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Pulse

Developers

Genevieve Martínez-García, Ph.D., M.A., P.M.P., Healthy Teen Network; Milagros Garrido, M.S., P.M.P., Healthy Teen Network; Nicholas Sufrinko, Healthy Teen Network; Meta Media Training International

Program Summary

Pulse is a web-based mobile health app designed to support healthy sexual behavior for Black and Latina women ages 18 to 20. Pulse includes content on birth control methods and method reminders; healthy relationships, sex readiness, and consent; reproductive anatomy, physiology, and sexually transmitted infections (STIs); reproductive health care access; and pregnancy and pregnancy testing. Pulse delivers content through audio, interactive comics and quizzes, and videos. It also provides a clinic locator and calendar tools to facilitate accessing reproductive care. The program includes an optional text message component that allows participants to receive three text messages per week for six weeks, reminding them to use the Pulse mobile health app.

Intended Population

Pulse is designed for Black and Latina women ages 18 to 20. The program was evaluated with young women between the ages of 18 to 19.

Program Setting

Pulse can be implemented in any setting where adolescents can access program content. It uses a web-based app accessed directly from a web browser so participants do not need to download any program, standalone app, or plug-in to view program content. It is recommended that participants access program content on a web-enabled smartphone or tablet, not a laptop or desktop computer. The program was evaluated as a web-based mobile app.

Contact and Availability Information

For curriculum, materials, and pricing information, please contact:
Milagros Garrido, M.S., P.M.P.
Director, Innovation and Research
(410) 684-0410
mila@healthyteennetwork.org

For training and support, please contact:
Milagros Garrido, M.S., P.M.P.
Director, Innovation and Research
(410) 684-0410
innovation@healthyteennetwork.org

Organizations or individuals interested in training and support can also submit an inquiry form through the Healthy Teen Network website: https://www.healthyteennetwork.org/ask.

Sample of Curriculum Available for Review Prior to Purchase

Yes

Languages Available

English, Spanish

Monitoring and Evaluation Tools

Monitoring and evaluation tools available

Yes

Monitoring and evaluation tool usage required

Information about available monitoring and evaluation tools (if applicable)

Healthy Teen Network provides a sample table for tracking use of and satisfaction with Pulse, as well as a sample self-reported use and satisfaction worksheet. If needed, organizations can set up a system to regulate and monitor registration and collect aggregated participant data using web analytics; however, these tools are not required for program implementation.

Program Components and Core Components

Last updated in 2024

The data presented on this page reflect responses from the program’s developer or distributor to a program component checklist that asked them to report on the individual components within their TPP program. The same program component checklist was sent to the developer or distributor of every active TPP program with evidence of effectiveness. The program component table provides information on seven types of program components including content, delivery mechanism, dosage, staffing, format, context, and intended population characteristics; whether the component was present or optional in the program; whether the component is considered to be core to the program; and the lesson number or activity where the component can be found in the program. In the drop-down menu below, under “Has component,” there are four options that indicate a component as present in the program: (1) “Yes” indicates that the component is present in at least one version of the program (whether that be the program version that was evaluated, the current version, or both versions); (2) “Yes (both versions)” indicates that the component is present in both the evaluated version of the program and the current version of the program; (3) “Yes (current version)” indicates that the component is present in the current, but not the evaluated, version of the program; and (4) “Yes (evaluated version)” indicates that the component is present in the evaluated version of the program, only. Note that for dosage components, the only possible response option was “Yes”, and the dosage is described in the Notes when available. For more details, refer to the FAQ. Some of the components identified are noted as core components of the evidence-based program, but this does not necessarily mean that these components have been rigorously tested and show evidence of effectiveness. Most often developers denoted components as core based on theory or experience in the field. Click here for the list of evidence-based components.

Category	Component	Component present	Notes
Content	Graduating from high school	No
Content	Meditation	No
Content	Other
Content	Volunteering/civic engagement	No
Content	Spirituality	No
Content	Morals/values	No
Content	Identity development	No
Content	Social support/capital	No
Content	Social influence/actual vs. perceived social norms	No
Content	Social competence	No
Content	Parenting skills	No
Content	Normative beliefs	No
Content	Leadership	No
Content	Gender roles	No
Content	Gender identity	No
Content	Connections with trusted adults	No
Content	Conflict resolution/social problem solving	No
Content	Communication skills	No
Content	Child development	No
Content	Boundary setting/refusal skills	Yes (both versions)
Content	Substance use cessation	No
Content	Substance use - Other drugs	No
Content	Substance use - Alcohol	No
Content	Substance use - Abstinence	No
Content	Brain development and substance use	No
Content	Vocational/skills training	No
Content	Supplemental academic services	No
Content	School engagement	No
Content	College preparation	No
Content	Alternative schooling	No
Content	Self-regulation	No
Content	Self-esteem	No
Content	Self-efficacy/empowerment	No
Content	Resilience	No
Content	Personal vulnerability	No
Content	Contraception - Other	Yes (both versions)
Content	Sexual orientation	Yes (both versions)
Content	Sexual health	Yes (both versions)
Content	Values and sexuality	No
Content	Risk of STIs and Pregnancy	Yes (both versions)
Content	Reproduction	Yes (both versions)
Content	Puberty/development	No
Content	Maternal health	Yes (both versions)	Focus on pregnancy symptoms
Content	Motivational interviewing	No
Content	Goal setting	No
Content	Cultural values	No
Content	Brain development and emotions	No
Content	Cognitive behavioral therapy (CBT)	No
Content	Empathy	No
Content	Contraception - Condoms	Yes (both versions)

Program Objectives

Pulse’s main objective is to help young Black and Latina women avoid unplanned pregnancies and increase their use of sexual and reproductive health clinical services.

Program Content

Pulse is grounded in the theory of planned behavior and social learning theory. The content included in Pulse is culturally and age appropriate, and content areas cover six topics:

Know your options: This section describes birth control methods and offers method selection guidance. It also offers a calendar feature to remind participants to use their chosen method of birth control. In addition, this section uses audio clips to demonstrate how to negotiate condom use with partners.
Get personal: This section presents information about healthy relationships, consent, and sexual decision making. Participants can complete quizzes to consider whether they are ready for sex and “test” their relationship.
Know your body: This section covers reproductive anatomy and physiology, the menstrual cycle, STIs, and fertility.
Take action: This section covers clinic utilization preparedness, appointment reminders, and a clinic locator tool. Young women share stories via video about their own clinic appointments, and information about common clinic practices is provided through text messages.
Make a plan: This section covers pregnancy symptoms and testing, pregnancy physiology, and prenatal care. It also includes an Am I Pregnant Quiz? to help participants determine whether they need a pregnancy test.
Get savvy: This section includes frequently asked questions, expert videos of health educators answering such questions, and external resources for more information.

Program Methods

Pulse is a web-based, mobile health app that uses multimedia features to support healthy sexual behavior. The program includes 16 core activities, including interactive graphics, videos, comics, self-assessments, a clinic locator, and appointment reminders.

Program Structure and Timeline

Pulse includes approximately three hours of content. It is delivered asynchronously on a web-based mobile app, and participants can complete the program on their own schedule. The program includes an optional text message component that allows participants to receive three text messages per week for six weeks, reminding them to use the Pulse mobile health app. It is recommended that participants complete at least one activity per topic area. Program content can be accessed at any time and as many times as needed.

Staffing

Pulse is a self-led program designed to be implemented without facilitators or staff. Organizations can set up a system to monitor app registration, but registration monitoring is not required for program implementation.

Staff Training

Staff training is not necessary to implement the program.

Program Materials and Resources

Pulse is a web-based, mobile health app; it does not include additional program materials. The program includes an optional text message component that allows participants to receive three text messages per week for six weeks, reminding them to use the Pulse mobile health app.

Additional Needs for Implementation

Pulse requires participants to have access to a smartphone or tablet. Internet connection or cellular service is required to use the web-based mobile health app.

Fidelity

Pulse is a self-led program and fidelity guidelines do not apply to it.

Technical Assistance and Ongoing Support

To discuss technical assistance and ongoing support, contact Milagros Garrido at mila@healthyteennetwork.org.

Allowable Adaptations

Adaptations are allowed. To discuss allowable adaptations, contact Milagros Garrido at mila@healthyteennetwork.org.

Adaptation Guidelines or Kit

Yes

Reviewed Studies

Citation	High-Quality Randomized Trial	Moderate-Quality Randomized Trial	Moderate-Quality Quasi-Experiment	Low Study Rating	Did Not Meet Eligibility Criteria
Manlove 2020	✓
Manlove et al. 2021	✓

Study Characteristics

Citation	Setting	Majority Age Group	Majority Racial/Ethnic Group	Gender	Sample Size
Manlove 2020	Mobile app	18 or 19	Hispanic or Latinx of any race	Young women	n.a.
Manlove et al. 2021	Mobile app	18 or 19	Hispanic or Latinx of any race	Young women	1013

Study Findings

Evidence by Outcome Domain and Study

Citation	Sexual Activity	Number of Sexual Partners	Contraceptive Use	STIs or HIV	Pregnancy
Manlove 2020	n.a.	n.a.		n.a.	n.a.
Manlove et al. 2021	n.a.	n.a.		n.a.

KEY

Evidence Indication

Favorable findings

Potentially favorable findings

Indeterminate findings

Conflicting findings

Potentially unfavorable findings

Unfavorable findings

Note: n.a. indicates the study did not examine any outcome measures within that particular outcome domain, or the study examined outcome measures within that domain but the findings did not meet the review evidence standards.

Detailed Findings

Citation Details

Citation	Details
Manlove 2020	The program was evaluated using a randomized controlled trial involving mostly Black or Latina women between the ages of 18 and 20 living in the United States. Participants were recruited online through social media. Participants were randomly assigned to either an intervention group that received a six-week Pulse app program or a control group that received access to a generic health app that did not include sexual education content. Surveys were administered immediately before randomization and six weeks after study enrollment. The study found that women participating in the program were significantly less likely to report having had sex without using a hormonal or long-acting contraceptive method in the past six weeks (effect size = -0.24 SDs). However, the study found no significant impact on the likelihood of having had sex without any birth control method in the past six weeks. The study also examined program impacts on measures of birth control use, knowledge about birth control, attitudes towards birth control, self-efficacy regarding birth control, and intentions around birth control. Findings for these outcomes were not considered because they fell outside the scope of the review. In addition, the study examined impacts on hormonal or long-acting reversible contraceptive (LARC) use during last sex - these findings were estimated on an endogenous subgroup and thus, received a low evidence rating.
Manlove et al. 2021	The program was evaluated using a randomized controlled trial involving Black and Hispanic women between the ages of 18–20 living in the United States. The study advertised on social media to recruit participants. Participants were randomly assigned to either an intervention group that received the self-paced Pulse app program or a control group that received a different health app. Surveys were administered immediately before the program (baseline), six weeks after study enrollment, and six months after study enrollment. The study found that, at the time of the six-week follow-up survey, there were no statistically significant differences in behavioral outcomes related to contraceptive use or differences in the outcomes of women in the treatment group and women in the control group. Results from the six-month follow-up survey also showed no differences between the two groups in pregnancy and contraceptive use outcomes. The study also examined program impacts on measures including use of hormonal or long-acting reversible contraceptives in the participant's last sexual encounter, birth control knowledge, attitudes about birth control, and attitudes about sexual and reproductive health care. Findings for these outcomes were not considered for the review because they fell outside the scope of the review. Finally, the study examined impacts on contraceptive use at last sexual encounter. These outcomes were estimated using an endogenous subgroup, and thus, these analyses received a low rating.

Manlove 2020

The program was evaluated using a randomized controlled trial involving mostly Black or Latina women between the ages of 18 and 20 living in the United States. Participants were recruited online through social media. Participants were randomly assigned to either an intervention group that received a six-week Pulse app program or a control group that received access to a generic health app that did not include sexual education content. Surveys were administered immediately before randomization and six weeks after study enrollment.

The study found that women participating in the program were significantly less likely to report having had sex without using a hormonal or long-acting contraceptive method in the past six weeks (effect size = -0.24 SDs). However, the study found no significant impact on the likelihood of having had sex without any birth control method in the past six weeks.

The study also examined program impacts on measures of birth control use, knowledge about birth control, attitudes towards birth control, self-efficacy regarding birth control, and intentions around birth control. Findings for these outcomes were not considered because they fell outside the scope of the review. In addition, the study examined impacts on hormonal or long-acting reversible contraceptive (LARC) use during last sex - these findings were estimated on an endogenous subgroup and thus, received a low evidence rating.

Manlove et al. 2021

The program was evaluated using a randomized controlled trial involving Black and Hispanic women between the ages of 18–20 living in the United States. The study advertised on social media to recruit participants. Participants were randomly assigned to either an intervention group that received the self-paced Pulse app program or a control group that received a different health app. Surveys were administered immediately before the program (baseline), six weeks after study enrollment, and six months after study enrollment. The study found that, at the time of the six-week follow-up survey, there were no statistically significant differences in behavioral outcomes related to contraceptive use or differences in the outcomes of women in the treatment group and women in the control group. Results from the six-month follow-up survey also showed no differences between the two groups in pregnancy and contraceptive use outcomes. The study also examined program impacts on measures including use of hormonal or long-acting reversible contraceptives in the participant's last sexual encounter, birth control knowledge, attitudes about birth control, and attitudes about sexual and reproductive health care. Findings for these outcomes were not considered for the review because they fell outside the scope of the review. Finally, the study examined impacts on contraceptive use at last sexual encounter. These outcomes were estimated using an endogenous subgroup, and thus, these analyses received a low rating.

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