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12TECHsexYouthSexualityandHealthOnlineAnationalstudyexploringtherelationshipsbetweentechnology,youth,andsexualreproductivehealthandrightsJamesLykens,ProgramCoordinator,YTHMollyPilloton,ProgramOfficer,YTHCaraSilva,DirectorofPrograms,YTHEmmaSchlamm,ProgramAssistant,YTHBhupendraSheoran,ExecutiveDirector,YTHFebruary2017SupportedbytheDavid&LucilePackardFoundation.
3AbouttheAuthorsYTH(Youth+Tech+Health)isanonprofitorganizationfoundedin2001andbasedinOakland,CA.
Usinginnovativetechnologiesandnewmedia,YTHsupportsandempowersyouthtomakeinformeddecisionsabouttheirhealth,therebyenablingthemtobecomepowerfulself-advocates.
AcknowledgmentsThisreportwasfundedbythegeneroussupportoftheDavidandLucilePackardFoundation.
Theauthorswishtothankthefollowingfortheircontributionstothereport:AshawndaFleming,JohannLarkin,andJoyaThompsonHetrick-MartinInstituteTiffanyPryorandNatalyBarreraIllinoisCaucusforAdolescentHealthTinaSimpsonandJanicePhillipsUniversityofAlabamaChildren'sHospitalVictorDiazREALMCharterHighSchoolEmmaPenceYTH(Youth+Tech+Health)MarilynYoungandAshleyMcKayTunicaTeensinActionKristieBardellLouisianaPublicHealthInstituteKeishaBurdineBerkeleyYouthAlternativesKateWilburnYTH(Youth+Tech+Health)JuneSugiyamaVodafoneAmericas4Wealsowishtoacknowledgeoursexualandreproductivehealthandrights(SRHR)andyouthhealthexpertsoftheStakeholderAdvisoryCouncilandthenationalYTHYouthAdvisoryBoard(YAB)whoprovidedcriticalinsightstothisreport.
LucindaHoltSex,Etc.
/Answer.
FredDillonHopeLabsSheriBaumanUniversityofArizonaMaxKamin-CrossYouthAdvisoryBoardDeborahS.
LevinePlannedParenthoodFederationofAmericaMulubaHabanyamaYouthAdvisoryBoardBrookeRobertsYouthAdvisoryBoardKristiMillerWestWindFoundationIanaSimeonovUCSFmLabs/PublicHealthInstituteRocioCordobaConwayStrategicDonyaNasserYouthAdvisoryBoardSusannahAllisonNationalInstituteofMentalHealthTiffanyPriorIllinoisCaucusforAdolescentHealthVianeyTwyfordYouthAdvisoryBoardElisabethDeeYouthAdvisoryBoardRebeccaLehnerYouthAdvisoryBoardBradTroegerHealthTeacher101MoniqueNguyenYouthAdvisoryBoardJanayaGreeneYouthAdvisoryBoardShawnReillyYouthAdvisoryBoardBaileyPolandFindlayUniversityEmilyLindinTheUnSlutProjectJohnRossYouthAdvisoryBoardDebraHauserAdvocatesforYouthTherecommendedcitationforthisreportis:Lykens,J.
,Pilloton,M.
,Silva,C.
,Schlamm,E.
,&Sheoran,B.
TECHsex:YouthSexualityandHealthOnline.
Oakland,CA:YTH,February,2017.
ThisworkislicensedundertheCreativeCommonsAttribution-ShareAlike4.
0InternationalLicense.
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org/licenses/by-sa/4.
0/5TableofContentsIntroduction6TechnologyandSexualHealth:ThePastDecade.
8SocialMedia9SexualHealthOnline.
9UpdatingtheLandscapewithTECHsex2017.
11Methodology.
12LiteratureReview.
14StakeholderInsights14NationalSurvey15FocusGroups16Findings18CurrentSexualLandscape19GoogleforSexualHealth.
21PopularWebsitesforSRHRIssues.
25Crosschecking.
26OnlineDatingandFlirting28CurrentDigitalLandscape.
35SocialMediaandMentalHealth37VideoGames.
38Cyberbullying39TheSouthernUS41StakeholderInsights452011vs.
2017;AnUpdate.
47Recommendations49Conclusion.
54References.
55Glossary.
576"Forsexualhealth,IGoogleit.
.
.
Idon'taskfamilybecausethat'stooweird.
"Youtharenowmoreconnectedthanever.
Appdownloads,smartphoneaccess,Wi-Fi,andsocialmediaarenowsocommonplacethatitisraretofindayoungpersonwithoutaFacebookorSnapchatprofile.
Withthissaturatedaccess,youthareturningtowardswebsites,blogs,andGoogleastheirmaincontactsforinformationoncountlesstopics,includingquestionsabouttheirsexualhealth.
ButwhatdowereallyknowaboutthecurrentdigitallandscapeamongyouthandhowitrelatestotheiraccesstoinformationIfyoutharefailingtogetanswerstotheirsexualhealthquestions,wherearetheygoingtoaskthosequestionsIn2016-2017,YTHreceivedfundingfromtheDavidandLucilePackardFoundationtoexplorethecurrenttrendsandpatternsamongyouthtechnologyuseandsexualhealthwithrespecttothechanginglandscapeidentifiedinYTH's2011TECHsexUSAfindings1.
ThemaingoaloftheTECHsex2017researchwastodiscoverhowyouthareaccessingsexualhealthinformationonlineandwhatthisimpliesforsexualhealthandsexeducationacrosstheUS.
Similaritiesanddifferencesofyouthtechnologyuseandtrendsareidentifiedbetweenthe2011and2017reports,andhighlighthowquicklythelandscapeischangingINTRODUCTION7(see2011vs2017:AnUpdate).
Inaddition,theUSSouthhasbeenbearingtheburdenofdisproportionateSTDandHIVratesamongyouth,butresearchershavefailedtotakeacloselookatthisregion.
ThisreporttakesacloserlookatthreeSouthernstates,Louisiana,Alabama,andMississippi,tounderstandmoreaboutsexualhealthanddigitaltechnologyamongyouthinthisregion.
FindingsincludedatafromaquantitativenationalsurveyandqualitativefocusgroupsacrosssevenUScities.
Boththesurveyandfocusgroupspaintamoredetailedpictureofwhatitmeanstobeayoungpersonaccessingnewdigitaltechnologiesandtheimplicationsthishasfortheirsexualhealth.
Bydescribingtheheavytechnologicalcontextthatayoungpersonlives,wecanfurtherunderstandtheirexperiences,needforhealthinformation,andbestpracticesforprogramimplementation.
Lastly,ageneraloverviewoftechnologyandsocialmediaissuesarepresented,aswellasconcreterecommendationsforworkingwithyouthandimprovingtheirhealth.
8TECHNOLOGYANDSEXUALHEALTH:ThePastDecadeAccordingtoa2015reportfromthePEWResearchCenter,nearly92%ofteensaccesstheInternetdaily.
Atthesametime,almost75%ofteensnowhavesmartphones,makingtheInternethighlyaccessibleandpersonal2.
Computeraccesshasalsoincreasedinrecentyears,with93%ofteensowningorhavingaccesstoapersonalcomputerin20133.
ThisdrasticincreaseinaccessibilityandfeasibilityhaspavedthewayforenhancedtechnologyuseamongUSyouth,whichhaschangedthewayyouthaccessinformation,entertainment,andresources.
Theseadvanceshavecreatedanenvironmentinwhichyoutharehardlyever"unplugged".
Nearly92%ofteensaccesstheInternetdaily.
YouthturntotheInternetforamultitudeofreasons,includingpeerconnection,informationaccess,confidentialsexualhealthinformation,andentertainment.
SocialmediaplatformslikeFacebook,Tumblr,andInstagramofferwaysforyouthtofacilitatefriendshipsinamannerthatisvisible,customizable,andpersonal.
Socialmediahasgrownsignificantlyinthepastdecade;71%ofallteensnowhaveaFacebookaccount4.
Withsomuchinformationonlineandthevastselectionofsocialmediaplatforms,youthhavetheirpickofthelitterwhenitcomestoinformation-seekingbehaviorsandtechnologicalpreferences.
Whileadigitaldivideacrossgender,race/ethnicity,socioeconomicstatus(SES),andagewascommonplaceinthisresearch,amajorityofyouthnowhaveaccesstosmartphonesandtheinternetacrosstheboard.
AccordingtothePEWResearchCenter,womenofcolorarenowsomeofthehighestusersoftechnology5.
Inthepastfewyears,African-AmericanwomenweresomeofthemostprolificTwitterusers,withmultiplesocialjusticecampaignsstartedbyyoungAfrican-AmericanwomenintheTwittersphere.
LatinawomenarealsosomeofthehighestusersofPinterest,Facebook,andTwitter.
9SocialMediaSocialmediausehasincreaseddramaticallyinrecentyears.
In2015alone,approximately71%ofteensusedFacebook,52%usedInstagram,41%usedSnapchat,and33%usedTwitter6.
Themostpopularsocialmediawebsitesamongyouthinearly2015wereFacebook,Instagram,Snapchat,Twitter,andVine7.
Inaddition,youthareusingmessagingappslikeKikandWhatsApp,anonymouschatalternativestotextmessaging8.
In2016,livestreaminggainedtractionthroughsiteslikeYouNowandPeriscope.
SexualHealthOnlineThenatureofsexualhealthcanbedifficult,andyouthfrequentlyusetheInternettoaccesssexualhealthinformationwithouthavingtoaskaparentorguardian.
Withincreasingratesofsmartphoneandinternetaccess,itmakessensethatyouthareaccessing10thisvitalresourcefortheirsexualhealthneeds;yet,littlehasbeendonetounderstandhowandwhyyouthconsulttheinternetforsexualhealthinformation.
Studiesshowthatonlinesexualhealthinformationandtech-basedinterventionscanbeespeciallyusefulforsexualminoritygroups9andminoritycommunitiesthatarenotrepresentedinpublicsexeducation10.
Inaddition,homelessandunstablyhousedyouthalsofrequentlyusetheinternetinordertofindresourcesandusesocialmedia,whichhasbeenconnectedtohigherknowledgeofHIVandotherSTIsamonghomelessyouth11.
Sexualhealthappsingeneralhavebeenontherise;arecentreportbyAnswerillustratesthebenefitsinreachingyouthviasmartphoneappsforsexeducation,includingtopicslikeconsent,condomfinders,andbirthcontroladherence12.
Youthalsopreferthesafetyoftechnologywheninteractingwithsexpartners,with49%ofteensusingtechnologyratherthanface-to-faceconversationtonegotiatesafersex13.
Textingprogramshaveprovidedsafespacesandoftencircumventstigmaandembarrassment,makingsafersexconversationspossible14.
Socialmedia-basedhealthinterventionshavebeensuccessfulinreachingyouthandimprovingsexualhealth.
Numerousstudieshaveshownthathealthbehaviorchangeandinformationaccessispossiblethroughonlinecampaigns,especiallywhentheyaresupplementedwithtexting15,16,17,18.
Thesetech-basedinterventionsholdsomeofthegreatestpromiseinreachingyoungpeoplewithsexeducation19.
11UpdatingtheLandscapewithTECHsex2017Despitethesefindings,littlehasbeendonetounderstandtherelationshipbetweenyouthsexualhealthneedsandtheinternet.
WhydoyouthtrustcertainsitesoverothersWhyisonlinesexualhealthinformationsosuccessfulforyouthInordertodevelopandimplementsuccessfulsexualhealthprograms,itisvitaltounderstandthesenuanceswithinsocialmediatrendsandtheyouthcommunity.
Thisreportdelvesfurtherintotherelationshipbetweenyouthhealth—particularlysexualandreproductivehealthandrights(SRHR)—andtechnology,andwhatwecanlearnfromthisnewdigitalworld.
Thesethemes,rangingfromsexualhealthinformationonlinetouseoftechnology,willbeexploredinthecontextofactualyouthexperienceandcurrentnationaltrends.
Weencouragereaderstothinkcriticallyaboutthesefindingsasyouengagewithyouthintoday'sdigitalworld.
12II.
METHODOLOGY13TECHsexwascompletedinmultiplephases:METHODOLOGYLiteratureReviewStakeholderInsightsNationalSurveyFocusGroups141.
LiteratureReviewAsystematicliteraturereviewwascompiledusingmultipledatabases,relyingonGoogleScholar,selectedbooks,andonlinedatabasesincludingPsycINFO(EBSCO),ProQuest,andERIC.
Referencesectionsofpublishedarticlesandwhitepaperswerealsosearchedforprominentstudies.
Onlypeer-reviewedjournalarticles,reports,newsarticles,orpublishedbookswereincludedintheliteraturereview.
Thefollowingkeywordswereusedinordertolocaterelevantliterature:youth,digitaltechnology,technologyaccess,teens,sexualhealth,reproductivehealth,smartphones,Internet,digitalbehaviors,media,videogames,digitaldivide,socialmedia,mHealth,cyberbullying,texting,andonlinehealthinformation.
KeywordswerechosenbyidentifyingprominentthemeswithintherecentandexhaustivetechnologyreportTeens,SocialMedia&TechnologyOverviewbythePEWResearchCenterin2015.
Duetotheevolvingnatureoftechnology,onlyliteraturedatedfrom2011-2016wasincludedforreview.
Twoteammembersreviewedarticleabstractstodetermineifthekeywordshadproducedrelevantpublicationsonyouthhealthandtechnology.
Oncethesystematicliteraturehadbeencompiledandanalyzed,articleswerecategorizedbymainthemes.
Themesincludedpopulartechnologyusedbyyouth,healthinformation-seekingbehaviors,sexualhealthonline,cyberbullying,onlinedating,healthinterventions,andvideogameaddiction.
Thesethemesdeterminedwhichexpertsweretobeincludedforthesecondphaseofthisproject,includingbuildinganinterviewprotocolandinterviewingmainthemeexperts.
2.
StakeholderInsightsStakeholdersandexpertsassistedinthestructureofthefocusgroupsandonlinenationalsurvey.
ThenationalYTHYouthAdvisoryBoard(YAB)wereconsultedforyouthinputandadvisementthroughouttheresearchdevelopment,andaStakeholderAdvisoryCouncilwasdevelopedtogainprofessionalinsightsandexpertiseinthefieldsofSRHR,sexeducation,socialmedia,youthhealth,andmobilehealth(mHealth).
Thirteeninterviewswereconductedoverthetelephone,recorded,andtranscribedforaccuracy.
1524%76%Hispanic/LatinoNon-Hispanic/Latino62%33%5%WomenMenTransgender-spectrum5%9%20%1%55%10%AmericanIndianorAlaskaNativeAsianBlackorAfrican-AmericanNativeHawaiianorotherPacificIslanderWhiteAnotherrace3.
NationalSurveyThenationalsurveywashostedonlinethroughQualtricsandadministeredto1,500youth.
Crosstabulationsandfrequencieswereanalyzedforpatternsintechnologyuse,SRHRissues,andyouthhealth.
100+onlinequestionsRace,GenderandEthnicityBreakdownN=1,5001,500respondentsages13-24NationalreachacrosstheUS161%3%81%1%4%1%AmericanIndianorAlaskaNativeAsianBlackorAfrican-AmericanNativeHawaiianorotherPacificIslanderWhiteAnotherrace19%81%Hispanic/LatinoNon-Hispanic/Latino51%42%7%WomenMenTransgender-spectrum4.
FocusGroupsFocusgroupswereconductedin7UScities,includingBerkeley,CA,Oakland,CA,Tunica,MS,Birmingham,AL,Newark,NJ,NewOrleans,LA,andChicago,IL.
Twofocusgroupspersitewereconducted,oneforparticipantsunder18yearsandoneforover-18.
Focusgroupswereaudiorecorded,transcribed,andde-identifiedforconfidentialitypurposes.
Twoteammembersanalyzedandcodedthetranscriptsusingathematicanalysisapproach,whichhighlightedthemesacrossfocusgroupsites.
12focusgroupsRace,GenderandEthnicityBreakdownN=6666respondentsages13-247citiesacrosstheUS17III.
FINDINGS18Resultsfromthenationalsurveyandfocusgroupsgiveusanideaofayoungperson'sexperienceinthecurrentdigitalworld.
Smartphoneandlaptopaccessishigherthanpreviousreportsin2011.
SocialmediaplatformpreferenceshavechangedfromFacebooktoInstagramandSnapchat.
Whileinterestinhealthtopicsvary,involvementinsocialmedia,videogames,onlineentertainment,andGooglingforSRHRinformationareexceptionallycommonplace.
Thesefindingshaveimplicationsforfuturesexualhealthinterventions,particularlyinpromotingyouthinterest.
FINDINGS1915%22%19%51%33%50%34%49%31%55%51%63%21%23%37%22%21%15%39%35%65%51%63%45%12%31%6%30%47%38%37%43%47%47%56%52%Figure1.
Ingeneral,whichofthefollowingtopicsareimportanttoyouCheckallthatapply.
Women(n=931)Men(n=504)Transgender-spectrum(n=65)*Tableswithinthisreportillustratesurveyresponsesviaproportionbygenderidentity.
Pleasenotethedifferingsamplesizespergenderwhendrawinginferencesfromgraphs.
CurrentSexualLandscapeYouthareinterestedinavarietyofhealthtopics.
Thenationalsurveyandfocusgroupsprovidetwocontrastingfindings;accordingtothesurvey,SRHRissuesarenotoneofthehighestconcerns.
Yet,focusgroupparticipantscitedSRHRissuesassomeofthemostimportantissuesintheircommunities.
Forthesurvey,birthcontrolisthefirstSRHRtopicthatarises,butitisonlythefifthmostinterestinghealthissuetoyouth.
Inaddition,farmorewomenthanmenreportedthattheyconsideredSRHRissuesimportant,includingbirthcontrol,pregnancy,andsexuallytransmittedinfections.
Intermsofgeneraltopics,youthreportedthateducationwasthemostimportant,followedbyhealth,career,dating,andgaming(Figure1andFigure2).
20"Iwouldsaycontraception[isthemostimportanthealthtopic].
Yeah,likebirthcontrolstuff.
Well,Ithinkit'sjustlikehavingaccessandknowingwhereyoucangotogetitcheap.
"Chicago,under18Incontrast,thefocusgroupparticipantsnotedthatSRHRissuesareimpactingtheircommunitiesinmanyways.
Teenpregnancywascitedasaparticularlyimportantissue.
FocusgroupparticipantsbelievedthatmoreprogressiveSRHRprogramscouldaddresstheseconcerns.
45%43%54%42%49%29%28%26%50%52%16%12%40%15%47%4%28%9%21%20%30%25%21%23%40%29%43%28%64%18%34%25%43%47%18%32%Figure2.
WhichofthefollowinghealthtopicsinterestyouCheckallthatapply.
Women(n=931)Men(n=504)Transgender-spectrum(n=65)21Youthstatedthatthelackofqualitysexeducationinschools,combinedwithparentswhorefusetotalkaboutsex,ledtotheirpeershavingareactiveratherthanpreventiveattitudetowardsSTDs.
ManyparticipantsknewoffriendswhoonlycaredabouttheirhealthaftertheyhadalreadycontractedanSTDorbecamepregnant.
Youthexpressedthathealtheducationshouldfocusonpreventativecareinordertogiveyouthtoolsfornavigatingtheirsexualhealth.
GoogleforSexualHealthThemajorityofrespondentsansweredthattheywouldconsultGoogleiftheyhadquestionsabouttheirhealth.
ThiswasparticularlytrueforquestionsrelatedtoSRHR.
FarmorewomenthanmenreportedthattheyconsideredSRHRissuesimportant,includingbirthcontrol,pregnancy,andsexuallytransmittedinfections.
"WeareawareofSTDs,butIthinkwereallywantmorevaccinationsthananything.
It'slike,'OhIhavechlamydia,letmejustgogetitcured.
'Peoplearelike'Icanjustgofixit.
'Butit'slikeafterawhileit'sgonnastarttakingatollonyou.
Ijustfeellike,likePlanB:'Oh,IneedaPlanBI'lljustgotakeoneaftereverytimeIhavesex.
'It'sjustlikeittakesawayfromresponsibility.
Itbecomesacrutch.
"Birmingham,over18236%9%51%24%10%CompletelydissatisfiedSomewhatdissatisfiedNeutralSomewhatsatisfiedCompletelysatisfiedn=1,500Figure6.
Howsatisfiedareyouwiththeinclusivenessofsexualhealthinformationyoufindonline1%3%16%60%20%CompletelydissatisfiedSomewhatdissatisfiedNeutralSomewhatsatisfiedCompletelysatisfiedn=1,500Figure5.
HowsatisfiedareyouwiththeaccuracyofsexualhealthinformationyoufindonlineAcrossthesurveyandfocusgroups,GooglewasapopularplacetofindSRHRinformation.
YouthtrustedGooglebecauseitofferedconfidentiality,quickanswers,andeliminatedtheneedtoaskanadultforSRHRinformation.
Conversely,youthfromthesurveyreportedthatthesinglebestwaytolearnaboutsexualhealthwasfromadoctor,nurse,orclinic(Figure3).
Thisdiscrepancypointstoacontradictionthatyouthface;whileGoogleisthemostpopularlocationforsexualhealthinformation,themajorityofrespondentsstillbelievethebestsourceforsexualhealthinformationisahealthprofessional.
AvaryingamountoftrustinGoogleforsexualhealthinformationwasreported;ofthosewhousedGoogleforhealthinformation,60%ofyouthsomewhattrustedtheinformation.
MostyoutharesomewhatsatisfiedwiththeaccuracyofSRHRinformationonlineandneutralinregardstotheinclusivenessofSRHRinformationonline(Figures4,5,and6).
Focusgroupparticipantsalso1%1%1%1%1%2%2%3%3%3%4%6%7%14%21%30%CommunitycenterOnlinevideosChurch/placeofworshipMagazinesOtherVideogamesFriendsSchoolhealthclinicTVSocialmediaAdultwebsites/pornSpecificwebsites(LikeSex,Etc.
)FamilyHealthclassGoogleorothersearchengineDoctor,nurse,orclinicn=1,500Figure3.
WhatdoyouthinkistheSINGLE,MOSTEFFECTIVEWAYtolearnaboutsex,sexuality,andreproductivehealth1%3%16%60%20%CompletelydistrustedSomewhatdistrustedNeutralSomewhattrustedCompletelytrustedn=1,500Figure4.
HowmuchdoyoutrustthesexualhealthinformationyoufindonGoogle23SomesharedthatGooglewastypicallyaprimaryresourceforSRHRandgeneralhealthissues.
ThiswasparticularlytrueforyouthwhohadnoonetoturntoortrustforSRHRquestions.
Thefearofaskingparentsoftenstoppedyouthfromseekinginformationorcare.
Otherparticipantssharedthattheycouldasksomehealthquestionsfromparentsorguardians,butthataskingaboutsexualhealthwouldgetthemintoserioustroubleorwouldbetooembarrassing.
Whileparticipantsusuallywantedtoturntoparentsfirst,theydidnotthinktheywouldbeallowedtoaskquestionsandreceivehonestanswers.
FocusgroupparticipantssharedthatGooglewasaperfectwaytolocateservices,anonymouslyaskquestions,andassurethemselvesthattheywerenotpregnantordidnothaveanSTD.
Mostnotably,participantsagreedthatGoogleoftenreplacedtheneedtoseeadoctor.
Similartothequantitativesurvey,participantsstatedGooglewastheirfirstgo-toresourceforsexualhealthinformation,eventhoughtheybelievedthebestwaytoreceivehealthinformationwasthroughadoctor.
Regardless,goingtoanactualdoctorwasoftenalastresortformostfocusgroupparticipants.
"PeopleaskGoogleaboutsexfacts,yeah,causesometimesyoudon'thaveanyonetoasknobody.
"Newark,over18"I'dsaymostpeoplegoonlinecausemostpeopleareprobablyscaredtoasktheirparents.
Youcan'ttellyourparentseverything,youknow.
Sometimesyoujustcan'ttellthem.
"Chicago,under1824Googleoffersbenefitsanddrawbacks.
TheanonymityofaGooglesearchallowsyouthtofindinformationconfidentially,butGoogleandothersocialmediasiteshavepoliciesthatblockcertainsexualhealthinformationfromappearinginsearchresults20,21.
Theseblockscanoftenleadtoincompleteorinaccurateinformation.
Despitethechanceofinaccuracy,participantsoftenwenttoGoogleduetoitseaseofaccessandconfidentiality.
Foryouth,thisprivacyistantamount—evensimplysearchingforasexualhealthtopicwithouthavingtoaskapersonmadeyouthfeelmorecomfortableandinformedatthesametime.
ThiscombinationofprivacyandquickinformationmakesGoogleahighlysuccessfulandpreferredsourceofSRHRinformationforyouth.
"Welllikeifit'sserious,ifGooglecan'ttellmetheanswer,thenI'llgotoaclinic.
"Newark,over18"Ilookitup,butatthesametimeit'snotthatI'mscaredtoaskpeople…it'sthatIdon'twannaputmybusinessoutthere,liketothewrongperson.
SoIwouldeitherlookituponGoogleormaybeactuallygotothedoctorandask.
"Chicago,under1825"IfyoulookonWikipediayou'renotgonnagetasmuchinformationasifyougoonPlannedParenthood.
Orlikeatleastnotasaccurate.
"Oakland,under18PopularWebsitesforSRHRIssuesAsidefromGoogle,someyouthuseacombinationofsocialmediaandotherwebsitestofindSRHRinformation.
WhileGoogleisthemostpopularsource,SRHR-specificwebsitesandsocialmediaareotherpopularplacesforyouthtofindSRHRinformation(Figure7).
Accordingtothenationalsurvey,themostpopularSRHR-specificsitesincludeWebMD,PlannedParenthood,Sex,Etc.
,TeenSource,andGoAskAlice.
SocialmediasiteslikeYouTube,Facebook,andTumblrwerealsopopularspacesforSRHRinformation.
Someyouthalsoreportedgoingtopornographywebsitesforinformation.
Accordingtofocusgroups,youthbelievedthatsexeducationfrom.
eduor.
govsitescouldbeinformationalbutonlyexiststocreatefeararoundthenegativeconsequencesofsex.
Insteadofprovidingsex-positiveinformation,participantscomplainedthatsexeducationfrom.
eduor.
govsitesoftencenteraroundextremecasesofSTDsorteenpregnancyasawaytodeteryouthfromengaginginsex.
Wikipediawasanotherpopularsourceforhealthinformation,yetfocusgroupparticipantsdidnottrustthisinformationasmuchasothersites.
YouthsaidtheyweremorelikelytotrustorganizationslikePlannedParenthoodforreliablesexualhealthinformation.
Overall,governmentsitesandlocalclinic-basedsiteswereconsideredthebestoptionsforfindingaccurateinformation.
4%6%6%7%8%13%14%16%21%31%38%62%Adultwebsites/pornGoAskAliceTeenSourceFamilySex,Etc.
HealthClassTumblrPlannedParenthoodFacebookWebMDYouTubeGooglen=1,500Figure7.
TopPlacesforSexualHealthInformation26"Wellonline,inaccuratesexed[isanissue],becauseoflotofpeopledon'tgetaccuratesexedandtheyjustgoinblindtothings.
Andit'smainlylikewhattheylearnisprettymuchshockvaluewhentheygetshownSTI'sandtheygetscaredofeverythingsotheyspreadtheirfeartoeveryoneandgiveinaccurateinformation.
"Chicago,over18Somefocusgroupparticipantsalsostatedthatpornographywasanotherspacetolearnaboutsexandsexualhealth.
Consideringhowpublicandaccessiblepornographyhasbecomeonline,thisisclearlyasourcethatyouthareawareofandaccess.
Pornographypresentsanopportunityforyouthtoseerealsexualexperiences—somethingnottypicallyincludedinsexeducation—andisoftenanintriguingsourceforinformation.
Somefocusgroupparticipantsstatedthattheyhadlearnedaboutsexbywatchingpornography:CrosscheckingFocusgroupparticipantswereawareofthepotentialforfalseinformationfromGoogleandotherwebsites,andstatedthattheyhadtolearnthegoodsourcesfromthebad.
Often,thisresultedincross-checkingGoogle'sinformationwithothertrustedwebsites.
Focusgroupparticipantssaidthattheymosttrusted.
gov,.
edu,orspecificwebsitesfromorganizationstheyknewandtrusted.
Thesetrustedwebsitesincludedsitesofclinicsthey"Ilearnedbyporn.
LikeIhadbadfriendsandtheywerelikeohlookatthisandtheyjustpoppeditinanditwasporn…wejustsattherewatchingitandwedidn'tknowwhatwasgoingon.
"Newark,under1827"IwentonGoogleforsomethinganditwaslike,eitheryoujustmessedupyourtoeoryougotcancer.
"Birmingham,under18hadvisitedorsexeducationwebsiteslikeScarleteenandAnswer.
Manyparticipantsfollowedsocialmediaplatformsforsexualhealthinformation,mostnotablyonInstagram.
SomefocusgroupparticipantssharedthatadangerofsearchingonlineforSRHRandgeneralhealthinformationisthetendencytodiagnoseyourself.
WebMD'slistofsymptomsandcauseshadatendencytomakeparticipantsworrythattheyhadanillnessfarmoredevastatingthanwhattheyactuallyhad.
SomeparticipantsnotedthatmanyoftheirpeersuseWebMDandcompletelytrustitasamedicalresource.
RegardlessofknowingabouttheaccuracyissuesofaWebMDsearch,youthstillhadatendencytoself-diagnoseandworryoversymptoms.
"TherearepeoplewhogoonWebMDand[…]theyreaditall.
Andtheystartmentallydeveloping.
Andthentheygotothedoctorandthey'relike'Ihavethis,'and[thedoctor]islike,'Youdon'thaveanyofthis.
'But,[WebMD]alsohelpsout,ifweseesomethingthatweareunsureabout.
Likeabumphere,wecanlookatitandthenbelike'Okay,Ishouldgogetthistested.
Thiscouldleadtothis.
'WebMDisadouble-edgedsword.
"NewOrleans,over182855%46%43%41%18%42%48%41%32%30%37%43%30%47%27%TomakefriendsTofindaromanticrelationshipTogoondatesToflirtwithpeopleonlineTo"hookup"withsomeoneFigure8.
Youmentionedthatyou'veusedoruseadatingapp.
WhatwasyourpurposeforusingthisdatingappWomen(n=301)Men(n=174)Transgender-spectrum(n=30)OnlineDatingandFlirtingYouthareformingromanticrelationshipsonlineandusingdatingappsmorethanever.
About34%ofrespondentsreportedthattheyusedatingsitesorhaveinthepast.
ThemostpopulardatingplatformswereTinder,OkCupid,andMatch.
Youthreportedthattheyusedatingsitestomakefriendsonline,goondates,flirtwithpeople,or"hookupwithsomeone"(Figure8).
Thisuseofonlinedatinghasimplicationsforhealthinterventions;somecurrentsexualhealtheducationprogramsondatingappsshowinitialpromise22.
34%(n=1,500)ofyouthuseorhaveusedonlinedatingsites70%(n=510)ofyouthwhousedonlinedatingsitesmetupwithsomeoneinperson2981%80%61%50%46%72%80%61%44%36%85%74%69%20%43%MessagethemLiketheirphotosLiketheirstatusFolloworfriendthemLeaveacommentontheirpagesFigure9.
Youmentionedthatyouusesocialmediatoflirtwithpeopleonline.
HowdoyouflirtwithpeopleonlineCheckallthatapply.
Women(n=346)Men(n=239)Transgender-spectrum(n=39)Althoughthemajorityofyouthdonotuseonlinedatingwebsites,socialmediaisanotherspacewhereonlineflirtingoccurs.
Nearly34%ofrespondentssaidthattheyusedsocialmediatoflirtwithothers.
Youngwomenaremostlikelytosendmessagestoflirtwithsomeone,youngmenarelikelytolikesomeone'sphotos,andtransgender-spectrumyoutharemostlikelytofolloworfriendsomeone(Figure9).
Formanyyouth,romanticrelationshipsareacentralpartofsociallife.
Theinternethasemergedasaspacewhereflirtingandrelationship-buildingoccurs.
Digitalflirtingoftentakestheformofcomments,privatemessaging,heart-shapedorinnuendoemojis(i.
e.
theeggplantorwatersquirtemoji),orlikingsomeone'sphotosonsocialmedia.
Itcanalsooccurinmoreprivateareasonline,likeindirectmessaging.
Digitalflirtinghassomelevelofstrategytoit.
Youthexplainedthattheyflirtonlineasawaytostartaconversationwithsomeonetheyareinterestedin.
Usually,youthflirtonlinewithfriendsoffriendsandcandiscoverotherpeopleofinterestbylookingthroughthefriendlistsofpeopletheyalreadyknow.
Becausedigitalflirtinghappensoversocialmedia30"Yeah,themoreyoutalktothemonlinethemorelikeyougonnagettheirinformationliketheirFacebook,theirSnapchat.
Andy'allstarttalking.
Theny'allwillbehookingup,whoknows.
"Tunica,under18andbehindascreen,itallowsyouthtomoreconfidentlyapproachsomeone,perhapswithjustasingleemojiorlikingafewoftheirphotosatoncetogettheirattention.
Digitalflirtingwascitedastheentrypointforhookingupanddating.
Inmanyways,digitalflirtingoraddingarelationshipstatustoyoursocialmediaaccounthasbecomeanassumedstepintheprocessofmeetinganddatingsomeone.
Instagram,Facebook,andSnapchatareplaceswhereyouthcanfindothersthathavesimilarinterestsandbeginconversationswithpotentialpartners.
FlirtingonlinelooksvastlydifferentnowthanitdidwhenplatformslikeFacebookfirstsurfaced.
Associalmediaplatformsintroducemorewaysforuserstoengagewithothers,moreflirtingstrategieshavedeveloped.
Someparticipantsfeltliketheycouldnotkeepupwiththesechanges:"Isendanemojifirst.
Yeah,Isendthehearteyes.
Whoknowswhatwillhappenafterthat"Tunica,over18"It'skindadangerousbecausepeoplecanjustbeputtingfalseinformationabouttheirselfonthere.
"Birmingham,under1831"Ithinkpeoplereadtoodeepintostufflikethatsometimestoo,likejustcauseI'msmilingitdoesn'tmeanthat.
LikewithemojisIfeellikesometimespeoplereadtoodeepintothose.
Eachemojishouldcomewithaparagraphstatingwhatmyemojimeans.
"Birmingham,under18Onlineflirtingseemstorequirereading"betweenthelines.
"Theneedtounderstandsomeone'sintentionasflirtatiousorfriendlycanbeveryconsumingforyouth.
Digitalflirtingrequiresalwayshavingtonavigatetherules,whatthingsmean,andwhattheflirtingcanleadto.
Althoughthemajorityoffocusgroupparticipantshadexperiencewithdigitalflirtingorhadflirtedwithothersonline,onlinedatingsiteselicitedamoremixedresponse.
Onlinedatingsiteswereperceivedasdoorstohookupcultureoraplacetotrickor"catfish"someone(i.
e.
,whensomeonehasafalseonlinedatingprofile).
Inrarecases,youthdidbelievethatyoucoulddevelopromanticandlong-termrelationshipsonline.
However,reactionstoonlinedatingweretypicallynegativeandcouchedwithingeneralmistrustofusingtechnologytomeetsomeone.
ManyfocusgroupparticipantscitedthehitTVshow"Catfish"onMTVastheirsourcefordistrustinonlinedating.
"Umokayso,flirtinghasgonefromasimplepokeonFacebooktolikeablow-upofyourDM[directmessages]andInstagram.
Like,ithasdramaticallychangedbutatthesametimeIdon'tunderstanditall.
.
.
"Birmingham,over1832"Becausetheinternetissomuch,there'ssomuchyoucandolikeyoucanfindsomeone'sprofile.
Youcanlie.
LikeI'veseenacoupleofepisodesofCatfish,thesepeoplehavesomuchtime.
"Chicago,over18"IknowlikeIhavefriendswhodothat,theyjustmeetupwithdudes[fromTinder]andlikegetthemtobuybottlesofstuffinexchangeforlikesex.
Andtheywilllikesleepattheirhouseandstufflikethatfornightsatatimeandit'sjustcrazy.
"Oakland,under18Focusgroupparticipantssharedstoriesoffriendsbeingcatfishedandattackedasaresult,sometimesresultinginassaultandrape.
Thiswasparticularlytrueforparticipantswhoidentifiedwithinsexualandgenderminoritycommunities.
Onlinedatingalsohasmanyimplicationsforthesexualhealthofyouth.
Participantsspokeabouthowpeersuseonlinedatingtohookupwithothers—insomeinstances,participantsknewfriendsthatusedonlinedatingappsfortransactionalsexorsexwork.
"Onlinedating,it'sveryeasyforyoutolie.
Andtheycanjustfindwhereyoulive.
Justshowupwhereyou'reat.
"Tunica,under18"SoIknowsomepeople,thatare,thataretransgender.
Transgenderpeoplethatgoonapps[…]Butyoucangetkilled.
Likesomeonewhodoesthatwhoistransgenderorgay,[homophobicpeople]willcomefindyou.
"Newark,over1833Despitetheoverallnegativereactiontoonlinedating,participantsdidsharepositiveexperienceswithonlinedating.
Theseparticipantsstressedthattherearewaystomakecertainyourdateissafeandspokeaboutmethodstomakesuresomeoneisreal.
Somefocusgroupparticipantswereveryvocalaboutthepositivesofonlinedating,citingitasanotherplacetopotentiallyfind"theone.
"Thiswasparticularlytrueforover-18focusgroups.
Theseparticipantswereveryawareofsomeofthedangers,butalsounderstoodthatonlinedatingworksforsomepeopleandcanresultinhappyrelationships.
Manyfeltthatifonlinedatingwasabetterfitforaperson'slifestyleorpersonality,thenitwasabsolutelyacceptable.
"SomytwopastexesImetthroughafriendontheinternetandthatwasinteresting.
Andlike,I'vehadatleastayear'sworthofrelationshipsthroughpeoplethatI'vemetlikethat.
Andit'skinda,it'snotsafeever,it'sneversafe,butlikeifyoucangetthemonFaceTimeandthewhole'Oh,willyoutakeapicturewhileyou'reholdingaspoonupsidedowntoprovethatyou'rereal'Thatkindastuff.
"Oakland,over18"Mybestfriendfoundhisfuturehusbandonline,onJack[adatingapp].
Iwaslike,aww!
That'slikesocute.
Butit'sjustlike,yousee,there'sanegativeandapositive.
Bothsidestothesedatingsites.
Theycanbebadandtheycanbegood,butattheendofthedayyouknow,yougottaexplore.
"Newark,over1834Anotherfocusgroupparticipantsharedthatonlinedatingisalsopositivebecauseitcanfacilitateintroductionsbetweenpeoplewhomaynothavemetotherwise.
Bybeingonline,apersonhasaccesstoanyoneelsewhoisonlineworldwide.
Fordating,thisopensupdoorstomorepotentialpartnersandallowsyouthtoconnectwithothersoutsideoftheirlocalcircle.
Thiswascitedasparticularlyhelpfulforpeoplelivinginruralareas.
Onlinedatingwasanexcitingtopicforthefocusgroups,andthemixedreactionsillustratethecomplicatednatureofmeetingothersonline.
WillitendwithdeceptionWillitendwithdangerOrwillitbeatrulypositiveexperienceYouthareveryawareoftheintricaciesofcommunicatingwithsomeonethroughascreen.
Clearly,communicationonlinecanbeverycomplicated,butcanhavebothpositiveandnegativeoutcomes.
"SoI'vehadagreatexperiencewith[onlinedating].
Ilovemeetingpeople.
Ilovedating.
"NewOrleans,over18"It'sprettyeasytofindpeoplethatdon'tlivenearyou.
Soifyouwannafindsomebodywithoutonlinedatingyouhavetolikegoandactuallyfindthem.
Withonlinedatingyoucanlikesearcheverywhere.
"Oakland,over183583%71%68%55%48%70%51%56%40%41%82%66%71%55%74%TextingSocialMediaUsingtheinternetTakingpicturesPhonecallsFigure11.
WhichofthefollowingdoyoudoonyourphonedailyWomen(n=931)Men(n=504)Transgender-spectrum(n=65)CurrentDigitalLandscapeYouthhaveincreasedaccesstotechnology,particularlysmartphonesandlaptops.
Comparedtothe2011TECHsexreport,youtharenowfarmorelikelytoownalaptop,tablet,andsmartphone,butarelesslikelytoownadigitalmusicplayerordesktopcomputer(Figure10).
Intermsoftimespentontechnology,nearly40%ofyouthspend30-40hoursaweekormoreontheirphone.
Ofthosethatownedasmartphone,53%ownediPhones.
Themostpopularactivitiesonphonesincludedtexting,pictures,andsocialmedia.
Phonecallswereonlythefifthmostpopularactivity,illustratinghowtext-heavyyouthdigitalcommunicationis(Figure11).
ThemostpopularsocialmediasiteswereSnapchat,Instagram,andFacebook.
Thisisincontrastwiththe2011TECHsexreport,whereFacebookwasthemostpopularsocialmediasite23.
26%57%57%16%87%8%32%45%SmartphoneCellphone(notsmartphone)Musicplayer(iPod,etc.
)iPad/TabletFigure10.
Whichofthefollowingtechnologydoyouown2017(n=1,500)2011(n=1,500)36Manyfocusgroupparticipantsfeltthattheycouldnotimaginetheirliveswithoutsocialmediaortechnology.
Acrossfocusgroups,themostpopularsocialmediaplatformswereInstagramandSnapchat.
Forolderparticipants,Facebookwasstillrelativelypopular.
Participantsunder18didnotlikeFacebook,andweremoreinterestedinanonymouschatappslikeKikorWhatsApp.
Thereisanexpectationthatallyouthareconnectedthroughsomesortofsocialmediaplatform,whetherthatbeInstagram,Facebook,orSnapchat.
Tonothaveanyofthesesocialmediaplatformswasconsideredunthinkabletomanyparticipants.
Somefocusgroupparticipantsfeltthattheywereunabletodisconnectfromtheomnipresenceofsocialmediaandphonesduetothatexpectation.
Despitethesefeelings,youtharenotdiscouragedfromcontinuingtoincorporatetechnologyintotheirlife.
Technologyandtheopportunitytoconnectwithotherpeopleatanytimeofthedayareundeniablebenefitstothesociallivesofyouth.
"Socialmediaismylife,it'showIstayconnectedtofriends.
"Newark,under18"Idefinitelyfeellikeifyoudon'thaveit[socialmedia],it'sthequestionofwhydon'tyouhaveitYoumustbeahippieortheremustbeaverystrongreasonthatyoudon't,becauseotherwisewhywouldn'tyou"NewOrleans,over1837SocialMediaandMentalHealthResultsfromthenationalsurveyshowthatsomeyouthreportbeing"preoccupied"withsocialmedia,resultingindistressandmentalhealthissues(Figures12and13).
Socialmediaissoimportantthat,ifyouthdeletetheiraccounts,nearly34%saidthatthiswouldhaveanegativeimpactontheirfriendships.
Youthareinvestedinsocialmedia,andtheirlivesonlineimpacttheirlivesinperson.
Respondentsfeltpressuredtohaveasocialmediapresenceinordertokeepincontactwithfriendsandhavetheirprofilesvisited.
14%18%19%28%21%AlwaysMostofthetimeAbouthalfthetimeSometimesNevern=1,500Figure12.
HowoftendoyoufeelpreoccupiedbysocialmediaMeaning,howoftencanyounotstopthinkingaboutsocialmediaevenifyoutried9%13%13%23%42%AlwaysMostofthetimeAbouthalfthetimeSometimesNevern=1,500Figure13.
Howoftendoyougetupsetoranxiousifpeopledonotlikeyourphotoorstatusupdateonsocialmedia19%(n=1,500)ofyouthfeelthattheyhavetodeleteapostifitdoesnotgetenoughlikesorcomments34%(n=1,500)ofyouthbelievethatiftheydeletedtheirsocialmediaaccountsitwouldnegativelyimpactfriendships38Focusgroupparticipantsnotedthatmanyoftheirpeersareobsessedwithsocialmediatothepointofneverleavingtheirhomes.
Manyhadconcernsaboutconstantaccesstosocialmediaandsmartphones.
Tomanyparticipants,thiswasconsideredadrawbackandamentalhealthissueintheircommunities.
Otherfocusgroupparticipantsnotedthatconstantlycomparingyourselftofriendsonlinecanleadtounhappinessandself-scrutiny.
Thefearofbeingjudgedonlinewasalsoafactorinsocialmediaobsession.
Thishadmultipleimplicationsformentalhealthandwellbeing.
VideoGamesVideogames—particularlymassivemultiplayeronlinegames(MMOs)—offeranidealwayforyouthtointeractwithpeersandbuildrelationships.
Themostpopularvideogameplatformswerecomputers,Xbox360,andNintendoWii.
Nearlyhalfofrespondentswhoplayedvideogamesplayedatleast5-7hoursormoreperweek.
Forthosethatplayedvideogames,nearlyhalfofrespondentssaidthattheyusedtheonlinechatfunctionatleast"Ifyouwalkaroundtoday,Idon'tgiveadamnwhereyouare,likeitcanbeanarmedrobberygoingonandeverybodywillstillbeontheirphones.
"Oakland,over18"SometimesIfeelthatIhatemylifeandeveryoneisanalyzingmethroughmyFacebook,soIneedtodeleteit.
"NewOrleans,over1839someofthetime.
Themajorityofgamerssaidthattheyhadbeenharassedorcyberbulliedonlinewhileplayingvideogames,andsomehavebeensexuallyharassedonline.
CyberbullyingJustover42%ofyouthreportedexperiencingcyberbullyinganddigitalharassment,andnearly60%ofyouthhavewitnessedsomeoneelsebeingharassedorcyberbulliedonline.
Someyouthreportedthecyberbullying,butevenaftertellingthecyberbullytostopharassingthemordeleting/blockingthecyberbully,nearly50%oftherespondentscontinuedtobeharassed.
Thesurveyresultsshowthatsocialmediawasthehighestreportedplaceforcyberbullyingincidences,followedbyvideogamechatandtexting(Figure14).
Cyberbullyingwasalsoaprevalentissueinthefocusgroups.
Nearlyeveryfocusgroupparticipanthadknownsomeonewhohadbeencyberbulliedorhadexperienceditthemselves.
Thestoriesthatweresharedrangedfrommildcyberbullyingexperiencestotragiccyberbullyingthatresultedinsuicide.
Regardlessoftheseverityofthestoryshared,allfocusgroupparticipantsfeltthatcyberbullyingwasaseeminglyendlessissuefortheiragegroupandneededtobeaddressed.
12%16%23%24%28%40%79%EmailLivestreamplatformWebsiteMessagingapp(i.
e.
Kik,etc.
)TextingVideogamechatSocialmediaFigure14.
Youmentionedyouhaveexperiencedcyberbullying.
WheredidyouexperiencethisCheckallthatapply.
57%(n=1,500)ofyouthhavebeencyberbulliedwhileplayinggamesonline24%(n=1,500)ofyouthhavebeensexuallyharassedwhileplayinggamesonlinen=1,50040"Commentscomeinfromlikepeoplewhenyou'replayingmultiplayerandlikeyougetcalledsomestuff.
"Birmingham,over18Participantsrecountedexperiencesoffriendsbeingcyberbullied,whichgravelyaffectedtheirbodyimageandself-esteemandsometimesresultedinsuicide.
Appearance,gender,andsexualitywerecommontargetsforcyberbullying.
AnumberofLGBTQparticipantshadbeenoutedbypeersonsocialmediawithouttheirconsent.
Formostparticipants,beingcyberbulliedfeltmoreextremethanin-personbullyingbecauseyouthareparticularlyfondoftheironlineidentities.
Agreatdealoftimegoesintocurating"goodselfies"anda"socialmediapresence.
"Inaddition,in-personbullyingwouldtheoreticallystopwhenayoungpersonarrivedathome,butwiththeubiquityoftechnology,cyberbullyingisconstantandinescapable.
Similartothequantitativefindings,cyberbullyingwascitedasparticularlycommoninvideogames.
Videogamesthathaveachatplatformwereplaceswherecompetitivelanguagewouldturnugly.
Whatmaybeperceivedasinnocentbanterbysomewasactuallyquiteupsettingorhurtfultoothersplayingthegame.
Focusgroupparticipantssharedthatthelanguagecanbeparticularlyaggressive,includingalotofname-calling.
"Honestly…Icansay…Anybodycangetcyberbullied.
Forreal.
Wrongplace,wrongtime.
"Birmingham,under18"Cyberbullyingismorethanwhathappensonsocialmedia…itactuallycomesinyourfrontdoor,inyourhouse,inthelivingroomwithyou…It'sthere.
It'severywhere.
"Birmingham,over1841TheSouthernUSItisimportanttonotesomeofthesubstantialdifferencesbetweentheSouthernStatefocusgroups(Louisiana,Mississippi,andAlabama)andtheotherUSfocusgroups.
DuetoanincreaseindisproportionateSRHRoutcomesfromtheSouth,itwasimportanttoinvestigatethedigitallandscapeinthisparticularregion.
SomeofthehighestSTIandteenpregnancyratesarefoundintheUSSouth,andparticipantsinthethreeSouthernsiteswereawareofthis24,25.
Duringdiscussions,participantsstatedthattheseratesmaybeduetolackofaccesstoinformationandservices.
Therewasintenseconcernaboutthelackofeducationaroundmethodsofprotectionandauthenticsexeducation:Forparticipantsinthesestates,thedesiretofindinformationonlinewasmorenuancedthanthegeneralsample.
ParticipantsfromAlabama,Louisiana,andMississippiseemedtorelymoreontheirfamiliesforsexualhealthinformationandplacedlesstrustoninternetsources.
SomeparticipantsintheSouthernfocusgroupsdidnothaveaccesstoyouth-friendlyclinics,andstatedthattheytrustedtheirfamiliesandfamilydoctorstoanswerquestionsaboutsex.
Iftheydidhaveaccesstoyouth-friendlyorganizations,participantsoftenlearnedaboutsexualhealthfromthosespacesinsteadofschool.
Theyoftendidnotbelievethattheirsexualeducationatschoolwascomprehensiveenough.
Outsidecommunityorganizationswhereparentsenrolledtheirchildrenofferedopportunitiestolearnmoreaboutsexualhealth.
"WhenIthinkabouthealthIthinkaboutteenpregnancyandIthinkabouttheSTDsandthedifferentthingsthattheyoungergenerationiscurrentlycatchinganddon'ttoomuchcareaboutit…or,I'mnotgoingtosaydon'tcareaboutit,they'rejustnotawareofit.
"Birmingham,under1842YouthintheSouthhadaverydifferentexperiencefromotheryoutharoundthecountry,particularlyrelatedtoseekinginformationabouttheirSRHR.
Additionally,thegeneralhealthissuesthatweremostimportanttothem,andtheircommunity,weredifferentthantherestofthecitiesandregions.
IntheSouth,focusgroupsweremostconcernedaboutweightgain,diabetes,policebrutality,teenpregnancy,andnutritionalhealth.
Inotherregions,youthweremostinterestedinmentalandemotionalhealth,followedbycyberbullyingandsexualhealthtopics.
TheseregionaldifferencesofferopportunitiesformorespecificinterventionsthatarerelevanttotheissuesthatcommunitiesintheSouthmayface.
Teenagepregnancy,inparticular,isatopicofinterestformanyoftheyoungfocusgroupparticipants.
Forthoseunder18,manyhadexperiencesofclassmatesbeingpregnant.
"Howboutwejustletitbeandletyourmommadealwithit!
Askyourmom.
"Birmingham,under18"Becausetheysaysomestuffisnotbestforyoutolearnatschool,theysayit'sinappropriate.
[Inoutsideorganizations],theydolikecondomdemonstrations.
Theyteachyouaboutwhattouse,whatnottouse.
Inschooltheyteachyoutobeabstinentandnothavesexatall,atthisorgtheypreferforyounottohaveitbutyoucanifyouarewillingtodoit.
"Tunica,under18"Yeah,I'minmiddleschool.
Ithinkaboutagoodhalfofmyclassmatesarepregnant.
"Tunica,under1843OneofthemoststrikingdifferencesthatemergedintheSouthwasthetendencyforyouthtoimmediatelyturntoparentsandfamiliesforadviceaboutSRHRissuesandquestions.
Unlikeothersiteswhereyouthdidnotfeeltheycouldhaveopenconversationsabouttheirhealthandsexuality,focusgroupparticipantsintheSouthweremuchmoreinclinedtospeaktoatrustedfamilymemberthananyoneelse.
Speakingtoafamilymemberevenoutweighedgoingtotheinternettosearchforinformationindependently.
BecauseofthestrengthoffamilialrelationshipsintheSouth,youthfeltthatfamilymemberswereamorereliableandsafespacetohavetheseconversations.
ThissafespacetotalkaboutsexualityisanassettomanyyouthintheSouth.
Theonlyquestionitraisesistheaccuracyoftheinformationbeingshared,andwhetheryoutharebeingconnectedtoappropriateservices.
"Iknownottogetpregnant…butmyfriendgotpregnant.
"Birmingham,under18"Thatstuff,IbetteraskmyAuntieforthatstuff.
Ilovemyfriends,butyoucan'ttrustyourfriends.
Whatkindofinformationthey'regonnagiveyou"Birmingham,over18"Wehavegotogetkidsoutside,we'rejustsittingaroundonsocialmedia.
Theweightgain,diabetes…it'sreal.
"Birmingham,under1844Inaddition,theyouthintheSouthhadawaryperspectiveononlinedatingandthepotentialforrelationshipstoemergefrommeetinginonlinespaces.
Theirreactionstoonlinedatingandonlinerelationshipswereverystronglynegative,citingdistrustwithotherpeople'sintentions.
Focusgroupparticipantswereveryawareandafraidofthepotentialtobe"catfished",andtobemisledbysomeoneonline.
Additionally,theyweremuchmoreexpressiveaboutthepotentialphysicaldangersthatcanstemfromcatfishing.
Participantsbelievedthattryingtofindandnavigaterelationshipsonlinecouldneverendpositively.
Youthwereparticularlyconcernedwithchronicdiseases,particularlythoserelatedtodietandexercise.
Quiteafewparticipantsnameddiabetesandweightgainasissuesthatwereveryrelevanttotheircommunities.
Theywerealsoawareofteenpregnancyratesfortheirregion,andthoughtthatwasanimportantissuefortheircommunitytotackleaswell.
Bothofthesehealthoutcomesortopicsareprioritiesforregionalhealthauthorities.
Thisdemonstrateshowyoutharecognizantoftheissuesthattheircommunitiesarefacing,andidentifyingareasforimprovement.
"Ihaveanauntieandmymom,they'reLNs.
Igotothemfirst,always.
"Tunica,over18"Ifyou'regonnatalktomeitbetterbefacetoface,I'mnotdoingnoonlinestuff.
"Birmingham,under1845StakeholderInsightsOurexpertinterviewsassistedinthecreationofthesurveyandfocusgroupquestions,butalsoprovidedkeyinsightsintothefutureofonlinesexualhealtheducation,technology,andyouthinterestinhealthinterventions.
Mostnotably,expertstakeholdershighlightedtheneedforonlineprogramsthatallowyouthtoco-createthecontent.
Theywereawarethatthisisnotalwayseasy,astechnologyandyouthtrendsseemtobechangingconstantly.
Becauseofthis,theyconsidereditalwaysimportanttoincludeyouthintheconversationsothatyouknowwhichplatformsarepopularatthetime.
Stakeholdershighlightedthattheinternetofferstheonethingthatclassroomsandparentscannot:privacy.
Similartothefindingsfromthefocusgroups,thisabilitytosearchforinformationinprivatewasseenasoneofthemainreasonswhyyoutharen'tturningtoexpertsandparentsforinformation.
"Technologyoftenmovesfasterthanteachersarepreparedfor.
""Theteacherorinformationgiverislikeadinosaur.
Youthhavealltheinformationintheirhands.
Whateveryoudon'tknow,they'regonnaGoogleit.
""Youtharelookingforwaystoaccessinformationthatisbothconfidentialandprivate.
Youalwayshavetomakeitprivate.
"46Stakeholdershaveseensuccesswithprogramsandcontentthatengageyouthonmultiplelevels,notjustsexualhealth.
Funinteractivegamesandsocialmediapageshavethepotentialtoengageyouthandenhancewellness.
Finally,stakeholderstoutedtheeffectivenessofpeer-to-peereducationonline.
Sexualhealthsitesthroughsocialmedia,whereyouthcanco-createcontentandshareittotheirfriends,hadsuccesswithenhancingsafersexandcontraceptionknowledge.
This,combinedwithauthenticconversationsinaprivatemanneronline,weresomeofthehighestrecommendedfunctionalitiesforfuturehealthprograms.
"Ourschoolsystemsorourhealthsystemsarenotsetuptohavehonestconversationsaboutsexualhealthandsoyoungpeopleareturningtotheinternetforinformation.
""We'rereallyhopingtoreachyoungpeoplebeforethey'veengagedinsextomakethecommitmenttousebirthcontrolandcondoms.
Wetrytomakethingsfun,becausetheygoonlineandanswertwentyquestionsaboutwhichDisneycharactertheyare,andifwecangetenoughfunintoit,thenwecanreachyoungpeoplebeforeoronthecuspofneedinginformation.
""Thereisalotofpeerknowledgethatishappening.
There'sallthisgreatsharingonunusualplatformsthatyouwouldn'tthinkofforinformation—likeInstagram,WhatsApp,andSnapchat.
"472011vs.
2017;AnUpdateThe2017reportexpandsonYTH's2011TECHsexUSAreporttohighlightthechanginglandscapeofyouthsexualityinformationandaccessonline.
IllustratedherearesimilaritiesanddifferencesbetweenTECHsexreports,focusingonyouthtechnologyuseandtrends.
Thesefindingsshowhowquicklytechnologycanchangeandtheimportanceofcarefullyconsideringtheplatformortechnologytousewhendevelopingprograms.
In2011and2017,themostimportanthealthtopicstoyouthwerethesame;fitnessandnutrition.
IntermsofSRHRissues,womenin2011werestillmorelikelytostatethatbirthcontrol,pregnancy,andSTD/HIVissueswereimportant.
Thesetrendscontinue;fitnessisstillthemostimportanthealthtopictoyouth,andyoungwomenarestillmorelikelytofindSRHRissuesmoreimportantthanyoungmen.
In2011,youthreportedtheywerelikelytoreceiveSRHRinformationfromthefollowingsources;school,friends,family,healthprofessionals,andonlinesources.
The2017reportshowsthatonlinesourcesarethefirstsourcesutilizedforSRHRissues,butyoutharestillreportingthattheyaskfamilyandpeersforSRHRinformation.
OtherpopularsitesforSRHRinformationin2011and2017werethesame:Sex,Etc.
andPlannedParenthood.
In2011,youthweremorelikelytoownalaptopandfarlesslikelytoownasmartphone.
In2017,smartphonepenetrationhasreachednearly90%(Figure15).
Lastly,Facebookisnolongerthesocialmediaplatformofchoiceforyouth.
In2011,Facebookwascitedasthepreferredsocialmediaplatform;in2017,youthwereextremelycriticalofFacebookandmadefunofthesocialmediaplatformbecausetheirparentshadbegunusingit.
YouthidentifiedImage-heavysocialmediaplatformslikeSnapchatorInstagram,asthemostpopularsocialmediasitesin2017.
26%57%57%16%87%8%32%45%SmartphoneCellphone(notsmartphone)Musicplayer(iPod,etc.
)iPad/TabletFigure15.
Whichofthefollowingtechnologydoyouown2017(n=1,500)2011(n=1,500)48IV.
Recommendations49RecommendationsThefollowingrecommendationsarebuiltuponfindingsofthisreporttoinformdesign,innovation,policy,andadditionalresearchintheSRHRfield.
Thedataprovidesopportunitiesforstakeholders,organizations,parents,andadvocatestolearnfromyouthexperienceandtakeactiontoreachyouthwithSRHRinformationandsupport.
1.
EngageyouthinSRHRprogramdesignanddevelopment.
Youtharetheexpertsoftheirownexperience,particularlyinregardstotheirhealth.
Ratherthanviewyouthasissuestobesolved,youthshouldbeconsideredassetstoenhancingyouthhealthandwellness.
Anapproachthatcombinespositiveyouthdevelopmentandhuman-centereddesigncanincludeyouthinallaspectsofdevelopmentandgivethemthecontroltoleadprograms,resultinginmoreauthenticexperiencesandprojects.
BecauseyouthdidnotprioritizeSRHRasacriticalhealthissue,youthorganizationsandprovidersmaybenefitfromtheseapproachestoengagewithyouthmoreeffectively.
Byincorporatingyouthfromthebeginning,thereisahigherlikelihoodthatyouthwillcontinuetobeinvolvedduetotheirinvestmentattheideationphase.
Stakeholderinsightsfurthersupportedthatyouth-drivencontentandyouth-centeredprogrammingcanhaveahigherlikelihoodofsuccess.
Someorganizationsarealreadyusingtheseapproaches,includingYTH,TheRepresentationProject,GLSEN,andAdvocatesforYouth.
2.
UtilizeonlinedatingplatformstoenhanceSRHRinformationdiffusion.
Datingappswereusedtofindhook-uppartners,notjustrelationships.
Regardlessofhowonlinedatingisperceived,thereisagrowinghook-upcultureamongyouthwhouseonlinedatingapps.
WiththisculturecomesthepotentialforsharingSRHRinformationandaccesstoservicesthroughonlinedatingsites.
ConsiderpartnershipswiththeseplatformsoruseofonlineadstoexpandSRHRinformation.
Theopportunitytoconnecthook-upcultureandonlinedatingtoSRHRservicescouldleadtoopenandhealthyconversationsbetweenpartners,aswellasanincreaseinserviceutilization.
503.
Offermedicalservicesandinformationonlinetoengageyouth.
Youthfeltverystronglythatseeingamedicalproviderwasthebestwaytogetinformationabouttheirhealth,particularlyforSRHRissues.
Despitethisbelief,Googlewasthefirstresourcethatyouthturnedto.
Providerscouldeasilybridgethisgapbyintegratingtechnologyintotheirpractice.
ThismaylooklikeonlineSkypeappointments(telemedicine)orcreatingyouth-centeredvideosofSTIpreventionmethodsonInstagram.
Someorganizationsarealreadymovinginthisdirectionwithsuccess.
PlannedParenthoodhaslaunchedtheapps"PlannedParenthoodDirect"and"PlannedParenthoodCare,"26whichofferconfidentialSTItestingkitsandonlineconsultationswithaprovider.
Morerecently,thepornographysitePornhubannouncedthelaunchofthe"PornhubSexualHealthCenter",asiteforSRHRinformation27.
Lastly,Amaze.
orgoffersanimatedsexeducationvideosmeantfortweens,parents,andeducatorstomakeconversationslessawkwardandmoreengaging.
ThesesuccessescanbeutilizedasresourcesformedicalproviderstoconnecttheirpatientstoSRHRinformationonline.
4.
DevelopSRHRtechnologysolutionsforparentsandyouthintheUSSouth.
IntheSouthernstates,focusgroupparticipantsweremorelikelytoturntotheirfamilyforinformationaboutSRHR.
Parentswereoftenprioritizedovermedicalproviders.
Atthesametime,technologyandsocialmediausewasstillveryhighamongSouthernparticipants.
ThiscreatesanopportunitytobuildatechnologyplatformforSouthernparentsandyouthtohaveaccesstoSRHRinformationonline.
Ofcourse,conversationswithparentsarenotstandardized.
Someparticipantssaidtheycouldnotreceiveaccurate,orinclusiveinformationfromtheirfamilies.
Atrustedonlinesourcemayassistparentsinprovidingaccurate,inclusive,andcommunity-vettedSRHRinformation.
SuchatoolcouldincreasethepowerofafamilymemberwhoisaskedquestionsaboutSRHRissues.
5.
InvestinpolicyandinnovationstoimproveaccessofSRHRinformationthroughpopularsearchengineslikeGoogle.
MostparticipantsnamedGoogleasthefirstplacetheygotoforSRHRinformation.
Nearly20%ofsurveyrespondentscompletelytrustedtheinformationtheyfoundonGoogle.
BecauseofthetrustthatyouthplaceinGoogle,therearetwoopportunitiesthatconnectyouthtoanevenbetterexperience.
First,workingwithGoogletoliftthebanoncertainresultsfromappearinginthesearchwindowbecauseof"sexuallyexplicit"terms51mayleadtomoreaccurateSRHRsearches.
Second,creatingadigitaltoolwithasearchfeaturethatismuchlikeGooglebutforSRHRinformationmayleadtohighuptakeamongyouthduetoitsfamiliarity,confidentiality,andaccessibility.
6.
Harnessthetoolsandreachofsocialmediaplatformstobuildasaferspaceforyouthandtheiridentity.
YouthspendalotoftheirtimeonFacebook,Instagram,Twitter,andSnapchat.
Inboththesurveyandfocusgroups,youthsharedfeelingsofcyberbullyingandonlineharassmentontheseplatforms.
Thereisanopportunitytocreateanti-cyberbullyingpluginsandappsthatcombattheseissuesonsocialmedia,aswellasutilizeexistingandexpandingtoolswithinmanysocialmediaplatformstoday.
Forinstance,Instagramisalreadyworkingtoofferoptionstoconnectpeopletomentalhealthservices,whileTwitteristryingtoblockaccountsthatareharassingothers.
In2016,Instagramaddednewfeaturesaroundonlineharassment,includingdisablingcomments,flaggingcommentsthatmaycontainabuse,andofferingconnectionstomentalhealthsupportbasedonkeywordsfoundinposts.
Theseplatformsreachmillionsofyouthonadailybasis,andofferanexpandingopportunitytoprovidesupportivetoolstosupportasaferspace.
7.
UtilizetechnologytoincreaseyouthinterestinSRHR.
Asseeninthenationalsurvey,SRHRwasnotatopicthatyouthwereincrediblyinterestedin.
Whenaskedwhattopicsweremostimportanttothem,theonlySRHR-relatedtopicrankedhighlywasbirthcontrol(33%),andthatwasstillsixthinthelist.
Additionally,femalerespondentswerefarmorelikelytoreportinterestinSRHRhealthtopicsthantheirmalecounterparts.
Toincreaseinterestandconversation,SRHRprogramscanseektoengagewithyouthinamoretechnology-basedway,suchasgamifyingcontentorproducingonlinevideos.
Forexample,gamificationisaninnovativeapproachthatutilizesgamingtechniquesandtechnologytoengageyouthintheirhealth.
Theuseofpoll-likeposts,contests,orfunnycontentlikeinternetmemescangamifycontent.
SRHRorganizationscanuseinteractivesocialmediacontenttogainmorefollowersandtailortheircontenttomultiplegenders—notjustyoungwomen.
Additionally,organizationsthatareworkingtoempoweryoungmencouldincorporatemoredirectedSRHRconversations,bothinpersonandonline.
MuchoftheSRHR"burden"fallsonyoungwomen,particularlyforcontraceptivemethods.
Byencouragingyoungmentoinvestinthesedecisions,theremaybemoreinterest.
528.
InvestinanddisseminateresearchsimilartoTECHsex2017.
Researchinthissphereisaninvestmentthatcanultimatelybeheardinalanguagethatayoungpersonspeaks.
Understandingthecurrentandnationaltrendsofonlineaccessofyouthsexualityandhealthisvitaltoinformingpolicychange,interventions,andreachingyoungpeopletoday.
Thedisseminationofsimilardataandresearchthroughonlineaccess,nationalconferences,socialmedia,andpeerreviewedjournals,informsandbenefitstheSRHRfield,andultimately,ouryouth.
9.
Workwiththegamingindustrytocombatvideogame-basedcyberbullyingandsexualharassment.
Youngwomensharedthatonlinegamingbringswithitinevitableonlineharassment.
Often,thisonlineandgender-basedviolenceinthegamingcommunityresultsindoxing,stalking,andfurtherharassment.
Whilesomegamingcompanieshavemadestepstocombattheseissues,itiscriticalthatweworkwithgamedevelopersandprogrammerstoinsurethattheseissuesstop.
Byincludinggenderempowermentmessaging,reportingtools,anddocumentationsettingsingamesthatallowplayerstorecordincidences,wecanempoweryoungpeopletotakecontrolofthesituationandstopcyberbullying.
10.
Fosterpeersupportinonlinespaces.
Youngpeopleoftenturnedtopeersforsupportforanumberofreasons,mostoftentocopeorsimplytoconnect.
Itiswidelyknownthatyoutharegreatlyinfluencedbytheirpeers,andthisinfluencepresentsanopportunityforsupport,particularlywithSRHR.
Iffutureyouthprogrammingcanincorporate"onlinepeercircles"asawaytocapitalizeonsupportiverelationships,andtheeaseofonlinespaces,youthmayfindmoresupportiveconnections.
Somepotentialoutcomesof"onlinepeercircles"mightbelinkagesandreferralsthataremoreyouth-friendly,strategiesthatareworkingforpeerswhoarecopingwithahealthissue,orstrengtheningrelationshipsandfriendships.
Byadopting"onlinepeercircles"asacriticalpartofyouthprogramming,wecancapitalizeontheiruseofsocialmediaandtechnologytofacilitateinformationsharinginasupportivemanner.
53V.
Conclusion54ConclusionAssocialmediabecomesmorerampantandyouthturntoGoogleandonlinepeersforinformation,itisvitaltobeginrevampingourprogramsandhealthinterventionstomeettheneedsofyouth.
Asseeninthisreport,themajorityofyouthturntoGoogleandawayfrommoreaccurateformsofhealthinformationaccess(i.
e.
,doctorsorclinics)duetostigma,embarrassment,orlackofsupportivenetworks.
Theeaseinwhichsocialmediaandonlinesearchenginesproducehealthinformationondemandaremoreenticingthansufferingtheembarrassmentofaskingaparent.
ThesedocumenteddrawbackstosuchsocialmediaandGoogleuse—findinginaccurateinformation,becomingpreoccupiedwithsocialmedia,andexperiencingcyberbullying—makeourmissionclear.
Futureprogramsmustintegratethespacesmostfamiliartoyouthandalleviatetheconsofsuchspaces.
Healthprofessionals,parents,stakeholders,organizationalleaders,andteacherscanusethisreporttounderstandthecomplicatedrelationshipsthatyouthhavewithtechnology,sexualhealth,healthinformation,socialmedia,andtheinternet.
Wecannolongeraffordtoignorethesespacesaspossibleavenuesoflearningandhealthinformationdissemination.
Byincorporatingthedataandlessonslearnedinthisreport,wearebetterequippedtocreateprogramsauthentically,alongsideyouth,toensurethattheirhealthandwellnessisaddressedinthisnewdigitalspace.
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fm:Ananonymousquestionandanswerwebsiteusedbymanyyouth.
Itisusuallyusedtopostanonymouscommentsandquestions,andhasbeenconnectedtohighlyabusivecommentsandcyberbullyinginstances.
Catfish:Theactofcreatingafakeonlinedatingprofileoronlineidentity.
Facebook:Apopularsocialnetworkingsiteacrossallages,butisbecominglesspopularamongyouth.
ClinicsorservicesitesareusingFacebooktoadvertiseservicesaswellasallowforuserstoratethem.
Facebookalsoallowsforuserstogolive,whichmeanstheycanlivestreamvideoandsharewhatishappeninginreal-time.
Google:Apopularsearchengineamongyouthparticipatinginsurveysandfocusgroups,GoogleisusedtolocateSRHRandgeneralhealthinformation.
Google+:Google+wascreatedbyGoogletobeasocialnetworkingcomponentofthegreaterGoogleplatform.
Google+didnothaveastronguptakeamongyouthcomparedtoothernetworkingsites.
Itallowsuserstocreateprofilesforindividualsandorganizationstoconnectandfolloweachother.
ICAH:IllinoisCaucusofAdolescentHealth.
Instagram:Oneofthemostpopularsocialnetworkingappsyouthareusingtoday,particularlyforthose18andunder.
Becauseapostiscomprisedofaphotoorvideowithacaption,contentcanbeexcitingandinteractivethanasolelytextual.
InstagramrecentlyintroducedInstagramStories,areal-timevideostreamingactivitythatrivalsSnapchat.
Kik:Achatplatformthatallowsuserstoconnectwithfriendsandgroupsaroundtheworld.
KikispopularamongyouthbecauseitcanfunctionwithoutSMSdata.
AslongasauserhasaccesstoWi-Fiordata,theycanconnectwithotherKikusers.
Youthusethisfrequentlyasanalternativetotexting.
Meme:Akeyelementoftoday'sinternetculturethatiscomprisedofaviralimageorvideo,usuallyattachedtoahumorousmessagethatissharedwidelyacrosstheinternet.
Memeshavebeencalledthe"insidejoke"oftheinternet.
NIMH:NationalInstituteofMentalHealth.
Periscope:AlivestreamingappcreatedbyTwitter.
Periscopespecificallycreatesaplatformwhereuserssharereal-timevideooftheirexperiencesaswellastheirsurroundings.
Periscopecanbeusedtodocumenteverythingfromday-to-dayexperiencestolargerscaleevents,likeconferencesorprotests.
PHI:ThePublicHealthInstitute.
PPFA:PlannedParenthoodFederationofAmerica.
SRHR:Sexualandreproductivehealthandrights.
Snapchat:Snapchatisgainingpopularityamongyouth,notonlyasanewsocialmediaapp,butasawaytoreceiveinformationorengagewithyouthorganizations.
Forpurelynetworking,youthsendeachothervideosandphotosthatdisappearaftertheyareviewed.
Twitter:Asocialmediaplatformbasedonnewssharing,slightlylesscommonamongyouth.
Twitterisapowerfulplatformfororganizationsandprofessionalstoshareinformationandnews.
WithconversationsandchatsthatoccuroverTwitter,userscanengagewitheachothertoshareandnetwork.
58UCSF:UniversityofCalifornia,SanFrancisco.
WebMD:Apopularmedicalwebsitethathasavarietyofresources,includingasymptomfinder,recommendationsforwhentoseekserviceswithaprovider,andmanymoreitemsspecifictohealth.
WhatsApp:Achatappthatallowsuserstochatwithfriendsandgroupsaroundtheworld.
Italsohastheabilitytomakein-appphonecalls,whichmakesforeasyandinexpensivecalls,especiallyinternationally.
SimilartoKik,itallowsuserstoavoidcuttingintoSMSlimits.
Whisper:Asocialmediaplatformthatallowsausertosharepersonalstoriesorsecretsontheirplatform.
Italsoallowsuserstoanonymouslytalkaboutexperiencesthatmayotherwisebehardtoshareinperson.
YAB:YouthAdvisoryBoard,thenationalgroupofyouththatadvisesYTH'sprogramdevelopmentandimplementation.