Exploring interactive stories for sexual health education among young adults in the USA

Adolescents and young adults in the USA face significant sexual health challenges. Immigrant and refugee youth are particularly vulnerable due to barriers such as cultural silence around sex, contraception stigma, and knowledge gaps in sexual health. This pilot study explored the potential of a choose-your-own-adventure (CYOA) story intervention to address reproductive and sexual health disparities and enhance prevention engagement among immigrant and refugee youth in Central Ohio. We conducted semistructured interviews with 32 immigrant and refugee young adults recruited through a community organization. The interviews explored the impact of CYOA stories on participants' understanding of dating and sexual health and identified key design features and player experiences that contribute to the intervention's effectiveness. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Participants (n = 32) were predominantly female (87.5%) and aged 18-25 years. The CYOA intervention significantly improved understanding of sexual health through engaging scenarios that simulated real-life interactions and decision-making processes. The intervention's inclusive design and interactive elements were pivotal in enhancing understanding, though minor technical and navigational issues were noted as areas for improvement. Realistic scenarios, peer interaction, and customization features were particularly effective in promoting engagement and learning. The CYOA format is a promising tool for sexual health promotion among immigrant and refugee youth. Carefully designed interactive stories can significantly improve young adults' understanding and communication regarding sexual health.