said the BPHC's viral messaging approach is a step in the right direction but that it needs to be taken to the next level in order to change teenage sexual behavior.
"The underlying principle on this campaign that is different from past campaigns is that if we want to be successful, we need to be youth driven and youth appropriate," said Dr. Barbara Ferrer, executive director of the BPHC, particularly in terms of what venues are most likely to be sought after and seen by adolescents. "They have input into how messages are created that target them. The content is definitely not ours."
Youth-to-Youth Internet STI Education Efforts
The youth-driven campaign, launched yesterday, utilized an interactive Facebook page where users can post anonymous health questions, YouTube video skits about STIs that also run on the cable channels MTV, BET and FX, advertisements on billboards and buses around Boston, and in-person outreach in the form of public skits performed by youth volunteers.
"In terms of today's vehicles, you have to meet teens where they're at," said Tara Cousineau, a psychologist and founder of bodimojo.com, a health site for teens, citing the Internet, Facebook, Twitter and MTV as popular information disseminators. "The part that is still a challenge is how to get the messages to sink in. ... You have to be passing the message along but engaging the kid in the message along the way."
Cousineau said using interactive Web features such as quizzes that could be completed and forwarded to friends was one way to continue spreading a message.
The Old Sex-Ed Wasn't Working, Study Shows
"Anonymity is a great idea," said Lea Guise, 20, from Milton, Mass., referring to the question-and-answer feature on the campaign's Facebook page. "It's embarrassing. ... No one really wants to ask any questions in front of their whole [health] class."
And information that comes from other peers may be valued higher than information that comes from an adult because it seems -- and often is -- more sympathetic, which is one reason the BPHC has involved so many youth leaders in their STI education campaign.
"There's no question that adolescents respect peers in regard to issues that are important to them," said Dr. Mark Goldstein, chief of the Division of Adolescent and Young Adult Medicine at Massachusetts General Hospital. "We've found that [youth] are much more comfortable talking with people their own age about STI issues rather than an adult."
Past Education Methods Proved Ineffective
Ferrer pointed out that past sexual health education methods, in which adults imparted factual information to teens in school or at home, have become increasingly unsuccessful.
"[That way] doesn't work as well and we have the statistics that show that," she said.
A 2009 report from the BPHC showed that, among Boston adolescents ages 15-19, the rate of those diagnosed with chlamydia increased 66 percent over eight years to infect 1,383 youths in 2007.
Adolescents who are sexually active are uniquely at risk because they may be more likely to have multiple sexual partners, engage in unprotected sex, use alcohol or other substances before or during sex, and are more likely to have an injury during sex, which makes it easier to contract STIs.
In addition to better screening for STIs, Ferrer said the report's results are likely the result of increased complacency among teens and educators about understanding risks and how to protect themselves.
And saturating teens with nuts-and-bolts information about STIs and sexual health may not be enough, as the rising rates of infections show.
"You can plaster information all over the place, but still, the behavior isn't changing," Cousineau said. "That [AIDS] scare factor that was really real 20 years ago isn't prevalent amongst the current generation of teens."
Negotiating Safer Sex Is the Next Educational Challenge
Instead, there is a wide gap for information about learning the skills to negotiate conversations about safer sex -- conversations where factual information might be relevant but using it could be intimidating.
This gap is one new media venues could be poised to fill.
"This is, I think, the next step for YouTube type of videos -- role playing how to negotiate saying no if your partner doesn't have a condom, what to do if it breaks and how to go about asking for help," Cousineau said. "Have teens portray the skills the way they think are helpful and teach it that way as opposed to [simply] what an STI is."
The BPHC's program could easily segue into other topics affecting adolescent health such as drug abuse or academic achievement. Ferrer said the BPHC plans next to launch a similar campaign utilizing Facebook and YouTube aimed at dating violence.
"I think it's going to change the way we think about doing public health work in the future as well as change response from young people," Ferrer said. "With young people, it's really different, the level of communication and the technology used to do that communication. We need to take advantage of it."