Predictors of intention to use mobile health apps for comprehensive sexuality education among young people in the Democratic Republic of Congo: a correlational study

BackgroundComprehensive sexuality education (CSE) is essential to the health and well-being of young people. In the Democratic Republic of Congo (DRC), where more than 65% of the population is under the age of 25, access to interpersonal CSE remains limited owing to sociocultural and structural barriers. This exposes young people to persistent socio-sanitary vulnerabilities. In this context, mobile health apps (MHAs) constitute a promising solution, supported by the growing use of smartphones among young Congolese. However, this groups intention to use MHAs for CSE has been the subject of little research to date. ObjectiveThe aim of this study was to identify predictors of intention to use MHAs among young Congolese, based on the extended Unified Theory of Acceptance and Use of Technology (UTAUT2). MethodsA predictive correlational study was conducted in eight public secondary schools in Bukavu (DRC) with a stratified random sample of 859 students. Predictors of intention to use--performance expectancy (PE), effort expectancy (EE), social influence (SI), facilitating conditions (FC), and perceived risk (PR)--and moderators--age, gender, and past MHA experience--were measured from data collected through a self-administered UTAUT questionnaire. Descriptive and multivariate analyses were run on SPSS version 28. ResultsMean age of participants was 16.3 years (SD = 1.5). Boys made up 55.1% of the sample. Overall, 51.0% of the sample owned a smartphone, of which 62.3% reported having easy access to mobile data and 16.2% were already using MHAs to learn about sexual health. Intention to use MHAs was positively influenced by PE ({beta} = 0.523, p < 0.001), EE ({beta} = 0.115, p < 0.001), and SI ({beta} = 0.113, p < 0.001). FC (p = 0.260) and PR (p = 0.631), however, had no significant influence. Age moderated all of the relationships tested (F (1, 849-854) = 9.97-20.82; p [&le;] 0.002), with more marked effects observed among younger participants 14-15 years old. The final model explained 44% of the variance, indicating good predictive power. ConclusionIntention to use digital CSE was explained primarily by PE, EE, and SI and moderated by age. To strengthen this intention, stakeholders will need to promote e-interventions that are pertinent, easy to use, socially valorized, and tailored to young peoples needs and to the local context. Author SummaryYoung people in the Democratic Republic of Congo often face barriers to accessing reliable comprehensive sexuality education, including social taboos and limited resources. At the same time, smartphones are becoming more common, creating new opportunities to deliver this information through mobile health applications. In this study, we explored what drives young peoples willingness to use mobile health applications for comprehensive sexuality education. We surveyed 859 students from eight public secondary schools in Bukavu, South Kivu Province, in the eastern Democratic Republic of Congo. We found that young people were more likely to intend to use these applications when they perceived them as useful, easy to use, and socially supported. Concerns about risks, such as privacy, did not reduce their intention. Our findings suggest that mobile health applications could help expand access to comprehensive sexuality education if they are codesigned with young people, tailored to their needs, easy to use, and supported by their social environment. This work highlights the importance of understanding young peoples perspectives before developing digital tools for comprehensive sexuality education, especially in settings where access remains limited.