Optimizing a Multi-Modal Intervention to Reduce Health-Risking Sexual Behaviors: Component Selection

Not Applicable

Completed

• Conditions: Pregnancy, Unplanned; Sexually Transmitted Infections; Military Personnel
• Interventions: Behavioral: Basic Education ("Education"); Behavioral: Narrative Videos ("Narratives"); Behavioral: Skills Building Videos ("Skills"); Behavioral: Interactive Scenarios ("Scenarios"); Behavioral: Future Life Planning Tool ("Future"); Behavioral: Epidemiological Risk Scenario ("Risk")

• Registration Number: NCT04661566
• Lead Sponsor: Uniformed Services University of the Health Sciences

Brief Summary

The goal of this project is to evaluate the components of the app-based intervention Mission Wellness to reduce health-risking sexual behaviors (HRSBs; e.g., condom non-use, multiple sexual partners) in active-duty members of the US Military to improve their sexual and reproductive health (SRH) and readiness to serve. Following the multiphase optimization strategy (MOST) framework, factorial component selection experiments (CSEs) will be conducted to evaluate which five experimental intervention components (i.e., Narratives, Skills, Scenarios, Future, and Risk) elicit the greatest improvements in the outcomes of interest given key constraints.

Detailed Description

Negative SRH outcomes (e.g., sexually transmitted infections \[STIs\], unintended pregnancy, STI-related cancers) reduce human performance and undermine military readiness. Service members face unique challenges to maintaining SRH during their military service. HRSBs (e.g., multiple sexual partners, unprotected sexual behavior) offer potential intervention targets to improve SRH. Electronic-health interventions are cost-effective and dynamic, and have the potential to reach millions of users as part of an overall strategy for individual behavior and systems change. In civilian populations, e-health interventions have demonstrated success in reducing HRSBs. However, effective HRSB-prevention interventions must consider the specific values, mission, and context of military populations and settings. The MOST framework is used to develop highly effective, efficient, and economic behavioral interventions that is particularly well suited to be used in this context.

This project aims to address this problem by delivering an optimized app-based prevention intervention package ready for evaluation via a subsequent randomized controlled trial (RCT). The specific purpose of this project is to determine which component(s) should be included in the packaged app-based intervention Mission Wellness for US service members based on their effects on the outcomes of interest (i.e., improved knowledge, motivation, and behavior skills related to SRH and reduced HRSBs) in no more than 25 minutes of content. The components tested in the factorial CSEs include: Narratives; Skills; Scenarios; Future; and Risk. Each component has two levels: "on" (included) or "off" (not included). Main and interaction effects of components will be measured to determine the components constituting the packaged intervention.

Study Timeline

• Study First Submitted: 2020-10-23
• Study First Submitted QC: 2020-12-03
• Study First Posted: 2020-12-10
• Study Start: 2021-09-02
• Status Verified: 2022-05
• Primary Completion: 2022-12-09
• Study Completion: 2022-12-09
• Last Update Submitted: 2023-01-03
• Last Update Posted: 2023-01-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 549

Inclusion Criteria

1. Age 17 or older,
2. currently serving as active duty in the US military, and
3. willing to participate in all study activities if eligible and enrolled

Exclusion Criteria

1. Does not meet eligibility criteria,
2. unable to read, speak, or comprehend English, or
3. unable or unwilling to give informed consent

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Arm && Interventions

Group	Intervention	Description
Education+Narratives+Skills+Scenarios+Future+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, Future, and Risk
Education+Narratives+Skills+Scenarios+Future+Risk	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, Future, and Risk
Education+Narratives+Skills+Scenarios+Future+Risk	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, Future, and Risk
Education+Narratives+Skills+Risk	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Risk
Education+Narratives+Skills+Future	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Future
Education+Narratives+Skills+Risk	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Risk
Education+Narratives+Scenarios+Future+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives. Scenarios, Future, and Risk
Education+Narratives+Skills+Scenarios+Future+Risk	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, Future, and Risk
Education+Narratives+Skills+Scenarios+Future	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, and Future
Education+Narratives+Skills+Scenarios+Future	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, and Future
Education+Narratives+Skills+Scenarios+Future+Risk	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, Future, and Risk
Education+Narratives+Skills+Scenarios+Future+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, Future, and Risk
Education+Narratives+Skills+Scenarios+Risk	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, and Risk
Education+Narratives+Skills+Scenarios+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, and Risk
Education+Narratives+Skills+Scenarios	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Scenarios
Education+Narratives+Skills+Scenarios	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Scenarios
Education+Narratives+Skills+Scenarios+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, and Risk
Education+Narratives+Skills+Scenarios+Future	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, and Future
Education+Narratives+Skills+Scenarios+Risk	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, and Risk
Education+Narratives+Skills+Future+Risk	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Future, and Risk
Education+Narratives+Skills+Future	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Future
Education+Narratives+Skills	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Skills
Education+Narratives+Skills	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Skills
Education+Narratives+Skills+Scenarios+Future	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, and Future
Education+Narratives+Skills+Scenarios+Future	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, and Future
Education+Narratives+Skills+Scenarios+Risk	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Scenarios, and Risk
Education+Narratives+Skills+Future+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Future, and Risk
Education+Narratives+Skills+Future	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Future
Education+Narratives+Skills	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Skills
Education+Narratives+Scenarios+Future+Risk	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives. Scenarios, Future, and Risk
Education+Narratives+Scenarios+Future	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Scenarios, and Future
Education+Narratives+Skills+Scenarios	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Scenarios
Education+Narratives+Skills+Scenarios	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Scenarios
Education+Narratives+Skills+Future+Risk	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Future, and Risk
Education+Narratives+Skills+Future+Risk	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Future, and Risk
Education+Narratives+Skills+Future+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, Future, and Risk
Education+Narratives+Skills+Future	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Future
Education+Narratives+Skills+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Risk
Education+Narratives+Skills+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Skills, and Risk
Education+Narratives+Scenarios+Future+Risk	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives. Scenarios, Future, and Risk
Education+Skills+Scenarios+Future+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, Future, and Risk
Education+Narratives+Scenarios+Future+Risk	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives. Scenarios, Future, and Risk
Education+Narratives+Scenarios+Future+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives. Scenarios, Future, and Risk
Education+Narratives+Scenarios+Future	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Scenarios, and Future
Education+Narratives+Scenarios+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Scenarios, and Risk
Education+Narratives+Scenarios+Risk	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Scenarios, and Risk
Education+Narratives+Scenarios+Future	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Scenarios, and Future
Education+Narratives+Scenarios+Future	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Scenarios, and Future
Education+Narratives+Future+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Future, and Risk
Education+Narratives+Future+Risk	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Future, and Risk
Education+Narratives+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Risk
Education+Narratives+Scenarios+Risk	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Scenarios, and Risk
Education+Narratives+Scenarios+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Scenarios, and Risk
Education+Narratives+Scenarios	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Scenarios
Education+Narratives+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Risk
Education+Narratives	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives
Education+Skills+Scenarios+Future	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, and Future
Education+Skills+Scenarios+Future	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, and Future
Education+Skills+Scenarios+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, and Risk
Education+Narratives+Scenarios	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Scenarios
Education+Narratives+Future+Risk	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Future, and Risk
Education+Narratives+Future	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Future
Education+Narratives+Future	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Future
Education+Narratives+Risk	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Risk
Education+Narratives	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives
Education+Skills+Scenarios+Future+Risk	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, Future, and Risk
Education+Skills+Scenarios+Future+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, Future, and Risk
Education+Narratives+Scenarios	Narrative Videos ("Narratives")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Scenarios
Education+Narratives+Future+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives, Future, and Risk
Education+Narratives+Future	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Narratives and Future
Education+Skills+Scenarios+Future+Risk	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, Future, and Risk
Education+Skills+Scenarios+Future	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, and Future
Education+Scenarios+Future+Risk	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios, Future, and Risk
Education+Skills+Scenarios+Future+Risk	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, Future, and Risk
Education+Skills+Scenarios+Future	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, and Future
Education+Skills+Scenarios+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, and Risk
Education+Skills+Future+Risk	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Future, and Risk
Education+Skills+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills and Risk
Education+Skills	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills
Education+Skills+Scenarios+Risk	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, and Risk
Education+Skills+Scenarios+Risk	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Scenarios, and Risk
Education+Skills+Scenarios	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills and Scenarios
Education+Skills+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills and Risk
Education+Skills+Risk	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills and Risk
Education+Skills	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills
Education+Scenarios+Future	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios and Future
Education+Future+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Future and Risk
Education+Skills+Scenarios	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills and Scenarios
Education+Skills+Scenarios	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills and Scenarios
Education+Skills+Future+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Future, and Risk
Education+Skills+Future+Risk	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Future, and Risk
Education+Skills+Future	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills Future
Education+Skills+Future	Skills Building Videos ("Skills")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills Future
Education+Skills+Future	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills Future
Education+Scenarios	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios
Education+Skills+Future+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Skills, Future, and Risk
Education+Scenarios+Future+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios, Future, and Risk
Education+Scenarios+Future	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios and Future
Education+Scenarios+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios and Risk
Education+Future+Risk	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Future and Risk
Education+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Risk
Education	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that only includes the static educational component.
Education+Scenarios+Future+Risk	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios, Future, and Risk
Education+Future	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Future
Education+Scenarios+Future+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios, Future, and Risk
Education+Scenarios+Future	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios and Future
Education+Scenarios+Risk	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios and Risk
Education+Scenarios+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios and Risk
Education+Scenarios	Interactive Scenarios ("Scenarios")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Scenarios
Education+Future+Risk	Epidemiological Risk Scenario ("Risk")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Future and Risk
Education+Risk	Basic Education ("Education")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Risk
Education+Future	Future Life Planning Tool ("Future")	Participants will receive a version of the Mission Wellness app (intervention) that includes the static educational component and the following components: Future

Primary Outcome Measures

Name	Time	Method
Change in perceived risk of having a negative SRH outcome as assessed by measures of Perceived Risk	Baseline, within 3 weeks post-intervention, and 30-to-90 days post-intervention	Change in perceived risk of having a negative SRH outcome assessed by Perceived Risk on an 5-point ordinal scale (from "no risk" \[better outcome\] to "very high risk" \[worse outcome\]) adapted from measures used in Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Change in attitudes about SRH as assessed by measures of Condom Attitudes on a likert scale	Baseline, within 3 weeks post-intervention, and 30-to-90 days post-intervention	Change in attitudes about SRH assessed by the composite Condom Attitudes (Outcome 4 and Outcome 5), composite Birth Control Attitudes (Outcome 6 and Outcome 7), and Norms (Outcome 8).; Condom Attitudes is a composite score of Outcome 5 and a 7-point likert scale (from "strongly disagree" \[1\] to "strongly agree" \[7; outcome varies by item\]) adapted from Crosby's et al (2008) Correct Condom Use Self-Efficacy Scale (CCUSS) and Helweg-Larson and Collins' (1994) UCLA Multidimensional Condom Attitudes Scale (MCAS).
Change in self-reported sexual behavior as assessed by measures of Sexual Behavior on yes/no/dont-know items	Baseline and 30-to-90 days post-intervention	Change in sexual behavior assessed by composite Sexual Behavior score (Outcomes 11-16).; Sexual Behavior is a composite score of Outcomes 11 and 13-16, and yes/no/dont-know (nominal; outcome varies by item) items adapted from measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits, Hwang's et al (2007) Sexual Behaviors After Universal Screening of Sexually Transmitted Infections in Healthy Young Women, and Booth-Kewley's et al (2001) One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps sample.
Change in self-reported sexual behavior as assessed by measures of Sexual Behavioral Intentions on open response (number input) items	Within 3 weeks post-intervention	Change in sexual behavior assessed by composite Sexual Behavioral Intentions (Outcomes 17-21).; Sexual Behavior Intentions is a composite score of Outcomes 17-19 and 21 and open response (number input) items adapted from measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits, Hwang's et al (2007) Sexual Behaviors After Universal Screening of Sexually Transmitted Infections in Healthy Young Women, and Booth-Kewley's et al (2001) One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps sample.
Change in self-reported sexual behavior as assessed by measures of Sexual Behavioral Intentions	Within 3 weeks post-intervention	Change in sexual behavior assessed by composite Sexual Behavioral Intentions (Outcomes 17-21).; Sexual Behavior Intentions is a composite score of Outcomes 17-20 and a 7-point likert-type (from "definitely" \[better outcome\] to "not likely at all" \[worse outcome\]) scale adapted from measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits, Hwang's et al (2007) Sexual Behaviors After Universal Screening of Sexually Transmitted Infections in Healthy Young Women, and Booth-Kewley's et al (2001) One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps sample.
Change in SRH knowledge as assessed by measures of STI Knowledge	Baseline, within 3 weeks post-intervention, and 30-to-90 days post-intervention	Change in SRH knowledge as assessed by STI Knowledge (Outcome 1) and Pregnancy and Birth Control Knowledge (Outcome 2).; STI knowledge is measured on a dichotomous (true/false \[outcome varies by item\]) scale adapted from measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits and Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Change in SRH knowledge as assessed by measures of Pregnancy and Birth Control Knowledge	Baseline, within 3 weeks post-intervention, and 30-to-90 days post-intervention	Change in SRH knowledge as assessed by STI Knowledge (Outcome 1) and Pregnancy and Birth Control Knowledge (Outcome 2).; Pregnancy and Birth Control is measured on a dichotomous (true/false \[outcome varies by item\]) scale adapted from measures used in Frost's et al (2012) Young Adults' Contraceptive Knowledge, Norms, and Attitudes: Associations with Risk of Unintended Pregnancy and Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Change in attitudes about SRH as assessed by measures of Condom Attitudes on an ordinal item	Baseline, within 3 weeks post-intervention, and 30-to-90 days post-intervention	Change in attitudes about SRH assessed by the composite Condom Attitudes (Outcome 4 and Outcome 5), composite Birth Control Attitudes (Outcome 6 and Outcome 7), and Norms (Outcome 8).; Condom Attitudes is a composite score of Outcome 4 and a 5-point ordinal item (from "very positive" \[better outcome\] to "very negative" \[worse outcome\]) adapted from measures used in Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Change in attitudes about SRH as assessed by measures of Birth Control Attitudes on a likert-type scale	Baseline, within 3 weeks post-intervention, and 30-to-90 days post-intervention	Change in attitudes about SRH assessed by the composite Condom Attitudes (Outcome 4 and Outcome 5), composite Birth Control Attitudes (Outcome 6 and Outcome 7), and Norms (Outcome 8).; Birth Control Attitudes is a composite score of Outcome 7 and a 5-point likert-type scale (from "very positive" \[better outcome\] to "very negative" \[worse outcome\]) adapted from measures used in Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Change in attitudes about SRH as assessed by measures of Norms	Baseline, within 3 weeks post-intervention, and 30-to-90 days post-intervention	Change in attitudes about SRH assessed by the composite Condom Attitudes (Outcome 4 and Outcome 5), composite Birth Control Attitudes (Outcome 6 and Outcome 7), and Norms (Outcome 8).; Change in attitudes about SRH assessed by Norms on a 5-point likert scale (from "strongly agree" to "strongly disagree" \[no better/worse outcome\]) adapted from measures used in Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Change in self-reported sexual behavior as assessed by measures of Sexual Behavior on dichotomous items	Baseline and 30-to-90 days post-intervention	Change in sexual behavior assessed by composite Sexual Behavior score (Outcomes 11-16).; Sexual Behavior is a composite score of Outcomes 11-13 and 15-16 and dichotomous (yes/no \[outcome varies by item\]) items adapted from measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits, Hwang's et al (2007) Sexual Behaviors After Universal Screening of Sexually Transmitted Infections in Healthy Young Women, and Booth-Kewley's et al (2001) One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps sample.
Change in self-efficacy about SRH as assessed by measures of Condom/Birth Control Use	Baseline, within 3 weeks post-intervention, and 30-to-90 days post-intervention	Change in self-efficacy about SRH assessed by Condom/Birth Control Use (Outcome 9) and Partner Communication/Negotiation (Outcome 10).; Change in self-efficacy about SRH assessed by Condom/Birth Control Use on 5-point likert-type scales (from "not at all confident" \[1; worse outcome\] to "extremely confident" \[5; better outcome\]) adapted from Crosby's et al (2008) Correct Condom Use Self-Efficacy Scale (CCUSS) and Marin's et al (1997) Condom Self-Efficacy.
Change in self-reported sexual behavior as assessed by measures of Sexual Behavioral Intentions on dichotomous items	Within 3 weeks post-intervention	Change in sexual behavior assessed by composite Sexual Behavioral Intentions (Outcomes 17-21).; Sexual Behavior Intentions is a composite score of Outcomes 17-18 and 20-21 and dichotomous (yes/no \[outcome varies by item\]) items adapted from measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits, Hwang's et al (2007) Sexual Behaviors After Universal Screening of Sexually Transmitted Infections in Healthy Young Women, and Booth-Kewley's et al (2001) One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps sample.
Quality and satisfaction of healthcare provider interactions as assessed by measures of Patient-Provider Communication	Baseline	Quality and satisfaction of healthcare provider interactions as assessed by Patient-Provider Communication on a 5-point likert-type scale (from "I do not agree" \[worse outcome\] to "I fully agree" \[better outcome\]) adapted from Bieber's et al (2010) Questionnaire on the Quality of Physician-Patient Interaction (QQPPI)
Change in attitudes about SRH as assessed by measures of Birth Control Attitudes on a likert scale	Baseline, within 3 weeks post-intervention, and 30-to-90 days post-intervention	Change in attitudes about SRH assessed by the composite Condom Attitudes (Outcome 4 and Outcome 5), composite Birth Control Attitudes (Outcome 6 and Outcome 7), and Norms (Outcome 8).; Birth Control Attitudes is a composite score of Outcome 6 and a 5-point likert scale (from "strongly agree" \[1; worse outcome\] to "strongly disagree" \[5; better outcome\]) adapted from measures used in Guzza and Hayford's (2018) Adolescent Reproductive and Contraceptive Knowledge and Attitudes and Adult Contraceptive Behavior.
Change in self-efficacy about SRH as assessed by measures of Partner Communication/Negotiation	Baseline, within 3 weeks post-intervention, and 30-to-90 days post-intervention	Change in self-efficacy about SRH assessed by Condom/Birth Control Use (Outcome 9) and Partner Communication/Negotiation (Outcome 10).; Change in self-efficacy about SRH assessed by Partner Communication/Negotiation on a 4-point likert-type scale (from "very difficult" \[1; worse outcome\] to "very easy" \[4; better outcome\]) adapted from Noar's et al (2002) Condom Influence Strategy Questionnaire and Quinn-Nilas' et al (2016) Sexual Communication Self-Efficacy Scale.
Change in self-reported sexual behavior as assessed by measures of Sexual Behavior on no/yes,previously/yes,currently items	Baseline and 30-to-90 days post-intervention	Change in sexual behavior assessed by composite Sexual Behavior score (Outcomes 11-16).; Sexual Behavior is a composite score of Outcomes 11-12 and 14-16 and no/yes,previously/yes,currently (nominal; no better/worse outcome) items adapted from measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits, Hwang's et al (2007) Sexual Behaviors After Universal Screening of Sexually Transmitted Infections in Healthy Young Women, and Booth-Kewley's et al (2001) One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps sample.
Quality and satisfaction of healthcare experiences as assessed by measures of Health Care on yes/no/dont-know nominal items	Baseline and 30-to-90 days post-intervention	Quality and satisfaction of healthcare experiences assessed by composite Health Care (Outcomes 22-27).; Health Care is a composite score of Outcomes 22-24 and 26-27 and yes/no/dont-know (no better/worse outcome) items adapted from measures used in Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Change in self-reported sexual behavior as assessed by measures of Sexual Behavior on ordinal items	Baseline and 30-to-90 days post-intervention	Change in sexual behavior assessed by composite Sexual Behavior score (Outcomes 11-16).; Sexual Behavior is a composite score of Outcomes 12-16 and ordinal (from "never" \[worse outcome\] to "all the time" \[better outcome\]) items adapted from measures used in Booth-Kewley's et al (2001) One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps sample.
Change in self-reported sexual behavior as assessed by measures of Sexual Behavioral Intentions on yes/no/dont-know items	Within 3 weeks post-intervention	Change in sexual behavior assessed by composite Sexual Behavioral Intentions (Outcomes 17-21).; Sexual Behavior Intentions is a composite score of Outcomes 17 and 19-21 and nominal (yes/no/dont-know \[outcome varies by item\]) items adapted from measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits, Hwang's et al (2007) Sexual Behaviors After Universal Screening of Sexually Transmitted Infections in Healthy Young Women, and Booth-Kewley's et al (2001) One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps sample.
Quality and satisfaction of healthcare experiences as assessed by measures of Health Care on ordinal items (from "very helpful" to "not helpful at all")	Baseline and 30-to-90 days post-intervention	Quality and satisfaction of healthcare experiences assessed by composite Health Care (Outcomes 22-27).; Health Care is a composite score of Outcomes 23-27 and on 5-point ordinal or likert-type (from "very helpful" \[better outcome\] to "not helpful at all" \[worse outcome\]) items adapted from measures used in Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Quality and satisfaction of healthcare experiences as assessed by measures of Health Care on no/yes,recent/yes,not-recent nominal items	Baseline and 30-to-90 days post-intervention	Quality and satisfaction of healthcare experiences assessed by composite Health Care (Outcomes 22-27).; Health Care is a composite score of Outcomes 22-25 and 27 and no/yes,recent/yes,not-recent (no better/worse outcome) nominal items adapted from measures used in Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Change in self-reported mental health as assessed by Anxiety (HAI)	Baseline and 30-to-90 days post-intervention	Change in mental health assessed by the Anxiety on the Health Anxiety Inventory (HAI)
Intervention acceptability as assessed by measures on Acceptability as open-ended items	Within 3 weeks post-intervention	Acceptability of the intervention assessed by composite measures on Acceptability (Outcomes 31-33).; Acceptability is a composite score of Outcome 31 and 33 and open-ended items adapted from Stoyanov's et al (2015) Mobile App Rating Scale and measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits and Kelley's et al (2005) An Evaluation of a Sexual Assault Prevention and Advocacy Program for US Navy Personnel.
Intervention acceptability as assessed by measures on Acceptability on a rating scale	Within 3 weeks post-intervention	Acceptability of the intervention assessed by composite measures on Acceptability (Outcomes 31-33).; Acceptability is a composite score of Outcome 31-32 and a rating scale (from 1 \["not at all likely"; worse outcome\] to 10 \["extremely likely"; better outcome\]) adapted from Stoyanov's et al (2015) Mobile App Rating Scale and measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits and Kelley's et al (2005) An Evaluation of a Sexual Assault Prevention and Advocacy Program for US Navy Personnel.
Change in self-reported sexual behavior as assessed by measures of Sexual Behavior on open response (number input) items	Baseline and 30-to-90 days post-intervention	Change in sexual behavior assessed by composite Sexual Behavior score (Outcomes 11-16).; Sexual Behavior is a composite score of Outcomes 11-14 and 16 and open response (number input) items adapted from measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits, Hwang's et al (2007) Sexual Behaviors After Universal Screening of Sexually Transmitted Infections in Healthy Young Women, and Booth-Kewley's et al (2001) One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps sample.
Change in self-reported sexual behavior as assessed by measures of Sexual Behavior on nominal items	Baseline and 30-to-90 days post-intervention	Change in sexual behavior assessed by composite Sexual Behavior score (Outcomes 11-16).; Sexual Behavior is a composite score of Outcomes 11-15 and nominal items (main/casual other \[no better/worse outcome\]) adapted from measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits, Hwang's et al (2007) Sexual Behaviors After Universal Screening of Sexually Transmitted Infections in Healthy Young Women, and Booth-Kewley's et al (2001) One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps sample.
Change in self-reported sexual behavior as assessed by measures of Sexual Behavioral Intentions on ordinal items	Within 3 weeks post-intervention	Change in sexual behavior assessed by composite Sexual Behavioral Intentions (Outcomes 17-21).; Sexual Behavior Intentions is a composite score of Outcomes 18-21 and 5-point ordinal (from "never" \[worse outcome\] to "all of the time" \[better outcome\]) items adapted from measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits, Hwang's et al (2007) Sexual Behaviors After Universal Screening of Sexually Transmitted Infections in Healthy Young Women, and Booth-Kewley's et al (2001) One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps sample.
Quality and satisfaction of healthcare experiences as assessed by measures of Health Care on ordinal items (from "strongly agree" to "strongly disagree")	Baseline and 30-to-90 days post-intervention	Quality and satisfaction of healthcare experiences assessed by composite Health Care (Outcomes 22-27).; Health Care is a composite score of Outcomes 22 and 24-27 and on 5-point ordinal or likert-type (from "strongly agree" \[better outcome\] to "strongly disagree" \[worse outcome\]) items adapted from measures used in Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Quality and satisfaction of healthcare experiences as assessed by measures of Health Care on ordinal items (from "to much" to "some to little")	Baseline and 30-to-90 days post-intervention	Quality and satisfaction of healthcare experiences assessed by composite Health Care (Outcomes 22-27).; Health Care is a composite score of Outcomes 22-23 and 25-27 and on 5-point ordinal or likert-type (from "too much" to "some too little" \[no better/worse outcome\]) items adapted from measures used in Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Quality and satisfaction of healthcare experiences as assessed by measures of Health Care on a cumulative scale	Baseline and 30-to-90 days post-intervention	Quality and satisfaction of healthcare experiences assessed by composite Health Care (Outcomes 22-27).; Health Care is a composite score of Outcomes 22 and 24-26 and a cumulative (outcome varies by item) scales adapted from measures used in Gold's (1997) CD-ROM Technology to Increase Appropriate Self-Care and Preventive Behaviors among Army and Navy Women.
Change in self-reported mental health as assessed by Depression (PHQ-2)	Baseline and 30-to-90 days post-intervention	Change in mental health assessed by Depression on the Patient Health Questionnaire-2 (PHQ-2) (from "not at all" \[better outcome\] to "nearly every day" \[worse outcome\])
Intervention acceptability as assessed by measures on Acceptability	Within 3 weeks post-intervention	Acceptability of the intervention assessed by composite measures on Acceptability (Outcomes 31-33).; Acceptability is a composite score of Outcome 32-33 and a 5-point ordinal or likert-type scale (from "do not agree at all" \[worse outcome\] to "agree completely" \[better outcome\]) adapted from Stoyanov's et al (2015) Mobile App Rating Scale and measures used in Acari's et al (2004) Feasibility and Short-Term Impact of Linked Education and Urine Screening Interventions for Chlamydia and Gonorrhea in Male Army Recruits and Kelley's et al (2005) An Evaluation of a Sexual Assault Prevention and Advocacy Program for US Navy Personnel.

Trial Locations

Locations (1)

Uniformed Services University of the Health Sciences; 🇺🇸 Bethesda, Maryland, United States