The Center for Innovative Public Health Research
Girl2Girl is a 20-week teen pregnancy prevention program delivered via text messaging to cisgender girls between the ages of 14 to 18 who identify as lesbian, bisexual, or queer ('cisgender' refers to individuals whose current gender identity is the same as the sex they were assigned at birth; CDC, 2023). Girl2Girl content focuses on teen pregnancy prevention, sexually transmitted infection (STI) testing, communication skills, and healthy and unhealthy relationships. In addition to receiving program content, participants have the option to be paired with another participant (a Text Buddy) they can text for support throughout the program.
Girl2Girl was designed for sexually experienced and inexperienced cisgender girls between the ages of 14 to 18 who identify as lesbian, bisexual, or queer.
Girl2Girl is designed for any setting. Text messages will be sent only during specified non-school hours.
|Category||Component||Core Component||Component present||Notes||Lesson number(s) / activities where present|
|Content||Graduating from high school||No|
|Content||Social support/capital||No||Yes (both versions)|
|Content||Social influence/actual vs. perceived social norms||Yes||Yes (both versions)|
|Content||Normative beliefs||Yes||Yes (both versions)|
|Content||Gender roles||No||Yes (both versions)||We talk about how some lesbian and bi girls feel hypersexualized by society|
|Content||Connections with trusted adults||No|
|Content||Conflict resolution/social problem solving||Yes||Yes (both versions)|
|Content||Communication skills||Yes||Yes (both versions)|
|Content||Boundary setting/refusal skills||Yes||Yes (both versions)|
|Content||Substance use cessation||No|
|Content||Substance use - Other drugs||No||Yes (both versions)||We make references to being high and how that impairs decision making but not in the detail described here (i.e., we say 'high', not: smoked, ingested, injected, etc.)|
|Content||Substance use - Alcohol||No||Yes (both versions)|
|Content||Substance use - Abstinence||No|
|Content||Brain development and substance use||No|
|Content||Supplemental academic services||No|
|Content||Self-esteem||Yes||Yes (both versions)|
|Content||Self-efficacy/empowerment||Yes||Yes (both versions)|
|Content||Risk of STIs and Pregnancy||Yes||Yes (both versions)|
|Content||STIs - Screening||Yes||Yes (both versions)|
|Content||STIs - Prevention||Yes||Yes (both versions)|
|Content||STIs - Information||Yes||Yes (both versions)|
|Content||Sexual risk reduction||Yes||Yes (both versions)|
|Content||Sexual risk discontinuation||Yes||Yes (both versions)||We promote the idea that you can have sex when you want - and not when you don't. and that it's ok to say no to sex if that's what you're feeling.|
|Content||Sexual risk avoidance||Yes||Yes (current version)||The adverse outcome we focus on is having sex when you don't want to.|
|Content||Sexual orientation||Yes||Yes (both versions)|
|Content||Motivational interviewing||Yes||Yes (both versions)|
|Content||Contraception - Condoms||Yes||Yes (both versions)|
|Content||Contraception - Long-acting reversible contraceptives||Yes||Yes (both versions)|
|Content||Contraception - Other||Yes||Yes (both versions)|
|Content||Contraception - Pills, patches, rings, and shots||Yes||Yes (both versions)|
|Content||Identity development||Yes||Yes (both versions)|
The goal of Girl2Girl is to provide content on teen pregnancy prevention, STI, communication skills, and healthy and unhealthy relationships to cisgender girls between the ages of 14 to 18 who identify as lesbian, bisexual, or queer.
Girl2Girl content focuses on teen pregnancy prevention and is guided by the Information-Motivation-Behavioral model. Topics covered through scripted text messages include male and female condom use and access, types of birth control, healthy and unhealthy relationships, and prevention of unintended pregnancy and STI. Additional content includes topics and scenarios relevant to sexual decision making. The program’s content is tailored based on sexual experience and sexual identity. In addition to receiving program content, participants are paired with another participant (a Text Buddy) they can text for support throughout the program.
The program is delivered through text messages.
Girl2Girl is a 20-week teen pregnancy prevention program. During the first seven weeks of programming, participants receive four to 12 text messages per day. They then receive one message two or three days per week for the following 12 weeks. The final week of programming is the booster period, which is intended for review of content delivered during program delivery. Participants receive eight to 15 messages during the one-week booster period. All Text Buddy messages are run through a server to protect participants’ privacy.
Staffing needed to implement the program includes staff to monitor the Text Buddy conversations, answer participant questions, and recruit and enroll participants.
Participants are required to have access to a text-capable phone. Unlimited text messaging plans are encouraged but not required.
The developer will ensure when text messages are sent and their receipt by the intended recipient.
Formal staff training is not required to implement the program. Staff will monitor the Text Buddy conversations, answer participant questions, and recruit and enroll participants.
Girl2Girl is a texting intervention; typically, implementers do not need technical assistance or ongoing support during program implementation. However, implementers can contact Michele Ybarra at email@example.com if there is a need for technical assistance or ongoing support.
Adaptations are allowed in consultation with the developer. To discuss adaptations, contact Michele Ybarra at firstname.lastname@example.org.
|The program was evaluated using a randomized controlled trial involving cisgender female youth ages 14–18 identifying as not exclusively heterosexual, who were recruited across the United States through Facebook and Instagram advertisements. Participants were randomly assigned to either a treatment group that received the 20-week Girl2Girl program or a control group that received similarly intense text messaging for the same length of time with content that was not focused on preventing teen pregnancy. Surveys were administered immediately after enrollment, which was right before the program started (baseline), and immediately after the 20-week program ended (5 months after study enrollment). The study found that at program end, teen girls participating in the program reported having used condoms while having sex significantly more often than the control group had in the past three months (effect size = 0.03) and reported significantly fewer sex acts without a condom in the past three months (effect size = -0.05). Those program effects held for the full sample and the subgroup that was sexually active at baseline (effect sizes = 0.05 and -0.29, respectively, for the subgroup on condom use during sex and having fewer sex acts without a condom). The study also found that at program end, teen girls participating in the program and those in the control group were not significantly different from each other in their reporting of abstaining from penile-vaginal sex in the past three months. Those null findings held for the full sample and the subgroup that was sexually active|