Technology-Enhanced Community Nursing Reduces Sexually Transmitted Infections

Published in Insight - Insight Sept/Oct 2019

A program featuring text messages and home visits worked better than traditional care for managing pelvic inflammatory disease (PID) among historically underserved teens and young women, a Johns Hopkins Medicine study shows.

Hoping to reduce PID numbers and impacts, the Johns Hopkins team tested an innovative care program known as technology-enhanced community health nursing (TECH-N) intervention.

“We’ve known for some time that PID disproportionately affects females between the ages of 13 and 25, and strikes hardest in low-income, minority and urban populations, yet we have continued to treat everyone with the disease in the same manner,” says Maria Trent, M.D., M.P.H., professor of pediatrics at the Johns Hopkins University School of Medicine. “Our study shows that TECH-N gives health care providers a practical, more effective way to team with younger patients to address their specific treatment and follow-up care needs.”

All of the study participants received standard-of-care treatment and follow-up, while a randomly selected group also received daily automated text messages on their own cellphones or study-provided, prepaid phones for two weeks after their first treatment. These messages reminded them to take their medicine and provide confirmation that they had done so. The TECH-N group also received weekly text messages about sexually transmitted infection (STI) management and prevention.

Additionally, the test group received four follow-up, in-home visits from a community health nurse. During these sessions, nurses examined the patients, collected specimens for STI detection and discussed risk reduction tactics.

The TECH-N group showed a significant decline in new STIs over the full 90-day study period: 28% compared with 14% for the standard-of-care group. Higher condom use, 21% versus 11%, also was seen in those receiving TECH-N intervention.

“These findings show that TECH-N can provide the close, personalized follow-up and support needed after STI diagnosis to successfully treat and manage PID, and subsequently prevent longer-term complications, in a group of urban adolescents and young women currently experiencing a disparity in that care,” Trent says.

Only 3% of the TECH-N participants required a cellphone at enrollment. “National data demonstrate that 95% of sexually active adolescent and young adult women, including those in low-income households, have access to mobile phones with text messaging and internet, and that they are online ‘almost constantly,’” Trent says. 

Read the Johns Hopkins Medicine news release: Visits + Phones = Better Outcomes For Teens, Young Women With Pelvic Inflammatory Disease