BACKGROUND: Sexually transmitted diseases and infections continue to disproportionately affect young adults in the United States, with half of all new STIs annually occurring in young adults between the ages of 15 and 24. Advances in digital technologies have allowed for the facilitation of fast and discreet information about sexual health but remains understudied in the context of newer technologies. There is limited research on the effectiveness of Home Assistant Devices as channels to facilitate the information seeking process in young adults. To address this gap, this study explored whether Home Assistant Devices can facilitate the sexual health information seeking process in young adults between the ages of 18 and 26 who already use the internet to search for health information. The purpose of this dissertation was to explore the perspectives of young adults to understand the depth of their sexual health information needs and whether a user-centric designed HAD can be a suitable alternative for fulfilling those information needs.

METHODS: Informed by the Theory of Motivated Information Management and Technology Acceptance Model, this qualitative study used the Design Thinking framework to understand young adults’ information needs and created a prototype voice skill to address that need. In-depth interviews were conducted virtually on Google Meet or Zoom and were recorded. This qualitative study occurred in three phases: in the first phase, 10 young adults were interviewed about their information seeking needs, current gaps, and how they thought Home Assistant Devices could fill that need. Insights from those interviews were then analyzed and used to create a prototype that would address sexual health information needs. The prototype was then tested with a new group of ten young adults, and their reactions to the prototype was recorded via interviews. In the third phase, the prototype was refined based on feedback from the previous group, and then re-tested with a new group of 10 young adults. In total, in depth interviews were conducted virtually with 30 young adults to understand information needs and create a prototype voice skill that could serve to facilitate the transfer of sexual health information in a convenient and relevant manner. Inductive thematic analysis was conducted to identify emergent themes.

RESULTS: Overall, the sample (n=30) was 63% female, 43% White, with 53% having completed a bachelor’s degree, and 47% having owned a Home Assistant Device for over 12 months. The average age of the sample was 24 years old. After analyzing interviews through inductive thematic analysis in NVivo, four themes that were noted in the first phase as it related to Home Assistant Devices and information needs: the use of HADs as a means of convenience, preferring to use screen-based devices for research, tradeoffs between privacy and functionality, and the ability to emergency triage users for medical attention based on symptoms. Three main themes emerged in the second phase after reacting to the first version of the prototype, including anxiety and frustration when experiencing the unknown, pre-existing positive perceptions of Home Assistant Devices, and negative perceptions of Home Assistant Devices. In the third phase, two main themes emerged: a desire to share visuals to build comfort and bridge the information gap, and an ambivalence towards privacy.

DISCUSSION: Privacy concerns remain prominent with Home Assistant Devices when engaging with them for information seeking purposes. These concerns are sometimes met with ambivalence by young adults, who were willing to trade some of their privacy for added features or functionality that could improve their user experience. Furthermore, challenges remain with voice search and screen-based devices are perceived to be easier to use. Lastly, the sexual health information seeking process is sensitive, and many young adults in this sample expressed wanting to have a more personalized experience that acknowledged their specific situations. To the author’s knowledge, this is the first study that explored the factors contributing to the sexual health information seeking process using Home Assistant Devices among young adults between the ages of 18 and 26. The results of this study have several implications for public health practice and research, especially as it relates to the Design Thinking approach for public health voice skill development, as well as addressing a new approach to providing sexual health information to young adults that may be more discreet and relevant to them. The findings from this study contribute to the emerging literature base on the use of Home Assistant Devices to address sensitive health information seeking behaviors.