Left on Read: Strategies to Improve SafeSpace Participant Engagement and Retention
The holiday season is upon us and so is Year 4 of the SafeSpace rigorous evaluation! Our team is very proud of the work we have accomplished thus far and we are excited to share this update. Get cozy as you read about our progress and what we have learned about the SafeSpace app users.
MyHealthEd, Inc. has completed the app usage data analysis for the first two cohorts of the SafeSpace study. Cohort 1 consists of 331 youth who completed the program from June - December 2023, and Cohort 2 includes 176 youth who completed the program from January - June 2024. We previously shared blog posts on how we developed an enrollment procedure and the valuable feedback we received from interviewing users. This blog post will describe the processes utilized to monitor user engagement and retain participants throughout the program and evaluation period. We will also share the results of these efforts and lessons learned.
SafeSpace is an innovative mobile app for youth that delivers 10 weeks’ worth of information on adolescent development, sexual and reproductive health, and overall well-being. Each lesson contains a youth-generated story, medically accurate facts, reputable resources, and a knowledge application activity. Delivering the SafeSpace material via a mobile app allows users the flexibility to learn at their own pace and convenience. This format also removes geographic barriers, extending our reach to a more diverse audience. Currently, SafeSpace participants come from more than 13 states throughout the U.S. and range from ages 14-18, with more than half identifying as LGBTQ+, Hispanic, and/or non-Hispanic Black.
As with any intervention, high participant engagement and retention are key to success. While we knew this would be challenging since we do not meet with participants in person, we saw this as an opportunity to be creative in how we keep participants interested in the program. Our team implemented two strategies to encourage engagement:
Providing incentives,
Strategizing outreach based on usage data analysis.
Strategy #1: Incentives
The first method we use to increase retention is to provide monetary incentives. Participants have four opportunities to earn up to $100 in gift card rewards. All eligible participants earn the first gift card after successfully enrolling in the study. To earn the second gift card, they must complete at least two lessons within the first five weeks. This midpoint incentive rewards engagement during the first half of the program and encourages use for the remainder of the study. If a participant does not initially meet the requirements for the second gift card, they are able to earn the reward before the program ends by “catching up” and reviewing the lessons that they missed. The final two incentives are distributed when participants complete the short-term and long-term surveys at 10 weeks and nine months, respectively.
We found these monetary rewards to be effective, with over 70% of participants receiving their midpoint incentive.
Strategy #2: Outreach
Once participants enroll in the study, their mobile device is registered in our monitoring system which tracks participant app usage. When the monitoring system detects that a user has not opened the app in five days, their status is changed to “inactive,” and a push notification is automatically delivered. This notification reminds the user of missed content and encourages them to return to the program.
After monitoring the program for a few weeks, we noticed a sharp decrease in active users soon after enrollment. The sudden lack of participation urged our team to investigate other ways to encourage engagement. We decided to implement a personalized outreach strategy midway through Cohort 1, texting inactive users at two time points. Our objectives for this strategy included
Retaining engagement,
Increasing midpoint incentive distribution, and
Streamlining communication efforts.
Since the greatest decline in participation occurs after the first week, we began reaching out to inactive users three weeks post-enrollment. Texting them during Week 3 serves two purposes; it enables us to communicate with participants early in the program to address initial drop off, and it acts as a reminder for the midpoint incentive. We send a second text message out during Week 8 to encourage engagement in the latter half of the program and remind participants of the next reward. Choosing these two time points maintains an evenly distributed communication schedule that does not overwhelm participants with too many notifications.
Our team created a spreadsheet monitoring participant status to track those who need outreach. The spreadsheet consists of each participant’s study ID number and their usage status at Week 3 and Week 8. Messages are sent via YakChat, and once participants are texted, our team checks their statuses every week to see if they have re-engaged. We also ensure to reply to messages from participants and address any questions or concerns they may have. These brief interactions are beneficial for re-engaging participants and help reveal any app issues that may have discouraged participation.
To assess the effectiveness of our outreach strategy, we analyzed attendance, defined as engaging with at least one of the app’s three weekly lessons. First, we compared attendance between cohorts, since only a portion of Cohort 1 received these low-engagement texts as opposed to all of Cohort 2.
Cohort 2 had higher attendance rates for Week 3 and Week 8, suggesting that our reminders prompted re-engagement.
We also calculated re-engagement numbers, looking at how many participants returned to the app after we texted them. Combining the two cohorts, we found that 25% of users returned after the Week 3 text and 23% after the Week 8 message.
While these numbers may be small, we consider these results a promising indication of our outreach strategy’s effectiveness. Communicating with participants taught us that some lost access to SafeSpace due to accidentally deleting the app or acquiring new phones. Our team has been able to quickly address these issues and get users back into the app. It also brings us joy when participants thank us for the helpful reminder messages! We will continue exploring new ways to enhance engagement and encourage participants to use the SafeSpace app throughout the 10-week program.
Lessons Learned
When our team identified a decline in participant engagement within the first few weeks of enrollment, we knew we had to act fast. We quickly implemented a new outreach strategy to keep users engaged throughout the second half of the program. After making these changes, we learned a few new things about engagement and retention:
Message Frequency
There are at least 10 text message reminders from our team (e.g. incentives, inactivity, and surveys), in addition to push notifications that come through the app. This may cause communication overload and lead some participants to ignore the messages, disable push notifications, and/or block our texts. When this happens, participants do not receive important messages regarding the study, which impacts engagement. We are learning to strike a balance between reminding participants to stay engaged while not over-messaging them by spacing out our messaging schedule, as we did with the Week 3 and Week 8 texts.
Personalized Text Messages
Given our reliance on push notifications and text messages as the primary form of communication, youth may not feel as inclined to engage due to a lack of personal connection. We learned that participants sometimes think our messages come from bots. However, once they realize that we are real people with whom they can communicate, they feel more supported while using the app. Using youth-friendly language in text messages is crucial to successfully communicating with participants. We also aim to use more engaging language so they know our team is here and available to answer their questions or concerns. We are currently updating our messages to be more personalized and sound less automated.
Program Length
Ten weeks is a long time for young people to keep up with a program on their own. We understand they are navigating school, work, and other life responsibilities. As such, a decline in engagement is expected. Not only may they become disinterested, but other priorities may also take precedence, inhibiting their app usage. The task is then to condense the content into a shorter time frame, which may be more beneficial to keeping youth engaged.
We’re excited to contribute these lessons learned to the growing research on mobile health interventions and use them to inform future iterations of the SafeSpace app.
Stay Tuned
SafeSpace is an innovative app that has allowed us to educate over 600 youth nationwide. We are working tirelessly to continue outreach to increase enrollments while maintaining participant engagement and retention. Stay tuned for more updates from our team as we navigate improving our program structure and addressing challenges that arise while implementing a completely digital sexual and reproductive health education intervention.
-Brittany, Bajha, & Marisa
Sex Ed at your Fingertips
MyHealthEd, Inc., in collaboration with Power to Decide, Child Trends, and Healthy Teen Network, has successfully completed the first cycle of our rigorous evaluation of the Real Talk app! Our team has been busy working on this study, and we are thrilled to share some updates on our progress.
Introducing the SafeSpace app
To evaluate Real Talk’s innovative use of youth stories as part of a comprehensive sex education intervention, without disrupting current user’s access to Real Talk, our team developed a new app called SafeSpace. SafeSpace aims to build health literacy and fill gaps in youths’ sexual and reproductive health knowledge. SafeSpace is a self-paced 10-week program containing youth-generated stories, medically accurate and youth friendly information, reputable resources, and knowledge application activities on a variety of topics related to adolescent development and wellbeing. New lessons are released weekly and cover healthy relationships, identity, sexual and reproductive health, communication and decision making, and accessing healthcare services.
SafeSpace Participants
We previously shared our approach to designing the enrollment procedure for this study and are pleased to report its success so far. Youth who see our ads on social media platforms like Instagram and TikTok are directed to download the SafeSpace app. Once in the app, they take a brief eligibility screener survey. Those who meet the study criteria can then complete the consent and enrollment forms, followed by a baseline survey. After the survey, participants are able to begin engaging with the SafeSpace curriculum and browse through the app.
The collaboration between our partners on this project has resulted in steady enrollment since we launched in June 2023. Our partners at Healthy Teen Network have done a phenomenal job navigating best practices for advertising sex education programs on social media (you can read more about their work in this blog post).
We are happy to announce that as of June 2024, we have enrolled over 600 young people! Participants are predominantly Black and Latinx, between the ages of 17-18 years old, and identify as LGBTQ+.
Recruitment is ongoing until we reach our goal of enrolling 1,000 young people. Until then, we are conducting continuous quality improvement to ensure the SafeSpace app, our study procedures, and communication strategies result in a positive experience for participants.
What we’ve learned from participants, so far
In order to understand participants’ experience, MyHealthEd staff began conducting user experience interviews in March 2024. We met with eight youth who completed the program to gain insight into how participants feel about the program. Through these conversations, we learned which aspects of the app they appreciated and the type of enhancements that would help to improve the program. These interviews will also inform the next steps we take with the app in terms of technological modifications, dissemination, and more.
SafeSpace Strengths
In terms of the technology and usability, participants found the app to be user-friendly with minimal bugs or challenges and noted that the design was aesthetically pleasing. They also considered the enrollment process short and easy to navigate.
With respect to the program content, participants appreciated being able to learn from their peers through the stories in each lesson. Supporting prior research, they also liked that the stories are presented in a text messaging format, as it made the content engaging, easy to follow, and digestible. They shared that the short-form content and connection of key facts to the stories helped them to learn more about the topics without it feeling like homework.
Each SafeSpace lesson includes a prompt related to the topic and gives participants the opportunity to express their thoughts and opinions on the matter. During the interviews, participants referenced these reflections as a safe space to speak candidly without fear of judgment or embarrassment.
The sense of privacy the app provided to users was a recurring theme among youth we interviewed. They noted that they were able to learn about sensitive topics regarding sexual and reproductive health and reflect on the topics in their own comfortable environment. Participants noted that they may have felt less comfortable with these topics in an in-person setting, hindering their comprehension of the material.
“I think that’s good to reflect on because when people come from unhealthy backgrounds and stuff, it’s like we only know what we’re taught and we see other things but we don’t always know the facts. So being able to do that and then reflect on it and knowing that it’s not going to be shared with anybody feels relieving. It’s scary for me to even write in a journal because I’m afraid of somebody opening it. [SafeSpace] gives you that privacy.”
Users also enjoyed being able to look through all their reflection entries at the end of the program to see what they learned and how they grew throughout the ten weeks.
Regarding the program format, participants appreciated that the app was self-paced and could be used at their convenience. The lack of deadlines also eliminated the sense of urgency felt with other educational or academic lessons.
“I do prefer to go about things without instructors. Typically, I like to self-manage and [SafeSpace] gave me something to do in my free time, something to read up on before I was going to sleep or while I was waiting for a friend to come pick me up.”
Lastly, we were thrilled to hear that some youth felt inspired to share what they had learned from the SafeSpace app with family and friends.
“I definitely talked about it with my mom and she gave me more insight and it was just really good…My mom is more old school, so at first she’s like, ‘oh, you don’t need to be using that’ but [after giving her an article to read] she saw it was actually something good. She liked it because not only was I able to [give] my opinion, but it was informative and it gave me prevention-first stuff, like problems that we face and solutions.”
Suggestions for Improvement
The user experience interviews also served as an opportunity for us to learn which aspects of the app and program were less enjoyable. In talking to youth, we asked for their suggestions on what more they would like to see in the SafeSpace app.
In addition to ideas for more topics, such as more mental health support and social media and internet safety, participants expressed a desire to add features to increase accessibility and functionality. Suggestions included creating a dark mode setting, adding a read-aloud option for stories and facts, more gamification to indicate their progression through the program, and allowing a voice note option for reflections.
“A dark mode would be nice because a lot of people are not super fond of light applications, especially now. So I feel like a dark mode where it was more black and blue instead of like white and blue would be nice. It makes it feel less clinical and more welcoming, I’d say.”
Based on this feedback, we have already begun implementing some of the suggestions with the addition of a dark mode option and are excited to release it to users soon!
Looking Ahead
One of the challenges of implementing a completely digital, asynchronous intervention is the lack of human connection and real-time feedback. However, user experience interviews have provided us with a great deal of valuable information. Hearing from youth directly helps to reaffirm the importance of the innovative work we are doing to reach young people from various backgrounds.
We are committed to creating and maintaining a positive experience for users throughout the duration of the study.
Stay tuned for more updates from the SafeSpace team coming soon!
-Marisa, Brittany, & Bajha
Sharing Key Insights from Our Real Talk High School Interns
During Spring of 2022, Real Talk hosted an internship program with two queer high school students from a school in Northern California. This internship lasted 13 weeks and was filled with interactive activities during weekly remote meetings with the Real Talk team. The two interns contributed to various activities that primarily focused on understanding mental health needs for LGBTQ+ youth.
Activities & Learning Questions
Together, we applied a human-centered design (HCD) approach to examine queer youth mental health and wellbeing while taking these questions into consideration:
How can we use technology to better support queer youth mental health?
What are the stages of the (queer) mental health journey?
The interns started off with completing photo journals and diagrams, and exploring Real Talk stories written by LGBTQ+ youth. Together, we identified key factors from these activities that are the most impactful to youth mental health and wellbeing overall. They also identified gaps that exist in current resources and support for LGBTQ+ youth. We then brainstormed solutions for how to fill those gaps at Real Talk. We closed up the last few weeks of our internship with reflecting, reviewing, and gathering feedback from teens. The interns contributed creative ideas and shared key themes from our work together that highlighted the need for more meaningful support for queer youth. As the final product for the internship, both interns worked together and created a journey map about the queer mental health journey. Below you can see some of the the themes and insights that informed the final products.
What We Learned: Emotions & Needs
Through stories, journals, and insightful HCD activities with the interns, we identified the following key emotions and needs among queer youth:
Community & Authentic Connection
Queer teens are lacking meaningful community. They have trouble fitting in with peers and feeling understood in all aspects of their identity. Being surrounded by other queer youth is refreshing and needed, but rare.
Queer teens generally need more sources of authentic support and care. They may be surrounded by friends and classmates, but these connections often do not provide the type of care that they need most. Authentic connection means queer teens feel seen and heard regardless of their situation.
Hope & Reassurance
Queer teens want hope and reassurance that they can find happiness. They want to hear from older queer folks who made it out of difficult times during their youth. Also, teens want more stories about happy queer couples to reassure them that loving relationships are possible.
Safety & Privacy
Queer teens lack spaces with true physical and emotional safety. They want better mental and physical health support at school. They also need adults in their lives who are more understanding of and responsive to their needs.
Social media is not always helpful to teens, especially queer teens who are navigating their identity. It is easy to feel like everyone is watching and judging based on what is happening on social media. Queer teens need safe spaces where they can feel supported by an inclusive online audience.
These emotions are key drivers of the queer youth experience. In order to effectively support them in addressing these needs, we need to take each of these into account when designing programs and services for queer teens.
What We Learned: Key Insights
After learning about the gaps in support for queer youth, the interns also shared new insights for Real Talk to consider to better support and serve LGBTQ+ youth. We learned that:
Social media does not equal community
Social media is one way to connect with teens, but it is not the only way. It can be difficult to have authentic connections online, especially when it comes to personal issues. Sometimes teens want to stay anonymous. There is a need for creative avenues to reach and connect with teens that do not center around social media channels.
Sharing the same story & experience is tiring
Having to re-tell your coming out story and experience when looking for support can be exhausting. We need to find new ways of engaging with queer teens that do not require them to recount difficult and traumatic experiences. Instead, we can focus on creating safe spaces to celebrate queerness and learn about positive aspects of the queer experience.
Most big picture LGBTQ+ support is performative
Many schools and organizations have made important changes to their programs, curriculum, and messaging for queer teens. But, oftentimes these expressions of LGBTQ+ support are not enough to truly change the culture and norms that impact queer teens.
The social norms in schools center the heteronormative experience and adhere to the sexuality and gender binary. Beneath heteronormativity lies homophobia and transphobia. When schools do not have authentic safe spaces or LGBTQ+ inclusive culture and curriculum, it sends a hurtful message to their students.
One intern summarized it like this: It’s nice to have a GSA club at school, but if only 10 students out of 4,000 are a part of it – that doesn’t really make me feel safe.
Safety and authenticity are intertwined. In order to create safe and authentic spaces for queer teens, schools need to challenge the binary view of gender and sexuality diversity in school culture.
Connection and relationship building needs to come first
Many LGBTQ+ support programs, like GSA clubs and LGBTQ+ centers, can be stressful and scary at first. Queer teens are expected to join a group of strangers and engage in vulnerable, personal conversations before they have had a chance to build relationships with anyone. This is a significant barrier to participation and limits the overall helpfulness of these types of programs.
Providing one-on-one check-ins or having opportunities to build more genuine relationships could help teens feel supported going into these programs.
Moving forward, our interns inspired a couple of questions for Real Talk to consider further:
What does a supportive community look like for queer teens?
What does meaningful support look like?
Real Talk values working with teens and learning from their experiences in order to better support youth mental health and wellbeing. Our goal for this internship was to learn more about how Real Talk can better support and care for queer youth mental health. We achieved this goal with the help of our interns who brought valuable ideas and a fresh perspective to Real Talk about queer mental health, which inspired new insights and questions. Real Talk will incorporate all that we learned from the internship for future programs and partnerships. We can’t wait to get started on the next steps and continue to share what we learned with our community!
In this learning journey together,
Arleth & the Real Talk team
P.S. There are lots of ways to support our work further – whether through financial support or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at hello@myhealthed.org
How to use prototyping to improve the design of study enrollment procedures
MyHealthEd, Inc, in partnership with Power to Decide, Child Trends, and Healthy Teen Network, is working on a rigorous evaluation of the Real Talk app. One part of the study involves setting up a process for participants to enroll in the study that can be completed entirely online. This post shares how we used a human-centered design approach to prototype the design of study enrollment procedures.
Background
Designing a high-quality enrollment procedure is essential for ensuring we reach our recruitment goal and target population for the study. This is particularly important given that this study is taking place completely online. The process needs to be clear and easy to follow, as participants will not have a study representative to assist them. Enrollment is also the first of many activities participants will be asked to complete as part of the study, so it’s important that we create a positive experience for all participants. The full enrollment process for this study includes four main steps: Participants are required to (1) complete an eligibility screener, (2) provide informed consent to participate, (3) complete the baseline survey, and (4) download the study app to their phone.
To begin, we brainstormed all the different ways the four required steps could be ordered. We created user journey maps in which we considered the user experience as well as technical and data needs for each step of the enrollment process. Working through these initial planning activities enabled us to identify different ways to organize this process and the benefits and drawbacks for each option. Using a design thinking approach, we set up a short prototype to test which version of the enrollment process would most appeal to youth. The main goal was to gather real data from young people to better inform how the process would be received.
Our Approach
We designed the prototype to answer two questions: At what point in the enrollment process do we see highest attempts to download the app? And, where do we see the most drop off (i.e., where do we lose people in the process)?
We considered three different versions of the enrollment flow that included downloading the study app at different points in the process. We wanted to know how much information participants need before they are willing to download the app and how many steps they are willing to complete before they abandon the process. For this prototype, we simulated the steps of the enrollment flow as closely as possible through an interactive experience. We wanted to understand genuine user behavior as they navigated the enrollment process, rather than asking about attitudes and preferences in a more abstract or hypothetical scenario like an interview or survey.
We also wanted to spend few resources and learn quickly, so we designed a one-week test that could be run for $200. To do this, we used social media platforms to run multiple ads that directed people to one of the three enrollment scenarios (Figure 1). We created web pages and used free survey software, along with click-tracking links to capture the necessary information to answer our questions.
Figure 1.
Results
Results from this prototype helped us identify the version of the enrollment process that resulted in the highest attempts to download the app. We assessed user behavior in two ways. First, we calculated the overall download click rate for those who viewed the initial eligibility screener web page. Of those who viewed the initial page, 21.4% of those in Condition 1, 20.8% of those in Condition 2, and 4.0% of those in Condition 3 were willing to download the app.
Second, we tracked the download click rate among those who started the enrollment process (i.e., began entering information in the eligibility screener). Of those who began the screener, 92.1% of those in Condition 1, 75.6% of those in Condition 2, and 50% of those in Condition 3 were willing to download the app.
From this test, we gained valuable insight into participants’ willingness to download the app, and the amount of information they need before they are willing to do so. We were also able to simulate the entire enrollment flow with very simple and lightweight tools which resulted in data and helped us to identify next steps to move forward with designing the enrollment process.
Recommendations
Prototyping, like the process described here, is a valuable learning tool that can be used when developing programs and procedures to support public health research and programs. Below we provide three key recommendations for applying these strategies to other efforts:
(1) Consider implementing simple prototypes when designing research study procedures
Even when research studies take a participatory approach to designing programs, there is often less attention paid to how aspects such as the enrollment process are designed. Studies typically report on the evaluation process, including the ability to complete recruitment and reach a complete sample, the costs of implementing a study, and how data was collected. However, researchers rarely consider the user/participant perspective when designing other aspects of the study. Those who do seek participant feedback on study procedures typically describe these quality improvement efforts after a study has been implemented and/or completed rather than as part of proactive efforts to design user friendly study procedures. Prototyping offers an easy, low-cost way to make data-driven decisions to inform the design of study procedures.
(2) Be thoughtful and creative about what data is most useful for answering your learning questions
Since prototypes (by design) are limited in scope and breadth, it is crucial to consider what learning question(s) are most important and which may be secondary. Take time to identify what you hope to learn and what data you need to gather. This also includes being expansive with what data mean. Data do not have to be perfect in order to be informative and useful to answering your questions.
For example, first determine your general learning question. What is the overall aspect about which you want to learn more or gather data? As you design a prototype to help you answer this question, you can narrow your focus and ask more specific questions. For our process, our overall question was to learn more about user behavior and willingness to download the app. As we designed the prototype, we realized that we also wanted to track the data at every step to monitor drop off and thus took steps to track this data.
This test helped us determine whether and when participants were willing to download the app, but questions remain unanswered about what participants do after they download the app and whether they will complete the enrollment. This was outside the scope of the prototype – in other words, one test does not need to answer all of your questions – but focusing on specific components to test was valuable nonetheless to help us determine next steps.
(3) Engage in frequent monitoring throughout the test to identify any issues early in the process.
Frequent monitoring is important for making any necessary adjustments as you implement and refine the prototype. By thinking through the data and proactively identifying problems, we were able to make better sense of the prototype outcomes, track areas for improvement for future prototypes, and note new questions we’d like to answer.
Conclusion
Prototypes, and other human-centered design tools, can be incorporated into many different aspects of research, including when designing enrollment procedures. By using a human-centered approach, we gathered key information to tailor the enrollment process based on how young people engaged with the three different scenarios. These findings will inform the enrollment process for our study based on data from the user perspective.
We look forward to sharing more updates, stay tuned!
-Marisa & the Real Talk team
P.S. There are lots of ways to support our work further – whether through financial support or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at hello@myhealthed.org
Building Real Moments of Connection
Earlier this month, we announced the Letter to Myself campaign – a collaborative effort between Real Talk and Hopelab to center stories of hope, resilience, and compassion among BIPOC and LGBTQIA+ youth and young adults. We have featured eight letters on social media and include the full text on our website, each describing moving accounts of family, relationships, identity, and love. These letters are beautiful, honest, and powerful, and I am honored they each trusted us to tell their stories.
The initial vision for this campaign was to activate youth and adults in our network to share stories that speak directly to one another. With each passing day – that brings new Covid-19 variants, anti-trans legislation, racism, gun violence, and so much more – the need to build these real moments of connection feels increasingly urgent.
I am writing this less than a full day after the horrific shooting at Robb Elementary in Uvalde, Texas. As I feel the heaviness of grief, I wonder what those children may have said to their future selves, what hopes they had for the future, and how we have completely and utterly failed so many families like these. I don’t have words to say much else on the matter, but I know this feeling is what drives me to protect and nurture young people of all identities, experiences, and walks of life. My hopes for the future are to live in a world that is radically different from the one we experience today – with more kindness, love, and justice.
In grief and solidarity,
Cristina & the Real Talk team
Announcing Real Talk’s Letter to Myself Campaign
In honor of Mental Health Awareness Month, we are launching the Letter to Myself campaign. Our goal with this campaign is to activate youth and adults to share stories of hope and resilience in support of BIPOC and LGBTQIA+ mental health.
Over the last few weeks, we have collected letters from young people writing to their future selves and from older folks writing to their younger selves. We will feature excerpts from select letters on our Real Talk Instagram account throughout the month of May, but the full content of each letter will be available on our website. We will continue updating this page as we feature new content and receive additional letters, so check back often!
This campaign has been a work in progress, in collaboration with Hopelab, an innovation lab and mission investor working to support, heal, and empower young people by harnessing the power of technology. Our shared commitment to improving the mental and emotional health of BIPOC and LGBTQIA+ youth and young adults meant we are natural partners in this work. We are grateful for their encouragement and creativity throughout this process.
We invite you to join us in building real moments of connection for the youth and young adults in your life – today and everyday.
With gratitude,
Cristina & the Real Talk team
P.S. There are lots of ways to support our work further – whether through financial support or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at hello@myhealthed.org
Meet the Team: Arleth Gutierrez (Content Curator)
My name is Arleth and I graduated from the University of California Santa Cruz in Fall 2021. I joined Real Talk as the Content Curator in June 2021.
I met Dr. Leos through a mentor. We were connected because I was interested in learning more about her adolescent health research and overall career path. After I got to know more about her and her work with Real Talk, I became deeply inspired by this work. I have a strong passion for helping my community, specifically amplifying LGBTQ+ youth voices.
As a teen, I had trouble coming to terms with my sexuality due to fear of disappointing my traditional Mexican family. I didn’t have the resources or the support to truly accept myself. I had no understanding of the spectrum of sexuality or gender, and worse, no one who I could confide in. I felt very alone and scared.
It wasn’t until my first year of college that I met people with stories similar to mine. I remember how amazing it felt to feel deeply understood and seen. It was a breath of fresh air. Thankfully, through my friends and various college resources, I was able to fully grow into myself-- the real me. I am now very confident in my sexuality and gender expression. I feel comfortable in my own body. I am a first-generation college grad and a queer, brown woman. Someone my teen self would be proud of.
The challenges I faced as a teen shaped my dedication to building safe spaces for youth to seek resources related to sexuality, gender, adolescent health, and more. If I had access to an app like Real Talk as a teen, I would have been able to grow into myself sooner and not feel so alone.
Real Talk does an excellent job of providing teens with genuine and helpful information about sexuality and gender expression in a way that makes them feel supported and understood. More importantly, it gives teens a voice and a sense of community during difficult times.
I am so excited to be a part of the Real Talk team and to work closely with Dr. Leos. I am truly inspired by her dedication to improving teen health. As a Content Curator, I get to oversee Real Talk’s content activities, including content planning, story review, and story publication. I enjoy seeing teens’ stories come to life on the app and providing them with helpful resources. Working at Real Talk and being the editorial voice would have made my younger teen self proud for helping create a safe space for teens to share and find support.
– Arleth & the Real Talk team
P.S. There are lots of ways to support our work further – whether by donating to our fundraising campaign or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at hello@myhealthed.org.
MyHealthEd, Inc. Wins Federal Grant to Evaluate Real Talk Mobile App
January 31, 2022 (Chapel Hill, North Carolina) – MyHealthEd, Inc., in partnership with Power to Decide and Child Trends, has been awarded a multi-year federal grant by the Administration for Children and Families (ACF) to rigorously evaluate the Real Talk mobile app. Real Talk is a mobile app that uses storytelling to improve adolescent mental, emotional, and behavioral health. Real Talk provides a platform for youth 13-17 years old to share and read stories on topics like relationships and mental health, with the purpose of helping young people realize they are not alone in their experiences. Youth are also able to find vetted resources directly within the app to help them navigate health issues.
Real Talk was initially developed through the Innovation Next Accelerator and has been publicly available since 2017. Since launching, Real Talk has helped nearly 30,000 youth and young adults across the United States access high quality health content and resources. Users on the platform have accessed over 15,000 online resources and shared over 4,700 stories. Real Talk has been featured in publications like Teen Vogue and Forbes, and was recently selected as an Anthem Award Health Innovation Finalist.
The five-year evaluation partnership is funded as part of the Personal Responsibility Education Innovative Strategies (PREIS) Program, which awarded $10.7 million to 12 recipients in 2021. This project will evaluate Real Talk’s innovative use of youth stories as part of a comprehensive sex education program delivered to youth entirely via a mobile app.
“We are proud of what we have accomplished with Real Talk over the last few years to support youth health. This partnership provides the expertise and resources to expand our work even further.”
– Cristina Leos, Co-Founder & CEO of MyHealthEd, Inc.
About MyHealthEd, Inc.
MyHealthEd, Inc. is a 501(c)(3) nonprofit organization dedicated to using human-centered design to improve the health and wellbeing of youth of every identity. MyHealthEd, Inc. was founded in 2016 by three women of color in efforts to increase access to health education in low-income and rural communities. The organization is based in Chapel Hill, North Carolina. For more information, visit www.myhealthed.org.
Media Contact:
Avanti Godbole
P.S. There are lots of ways to support our work further – whether through financial support or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at hello@myhealthed.org.
A Call to Action for Our Youth: U.S. Surgeon General’s Public Health Advisory on Teen Mental Health Crisis
On December 7th, U.S.Surgeon General Vivek Murthy issued a public health advisory on the adolescent mental health crisis following the pandemic. In this public call to action, Dr. Murthy notes that in recent years, there has been in increase in teen depressive symptoms and suicide ideation. In the report it was also noted that Black children (13 and younger) are more likely to die by suicide than White children, and on average children of color are disproportionately affected by mental health challenges over their White counterparts.
As pointed out by Dr. Murthy, adolescent mental health implications will quickly become a second pandemic if we do not move quickly and mobilize on all fronts to tackle the problem. The report lays out what specific groups, organizations, and politicians can do to prioritize teen mental health. It’s time for action.
“The challenges today’s generation of young people face are unprecedented and uniquely hard to navigate. And the effect these challenges have had on their mental health is devastating”.
- Dr. Vivek Murthy, U.S. Surgeon General
In the long term, there are many things that need to change. We need to see real accountability from groups like Meta, Instagram, and Twitter who benefit from time spent on their platforms, despite mounting evidence that they were aware of the negative mental health consequences being on their apps have for teens. We need politicians to push for funding mental health groups in schools, and pass policies that work to alleviate childhood poverty at a national level. And finally, we all need to increase discourse and education surrounding mental health to normalize help-seeking behavior.
In the short term, there are many groups that have been doing incredible work to increase mental health resources for teens:
The Trevor Project is the world’s largest suicide prevention and crisis intervention organization for LGBTQ+ young people.
Active Minds is dedicated to saving lives and building stronger families and communities through education, research, advocacy, with a focus on young adults ages 14–25.
TherapyTribe is passionate about using the power of the Internet to connect people in need. They work to help people find key mental health resources like therapists, support groups, wellness tools, as well as an overall sense of community.
Real Talk recognized this increased need for teen mental health resources and have realigned our program to meet this demand (in fact, Real Talk stories cover 94% of CDC recommended standards for mental health education). Teens want a space to share their stories, and communicate openly and honestly with one another regarding their mental health. Our goal is for Real Talk to provide a platform where they can feel less alone.
In this together,
Cristina & the Real Talk team
P.S. There are lots of ways to support our work further – whether through financial support or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at founders@realtalkapp.com
Real Talk Provides Teens with CDC Recommended Health Content and Fills Critical Gaps
Today, we announced a new report titled “Aligning Real Talk Stories with the CDC National Health Education Standards.” Real Talk provides inclusive, trauma-informed, medically-accurate, and developmentally appropriate health content for youth in the form of crowdsourced stories. This report describes the results of a review conducted in Summer 2020 to ensure the stories posted to the Real Talk app align with the National Health Education Standards Knowledge Expectations for Grades 6-8.
The National Health Education Standards (NHES) are a set of standards developed by the Center for Disease Control and Prevention (CDC), the American Public Health Association, and others, to promote health-enhancing behaviors for school-aged youth. They provide written expectations for what students should know and be able to do at particular grade levels to promote optimal health. The review focused on aligning Real Talk stories with the knowledge standards for two health topics areas: Sexual Health and Mental and Emotional Health. Below we share key findings from this report.
Real Talk provides developmentally appropriate content that aligns with CDC’s recommendations for high quality education programming for adolescents. Nearly 80% of the knowledge standards reviewed had at least one aligned Real Talk story, including 67% of Sexual Health knowledge standards and 94% of Mental and Emotional Health knowledge standards.
Real Talk fills important content gaps that youth may not be exposed to in traditional health education programming. Some Real Talk stories did not align to any knowledge standards. These stories covered a range of key topics for healthy adolescent development that are not currently included in the NHES recommendations for health education curricula. For example, STIs/HIV make up one third of all Sexual Health knowledge standards, but there are no standards focused on explaining sexual orientation, gender identity, or gender expression, and how these components may impact health.
New research shows only 50% of youth receive sex education that meets national goals. There also remains little emphasis on providing instruction on a comprehensive range of health topics, including the intersecting influences of sexual health, mental health, and identity. This highlights an important gap Real Talk fills to help adolescents access essential information and resources to support their holistic health and wellbeing. We are committed to providing high quality health content and will continue to be a trusted resource for adolescents and youth-serving organizations everywhere.
Read the Executive Summary here and visit our website to download the full report.
In this together,
Cristina & the Real Talk team
P.S. There are lots of ways to support our work further – whether through financial support or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at founders@realtalkapp.com
Join Real Talk in Supporting LGBTQ+ Youth
This month we launched a fundraising campaign as part of Bullying Prevention Month, LGBT History Month, and GLAAD’s Spirit Day to prevent bullying against LGBTQ+ youth.
Real Talk has a long history of working with LGBTQ+ youth, affirming their identities, and providing inclusive, relevant resources to support their health and wellbeing. Since launching in 2017, Real Talk has served over 10,000 LGBTQ youth across the United States.
Many of you all have financially supported Real Talk over the years. Today, I invite you all to continue your commitment (or to join us for the first time!) to making the world just a little kinder for all the young people in it. Every contribution helps us have even greater impact — donate today!
In this together,
Cristina & the Real Talk team
P.S. There are lots of ways to support our work further – whether by sharing our campaign with others or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at founders@realtalkapp.com
Meet the Team: Avanti Godbole (Digital Media Manager)
*By the way, October is Bullying Prevention Month and LGBTQ+ History month. Help us support even more LGBTQ+ youth with authentic stories and relevant, accurate resources to support their health and wellbeing by donating to our fundraising campaign today!
My name is Avanti and I joined Real Talk as the Digital Media Manager in July 2021. I graduated from the University of Virginia in 2018 and am now an MPH Candidate at University of North Carolina Gillings School of Global Public Health with a concentration in Health Behavior.
I first reached out to Dr. Leos because I am interested in all things adolescent health. Between puberty, menstruation, and mental health issues, adolescence is an overwhelming time! Throughout my teenage years I did not feel like I had the resources or knowledge to truly understand what changes were happening in my body, nor did I feel comfortable to talk to anyone about it in my school. For context, my high school’s take on health education and sex education was watching episodes of MTV’s Teen Mom. I really am interested in helping build an infrastructure that ensures all teens are able to get resources related to adolescent health.
It was not until I learned more about Real Talk that I realized what a tremendous opportunity there is in digital health to increase healthcare accessibility and utilization. People want fast and reliable information pertaining to their health, and what better way to deliver it to them than right to their phones. Real Talk provides teens with vetted information about their health in a way that makes them feel supported and heard. It gives them a platform to share their stories, and feel a sense of community during a time where it is really challenging to forge those in-person bonds.
There are countless stories in the news emphasizing the detrimental effects the pandemic has had and continues to have on adolescent mental health. Real Talk has the ability to intervene at a critical time by helping teens feel less isolated.
I’m so excited to be on the Real Talk team and work with Dr. Leos. Her commitment to see more accessible and comprehensive adolescent health care is inspiring. As the Digital Media Manager I get the chance to create graphics for and run Real Talk’s social media accounts. Working in health communications has given me a creative outlet and has allowed me to see which messages are resonating with our teens.
If you have any questions for me on why I love working with Real Talk feel free to message me via LinkedIn!
Avanti & the Real Talk team
P.S. There are lots of ways to support our work further – whether by donating to our fundraising campaign or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at founders@realtalkapp.com
Schools and Teachers Feel Unequipped to Address Youth Mental Health, Real Talk Can Help
A recent article published by The Hill noted that a majority of states are not ready to address youth mental health as their schools begin to reopen. This is in part due to the lack of mental health services provided at the school as well as limited policy support requiring mental health education. Students, and especially adolescents, were hit hard during the pandemic -- many teens have felt isolated, depressed, and experienced feelings of hopelessness. Unfortunately, there is a lack of mental health professionals available to support them. For example, the National Association of School Psychologists reports an average of 1 school psychologist for every 1,211 students instead of the recommended ratio of 1 for every 500 students. This often leaves emergency departments to pick up the slack when adolescents reach a point of crisis (Washington Post). We need to do better to support youth mental health.
“The analysis reports that just 14 states have fully expanded Medicaid to cover mental health services in schools, and only a handful have legislation requiring mental health education.” - The Hill
Mental health support, however, isn’t limited to professional therapy or clinical care. In fact, the strain on our healthcare system highlights an opportunity for alternative resources to support youth mental health that Real Talk can help fill. Peer support and community is an equally important and powerful form of mental health care (Mashable). Students need more ways to build connections and share their experiences with other students. Real Talk provides a safe, judgment free platform to do exactly this.
Through Real Talk, youth can share their stories, join a community, and -- by reading other teens’ experiences -- understand they are never alone in what they are feeling. We want schools, teachers, and all youth serving groups to share Real Talk with their students, so they can have a centralized place to access health resources and support, anytime and anywhere.
Partner with Real Talk
We recently launched our Partners Page where schools and other youth serving organizations can become an affiliate partner with Real Talk. Visit our Partners Page to learn more about how Real Talk can support your work, including a case study of how we partnered with Peer Health Exchange to enhance their youth health programming. If you are interested in receiving updates about partnership programs, please fill out the partner interest form.
Adolescent mental health is a critical priority, and we must act quickly to ensure the next generation feels supported to live a healthy and fulfilling life. Thank you all for being champions of sustainable and equitable adolescent health care.
In this together,
Cristina & the Real Talk team
P.S. There are lots of ways to support our work further – whether through financial support or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at founders@realtalkapp.com
Reflections on Real Talk’s Growth & Serving 8,000 New Teens During Covid-19
We just passed the midpoint of the year and I’m sure I don’t need to remind anyone what a long and challenging year this has been. Our team has certainly felt the weight of it as we tried to navigate the ever-changing circumstances of 2020 and the first half of 2021. We have been reflecting heavily on our mission to help guide us during this period of uncertainty, and today we wanted to share some insights about the evolution of our work over the last couple years.
Where Real Talk Started
When we launched the beta version of Real Talk in 2017, we had an exclusive focus on providing sexual health education. Our team had first-hand experience with the education system and we each saw how young people were left without essential information to support them in making healthy decisions. Our goal with Real Talk was to use storytelling to make sex education more modern, engaging, and effective.
Lessons Learned
Once Real Talk was out in the world -- and real teens across the U.S. and the world were using it -- we learned that Real Talk’s impact extends far beyond sex education. We got requests time and time again to include stories on more topics like mental health, navigating relationships with friends and family, and how to have difficult conversations. We also saw much greater engagement among LGBTQIA+ teens than we anticipated (though in retrospect, it makes total sense considering Real Talk’s focus on creating safe, judgement free spaces for teens of all identities).
Most importantly, we learned that Real Talk helps teens know they are not alone in their experiences growing up.
Too often, teens feel like they are the only ones in the world who are experiencing a particular situation. Parents dismiss these concerns as teenage angst (or otherwise don’t know how to talk with their teens about these issues), and social media only amplifies social comparisons, anxiety, and distress. Many teens are left without a safe space to share their experiences, learn, and find support -- and this is why they come to Real Talk.
With all of this in mind, we made the decision in 2018 to expand our focus beyond sex education to explicitly include mental health and LGBTQIA+ identity-related topics as part of our content strategy. We updated our theory of change, called on mental health and LGBTQIA+ experts in our network to help design new story prompts, and searched for new online resources to ensure we could properly support teens across all these topic areas.
Where Real Talk Is Now
When the pandemic hit in early 2020, we already had tools in place to address the overwhelming need for mental health support among youth that soon occurred. We are committed to providing young people with the support they need to be happy and healthy, whether that is through sexual health resources, mental health support, or simply a safe space where they can be embraced as their full selves.
Since the pandemic started in March 2020, we have:
Served over 8,000 new Real Talk users,
Received over 2,100 story submissions, and
Connected youth with more than 4,000 online resources
But we know this is just a fraction of the potential impact we can have. Real Talk is needed more than ever to help this generation of adolescents cope with the traumatic experiences of the last 16 months.
Learn More On Our New Website
We invite you to learn more about our new theory of change, our impact to date, and how to get involved with our work by visiting our new website. Real Talk has grown so much over the years and we are excited to more clearly share our history and impact through this new website. We would love for you to take a look and share feedback with us.
Finally, thank you to all of you -- our work throughout the years is made possible through the generous support of our partners, funders, and stakeholders. Your continuing support will allow us to have an even greater impact on Covid-19 recovery efforts.
In this together,
Cristina & the Real Talk team
P.S. There are lots of ways to support our work further – whether through financial support or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at founders@realtalkapp.com
Meet our new Board of Directors
It all begins with an idea.
This blog post was originally published on January 13, 2021
I have had this blog post planned for several months now, in anticipation of welcoming new board members we selected in the fall. However, as has been the case so often lately, I had no clue what exactly we might be facing just a few days into the new year. I hope that wherever you are, you are finding ways to care for yourself, care for others, and remain committed to the deep work that must continue in order to achieve a more just and equitable future. For now, I would like to share with you a bit of news that has me hopeful about our work supporting BIPOC and LGBTQIA youth through Real Talk.
At the beginning of 2020, I knew there would be many challenges as I stepped into my full-time role leading the organization. I was armed with project ideas, plans, and timelines that all quickly shifted as COVID-19 arrived and the world as we knew it changed. But 2020 was significant for our organization, specifically, for another reason: this was the year that our founding board reached their tenure, meaning we would have a brand new Board of Directors in place by the end of the year.
I know nonprofit boards can be a contentious arena for many organizations, so I am grateful to say we have had a pretty amazing founding Board of Directors. This group of professionals believed in us when Real Talk was a mere glimmer in our eyes and selflessly offered their guidance, expertise, and support through all of the ups and downs of early startup life. I am deeply grateful for their contributions and cannot imagine our nonprofit without them.
That being said, I am equally excited to welcome our new Board of Directors. We spent many months meeting with folks, sharing our vision, and crafting the contours of what the future of our organization might look like. We wanted folks with a desire to contribute their skills to make the world a better place and who could help us take our organization to the next level. I am thrilled that our new board members all share a deep commitment to supporting youth, an enthusiasm for technology and social impact, and are overall just cool people. Without further ado, I will let you meet them for yourself:
Carnellia Ajasin
CEO, Mind Katalyst, LLC
Arturo Bañuelos
Senior Program Manager & Business Strategist, Hewlett Packard Enterprise
Melissa Hung
Lead Counsel, Airbnb
Cal Sercu
Community Outreach Associate, Girls Scouts of San Jacinto Council
Leah Staub-DeLong
Product Marketer, Intuit
These five individuals join Danny Ceballos and outgoing board member Nicole Cushman. You can also read their full bios on our website here. Although there have been many (many, many, many) challenges for us all over the past year, I am grateful and excited to welcome these new members into our Real Talk network.
In this together,
Cristina & the Real Talk team
P.S. There are lots of ways to support our work further – whether through financial support, nominating a teen for our Youth Council, or partnering with us to bring Real Talk to teens in your community. Email us with any inquiries at founders@realtalkapp.com