By Emma Schlamm | December 9, 2019
Program Coordinator, YTH Initiative at ETR
First published on the blog of the Sexual Violence Research Initiative
Everyone’s doing it. We’re talking about tech. The allure of technological solutions seems to permeate every sector, both public and private. Our lattes are made by robots, our doctors chat with us on FaceTime, and most recently, technology is being used in the global public health sphere. It seems like every major NGO, CBO, and Foundation is using some version of digital technology; whether it’s a chatbot that provides cognitive behavioral therapy, or a mobile app that allows someone to order birth control right from their personal mobile phone.
At the YTH Initiative of ETR, we believe in the power of technology. We believe in the unique opportunity tech provides to young people to access information and services privately, quickly, and confidentially. We have had great success with SMS reminders, social media campaigns, apps, and more. However, we also recognize the power of human engagement and interaction. In many cases, an ideal solution is one that integrates online and offline interactions and engagements to truly amplify these solutions.
ZonaSegura: A Youth-Centered Mobile Application to Address Teen Dating Violence
The YTH Initiative of ETR, in partnership with the Public Health Institute (PHI) and GoJoven Honduras, is implementing and evaluating ZonaSegura. ZonaSegura is a multi-faceted, tech-based intervention that uses a website, native mobile app, and a WhatsApp messaging campaign to prevent teen dating violence among Honduran youth. The evaluation has demonstrated that the power of partnership and human effort is an essential and irreplaceable component of a digital solution’s success.
While the technological aspects make the project appealing and innovative, it is the in-country GoJoven staff that make the project happen.
The Evaluation
The ZonaSegura IRB approved study is testing the effect of ZonaSegura on teens’ access to and use of information, knowledge and attitudes to teen dating violence and overall self-efficacy in teen dating violence prevention. Teens living in Tegucigalpa, Honduras between the ages 14 and 19 are being enrolled in the study and agree to receive ZonaSegura content on their mobile phones for three months. Participants complete a baseline questionnaire at enrollment, and a follow-up questionnaire at 90-days to assess knowledge, attitudes, and acceptability of the mobile intervention.
ZonaSegura is important in the digital health landscape because while Hondurans experience disproportionately high rates of negative health outcomes, it is also a country that is often overlooked in research and in technology.
In-person Engagement Is Essential for Recruitment
Our goal of recruiting over 700 Honduran youth with access to mobile phones in Tegucigalpa in just three months seemed ambitious at first. We assumed we could reach and recruit youth through various social media channels. However, we overlooked the powerful and important connections our in-country partners had that made recruitment happen. The GoJoven team worked tirelessly to connect with local schools and youth-serving organizations to inform them about our project and request our teams to come in at lunch or recess or after school to recruit youth for the study. Violence is a taboo topic in Honduras and “selling” a digital intervention that addresses violence is even more taboo. In-person engagement allowed staff to build trust and rapport with the young people which facilitated a successful and smooth recruitment process.
In just two weeks after the official September 24th launch date, we had over 200 Honduran youth enroll in the study to receive messages about healthy relationships and make informed choices. We were astounded to say the least. We received immediate feedback through GoJoven that the schools were incredibly excited about the program, even asking if their team could continue the study through the rest of the school year in order to reach even more youth.
This photo highlights the genuine excitement and curiosity the young people demonstrate when presented with the information about participating in the intervention. Although the eligibility survey, baseline survey, and enrollment, and the intervention itself are all digital and can theoretically be done from anywhere in the world, none of this could happen without the presence and commitment of the GoJoven staff and the trust building with youth and key gate-keepers.
What we are learning
The overarching theory of change for the ZonaSegura initiative is Positive Youth Development (PYD). In order to find audacious solutions to build a society where youth can thrive in places they learn, play and live, adult allies need to engage with youth in deep and meaningful partnerships. The approach that ZonaSegura follows is youth-centered and acknowledges and treats youth as assets as opposed to problems that need to be solved by adults. Simply put, PYD is about promoting development, not just preventing problems. Youth provide direction to the innovations and are deeply involved in the prototyping, implementation and testing of the intervention design. Youth Centered Design leans into the resilience and wisdom of youth, supports the developmental stage of youth in their environment to ignite creativity and innovation to challenge or build a solution.
Some very early baseline data results (n=106) show that less than a third of young people know where to find information for a friend experiencing gender-based violence. Further, less than a quarter feel they have the skills and knowledge to be in a healthy relationship now or in the future and over 30% of youth surveyed said they would not know what to do if they found themselves in a violent situation with a partner.
Integrating both off-line and on-line interactions
As more public health practitioners begin to integrate technology into their interventions, acknowledging and integrating the online and offline allows us to truly be effective in our work with communities around the globe in reaching and engaging them.
Call to action
If ZonaSegura is shown to have an impact on TDV in the study population, there is potential to scale geographically country-wide, incorporating feedback from the pilot to improve the program design in the process. If the intervention is proven to be effective, YTH Initiative of ETR will continue to pursue partnerships and funding opportunities to bring ZonaSegura across the globe.
Emma Schlamm is a Program Coordinator with the YTH Initiative at ETR. She can be reached at emma.schlamm@etr.org. If you are interested in learning more about YTH Initiative of ETR’s innovative work around the world, be sure to register to attend our annual conference, YTH Live, which will be held in San Francisco on May 3-4, 2020.