Effects of a Creative Crowdsourcing Text-Messaging Intervention on Sexual Health Outcomes Among College Students in Eastern China: A Randomized Controlled Trial

Jaime, E, Hu, X, Li, C, Wu, S, Cao, B, Hall, BJ, Jones, A ORCID: 0000-0001-5951-889X and Pan, SW (2026) Effects of a Creative Crowdsourcing Text-Messaging Intervention on Sexual Health Outcomes Among College Students in Eastern China: A Randomized Controlled Trial. International Journal of Sexual Health. pp. 1-20. ISSN 1931-7611

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Abstract

Background
Creative crowdsourcing may be an effective means to mitigate higher-risk sexual behaviors among college students in China. We conducted an 8-month Randomized Controlled Trial evaluating a crowdsourced health promotion and text-messaging intervention among first-year college students in Eastern China.

Methods
Participants were randomly assigned to four arms: Active Creative Crowdsourcing Engagement (ACCE) arm that created messages promoting sexual health (n = 129); Text-Messaging Intervention (TMI) arm that received health promotion messages bi-weekly (n = 111); ACCE-TMI arm that both created and received messages (n = 105); and the control arm (n = 135). Sexual health attitudes and behaviors in the past three months were analyzed at baseline and follow-ups.

Results
Among 480 participants at baseline, 57% identified as male, 8% were sexually active in the past three months and 4% had condomless sex. Proportion of sexually active participants increased in all arms between baseline and last follow-up. A total of 812 messages were submitted throughout the intervention period. Odds of condomless sex were 76% lower in the ACCE arm compared to the control arm (OR = 0.24; p = 0.02, 95% Confidence Interval [0.07, 0.79]). No difference in other sexual activity or attitudes toward condom use was observed between arms.

Conclusion
Study findings indicate that Active Creative Crowdsourcing is a feasible and potentially effective intervention for promoting safer sexual behaviors among college students in China. Future research should examine using Active Creative Crowdsourcing to promote healthier behaviors in other areas.

Item Type:	Article
Uncontrolled Keywords:	1701 Psychology; Public Health; 5203 Clinical and health psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Divisions:	Psychology (from Sep 2019)
Publisher:	Taylor and Francis Group
Date of acceptance:	28 January 2026
Date of first compliant Open Access:	11 March 2026
Date Deposited:	11 Mar 2026 11:51
Last Modified:	11 Mar 2026 11:51
DOI or ID number:	10.1080/19317611.2026.2625658
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28229

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