Sex Tech by jolinmilioncherie

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									    Incorporating Youth Voice in Suicide
Prevention Programming: Implementation of
  the TextToday Crisis Support System in
                  Nevada
    Bill Evans, Ph.D. – University of Nevada, Reno
   Debbie Gant-Reed – Crisis Call Center of Nevada
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Overview

      •   Background
      •   Program Description
      •   Evaluation Methodology
      •   Evaluation Results
      •   Program Demonstration
      •   Conclusions/Future Directions/Q&A




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Age of Callers to CCC
                                                      2%
                                                                  Age of Callers
                                                                              0-17
                                11%
                           5%              19%                                18-30

                                                                              31-50
                        19%
                                                                              51-64

                                                                              65+
                                         44%
                                                                              Unknown



                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Nevada and Youth Suicide


    • Nevada youth have rates of
      suicide and ideation that are
      almost 2x the national
      average
                                    (YRBS, 2009)




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Youth and Text Messaging

• According to
  researchers…
      (and anyone who knows a teenager)



      Teens really like to text!




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Text and Web-Based Health
• Text/online health
  interventions are gaining in
  popularity
                           (Heron & Smith, 2010)

• Promising for:
       – Low SES and rural areas
       – Risk screenings
       – Hard-to-reach youth
                         (Internet & Suicide, 2009;
                        Pietrzak & McLaughlin 2009)




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



TextToday Online System

      A New Approach to Crisis Line Interventions

      • Piloted May 2010
      • First Live, 24-hour, text-based crisis line in the United
        States



                             “The medium IS the message”



                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Social Marketing Materials




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Social Marketing Materials




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Pilot Evaluation Methods

      •   Post-intervention text sheets
      •   Cell phone carrier data
      •   Focus groups with 110 middle and high school youth
      •   Focus groups with Crisis Call Center’s 8 TextToday staff




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Texter Characteristics

      Frequency of Texts
      • 167 total pilot text conversations (over 1,200 to date)
      • 49.4% of texters have texted in more than once

      Outcome of Texts
      • 57.4% information/support
      • 30.5% no resolution/opt out
      • 7.8% texter calmed/de-escalated


                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Texter Characteristics

      Basic Demographics

      • Gender
           – 51.1% female
           – 13.7% male
           – 35.3% unknown
      • Age
           – 61.7% ages 17 and under
           – 6.5% are 18 and older
           – 31.2% unknown

                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Primary Issues Reported
                                      Primary Issues Reported By Texters

                     Prank Call                      14

              Sexual Identity          5

                     Grief/Loss        6

                        Suicide            7

              Physical Health                   10

              Substance Use                          13

                       Violence                           17

               Mental Health                                         39

Concerned About Another                                                                              69

       Relationship Conflict                                                                              72

                                  0        10             20   30   40    50           60          70          80
                                                                          April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Youth Focus Groups

      Focus Group Questions:
      • Are youth aware of program?
      • Do they know how and when to use it?
      • Do they relate to the social marketing materials?
      • Do they think people their age would use the program?
      • What issues do youth face?
      • What resources do they currently use during crises?
      • What barriers would prevent them from using the
        program?
      • Do they know someone who has used the line already?
                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Youth Focus Groups

      Are Youth Aware of Program?
      • All youth were aware of the program
      • Most knew when they could use program

      Do They Know How to Use it?
      • Nearly all understood how to use it
      • Some confusion about who responds to texts




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Youth Focus Groups

      Do They Relate to Marketing Materials?
      • Positive reactions to marketing materials and location
      • Considered age and tone-appropriate
      • Want more information on line confidentiality

      Would They Use It?
      • Most would refer friends to program
      • Best when youth “just want to talk” and want anonymity
      • Might not be appropriate for all crises

                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Youth Focus Groups

      What Issues do Youth Face?
      • Relational and physical bullying, depression, sex-related
        issues, drug/alcohol abuse, interpersonal violence and
        conflict

      What Resources do They Use When in Crisis?
      • Frustration with current resources available
      • Reliance on friends during crisis
      • Mistrust of school-based resources

                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Youth Focus Groups

     Barriers to Text Line Use
     • No cell phones (~18%)
     • Concern about confidentiality/anonymity
     • May not be appropriate for all crises

     Know Someone Who Has Used It?
     • 8 knew someone who has used it
     • Generally positive
          – “They texted back pretty fast so that kinda shows like… they like
            care.” “Yeah it showed they took it seriously and that they were
            concerned.”
                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



CCC Focus Groups

      •   Strengths of system
      •   Weaknesses of system
      •   Opportunities to improve system
      •   Threats to improving system




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



CCC Focus Groups

      Strengths of the System
      • Meeting unmet youth needs
      • Anonymity of CCC staff
      • Saved record of all text conversations
      • Call line strategies can be used with text line




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



CCC Focus Groups

      Weaknesses of the System
      • No voice cues from texter of staff
      • Length of text conversations
      • Need to multi-task between texting and calling
      • Frequent opt-outs




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



CCC Focus Groups

      Opportunities to Improve System in Future
      • Acknowledging differences between texts and calls
      • Assigning select staff to texting full-time
      • Resource and strategy-sharing
      • Identification of staff who excel at texting
      • Adapting call sheets to text capabilities




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



CCC Focus Groups

      Challenges to Overcome for the Future
      • Intensive, high resource Social Marketing Campaign
      • Difficult to connect youth to resources
      • Difficult to transition crisis texter to phone




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



New Social Marketing Materials




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



New Social Marketing Materials




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



New Social Marketing Materials




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Conclusion

      •   TextToday increased youth help-seeking behaviors
      •   Response to program and materials very positive
      •   Youth and adults use Crisis Line differently
      •   Phone-based strategies can be adapted for text line
      •   Difficult to gather demographics on texters




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Future Directions

      •   Expansion throughout Nevada
      •   Follow-up with text line users
      •   Coordination with other text-based treatment programs
      •   Specialized training programs
      •   Evaluation of long-term outcomes




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH




      “I personally was like ‘Finally! Something that this school
         needs.’”
                                          – 16 year old female



      “Sometimes, you know, you just want someone to talk to.
        You don’t really want them to fix the proble, but you just
        want someone to talk to.”
                                        – 13 year old male


                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH




      “I don’t feel concerned anymore. I feel like I can breathe a
         little bit better… You have helped so much. Thank you
         very, very much!”
                                          – 34 year old male,
                                            father of three children




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH




        Thanks To the Rest of Our Team:
        • Kathy Jacobs
              – Executive Director, Crisis Call Center
        • Jonathan Holly and Tom Evans
              – TextToday System/Marketing Developers, Prevention
                Pays/Educational Messaging Services
        • Misty Allen/Stacy Gillham
              – Office of Suicide Prevention




                                                                  April 1st - 3rd, 2012   San Francisco, CA
5   TH Annual ISIS   CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH



Questions?

      • Bill Evans, Ph.D.
        College of Education
        University of Nevada, Reno
        wevans@unr.edu

      • Debbie Gant-Reed
        Crisis Call Center of Nevada
        debbieg@crisiscallcenter.org


                                                                  April 1st - 3rd, 2012   San Francisco, CA

								
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