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
No
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 Core Components

Last updated in 2023

The data presented on this page reflects 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 data on seven types of program components including content, delivery mechanism, dosage, staffing, format, environment, 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. For more details, refer to the FAQ.

Category Component Core Component Component present Notes Lesson number(s) / activities where present
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:

  1. 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. 
  2. 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. 
  3. Know your body: This section covers reproductive anatomy and physiology, the menstrual cycle, STIs, and fertility. 
  4. 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. 
  5. 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. 
  6. 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
Study Findings

Evidence by Outcome Domain and Study

Citation Sexual Activity Number of Sexual Partners Contraceptive Use STIs or HIV Pregnancy

Manlove, J., Cook, E., Whitfield, B., Johnson, M., Martinez-Garcia, G., Garrido, M. (2020). Short-term impacts of Pulse: An app-based teen pregnancy prevention program for Black and Latinx women. Journal of Adolescent Health, 66(2), 224–232.

 		n.a. n.a. Potentially favorable evidence n.a. n.a.

Manlove, J., Whitfield, B., Finocharo, J., Cook, E. (2021). Lessons learned from replicating a randomized control trial evaluation of an app-based sexual health program. International Journal of Environmental Research and Public Health, 18(6), 3305. https://doi.org/10.3390/ijerph18063305

 		n.a. n.a. Indeterminate evidence n.a. Indeterminate evidence
KEY
Evidence Indication
Favorable findings
Two or more favorable impacts and no unfavorable impacts, regardless of null findings
Potentially favorable findings
At least one favorable impact and no unfavorable impacts, regardless of null findings
Indeterminate findings
Uniformly null findings
Conflicting findings
At least one favorable and at least one unfavorable impact, regardless of null findings
Potentially unfavorable findings
At least one unfavorable impact and no favorable impacts, regardless of null findings
Unfavorable findings
Two or more unfavorable impacts and no favorable impacts, regardless of null 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

Manlove, J., Cook, E., Whitfield, B., Johnson, M., Martinez-Garcia, G., Garrido, M. (2020). Short-term impacts of Pulse: An app-based teen pregnancy prevention program for Black and Latinx women. Journal of Adolescent Health, 66(2), 224–232.

 		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, J., Whitfield, B., Finocharo, J., Cook, E. (2021). Lessons learned from replicating a randomized control trial evaluation of an app-based sexual health program. International Journal of Environmental Research and Public Health, 18(6), 3305. https://doi.org/10.3390/ijerph18063305

 		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.

Notes

Some study entries may include more than one citation because each citation examines a different follow-up period from the same study sample, or because each citation examines a different set of outcome measures on the same study sample. A blank cell indicates the study did not examine any outcome measures within the particular outcome domain or the findings for the outcome measures within that domain did not meet the review evidence standards.

Information on evidence of effectiveness is available only for studies that received a high or moderate rating. Read the description of the review process for more information on how these programs are identified.