Pulse
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
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.
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.
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.
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.
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.
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 dosage itself is described in the Notes when available.
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.
For more details about program components, refer to the FAQ page.
| Category | Component | Core Component | Component present | Lesson number(s) / activities where present |
|---|---|---|---|---|
| Delivery mechanism | Other | Yes (both versions) | ||
| Dosage | Frequency | Yes | ||
| Dosage | Intensity | Yes | ||
| Dosage | Duration | Yes | ||
| Dosage | Other | Yes | ||
| Staffing | Deliverer: Community health worker | No | ||
| Staffing | Deliverer: Faith-based individual | No | ||
| Staffing | Deliverer: Health educator | No | ||
| Staffing | Deliverer: Mental health provider | No | ||
| Staffing | Deliverer: Mentors | No | ||
| Staffing | Deliverer: Parents/family | No | ||
| Staffing | Deliverer: Peers | No | ||
| Staffing | Deliverer: Primary care provider | No | ||
| Staffing | Deliverer: Social worker and/or counselor | No | ||
| Staffing | Deliverer: Teachers | No | ||
| Staffing | Deliverer: Other | No | ||
| Staffing | Experience: Credentials | No | ||
| Staffing | Experience: Education | No | ||
| Staffing | Experience: Other | No | ||
| Staffing | Number of staff providing services | No | ||
| Staffing | Training: Additional training required | No | ||
| Staffing | Training: Developer-led training required | No | ||
| Staffing | Training: Other | No | ||
| Staffing | Other | |||
| Format | Group size: Full-group activity | No | ||
| Format | Group size: Independent/individual activity | Yes (both versions) | ||
| Format | Group size: Small-group activity | No | ||
| Format | Group size: Other | No | ||
| Format | Mode: In-person | No | ||
| Format | Mode: Phone (audio) | No | ||
| Format | Mode: Phone (text) | No | ||
| Format | Mode: Phone (app) | Yes (both versions) | ||
| Format | Mode: Online/computer (asynchronous) | No | ||
| Format | Mode: Online/computer (synchronous) | No | ||
| Format | Mode: Other | No | ||
| Format | Other | No | ||
| Context | Context: Environmental supports | No | ||
| Context | Context: Environmental constraints | No | ||
| Context | Context: Other | No | ||
| Context | Setting: After school | No | ||
| Context | Setting: Community based | No | ||
| Context | Setting: Correctional facility | No | ||
| Context | Setting: Faith based | No | ||
| Context | Setting: Health care clinic | No | ||
| Context | Setting: Home-based case management | No | ||
| Context | Setting: Home/housing | No | ||
| Context | Setting: In school (during the school day) | No | ||
| Context | Setting: Mental health clinic | No | ||
| Context | Setting: Residential facility | No | ||
| Context | Setting: School-based health clinic | No |
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.
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.
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.
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.
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 is not necessary to implement the program.
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.
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.
Pulse is a self-led program and fidelity guidelines do not apply to it.
To discuss technical assistance and ongoing support, contact Milagros Garrido at mila@healthyteennetwork.org.
Adaptations are allowed. To discuss allowable adaptations, contact Milagros Garrido at mila@healthyteennetwork.org.
| 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 |
| Citation | Setting | Majority Age Group | Majority Racial/Ethnic Group | Gender | Sample Size |
|---|---|---|---|---|---|
Manlove 2020 |
Mobile app | 18 or 19 | Hispanic or Latino | Young female | n.a. |
Manlove et al. 2021 |
Mobile app | 18 or 19 | Hispanic or Latino | Young female | 1013 |
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. |
|
| 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. |
Language directly from the program model developer or authors.