First health study of teenage boys using cellular telephones

A $4.15 million, four-year National Institutes of Health grant will enable researchers at the Indiana University School of Medicine to conduct the first health study of teenage boys using cellular telephones.

The researchers, led by Dennis Fortenberry, M.D., M.S., professor of pediatrics in the Division of Adolescent Medicine, will use text messaging to follow 72 males, ages 14-17 years, for three years. The adolescent males will be provided with cell phones and unlimited, free text messaging as long as they remain enrolled in the study.

A requirement of the study is that the teens answer a series of questions daily to enable the researchers to track and evaluate the behavior of the teens. Regular urine tests will be used to identify changes in microorganisms in the male genital tract.

"This is a fresh approach to behavioral studies our research group has used for a dozen years involving written daily diary entries used to track the behavior of adolescents," said Dr. Fortenberry. "That NIH-funded research has provided insights into young people's health risk and health protective behaviors."

The objective of the study is to identify and characterize changes in the microorganisms in the urethra of the adolescent male. The urethra connects the male bladder to the outside of the body. Participants will submit urine samples to be analyzed. The answers from the daily questions transmitted by their cell phone will be coordinated with the urine tests to determine how behavior influences changes in the microorganisms of the urethra.

In the past, physicians thought that the male urethra normally didn't have any microorganisms. It now is known this isn't true, but little else in known, said Dr. Fortenberry.

Researchers will look at the microorganisms to understand what organisms or communities of organisms are normally present and how they change naturally as young men get older and through the course of initiating sexual activity. By understanding the normal variations, researchers hope to be able to determine how the communities of organism increase or decrease to make a person susceptible to infections. They also hope to determine how some kinds of medical treatment, such as antibiotics, will affect the organisms.

The research is part of the Human Microbiome Demonstration Project, which is part of the National Genomics Institute, and is focused on characterizing microorganisms that inhabit the human body to discover how they are involved in human health and disease.

Indiana University Adolescent Medicine researchers have successfully used daily dairies as a research tool for the past 15 years. By incorporating social media, such as cellular telephones, into the process, they hope to engage a new generation of adolescents.

"We certainly did not develop the methodology, but we are at the forefront of its use," said Dr. Fortenberry. "Other studies with adults have used cell phones but this is one of the first large-scale studies with teens."

To assure confidentiality and privacy, the Indiana University Division of Biostatistics has developed a program that will synchronize all the responses to a mainframe on the Indiana University-Purdue University Indianapolis campus. The responses will be removed from the cell phones as soon as the teen hits the "send" button.

In addition to Dr. Fortenberry, other Indiana University researchers participating are Sarah Wiehe, M.D., from the Division of Children's Health Services Research; Mary Ott, M.D., from the Division of Adolescent Medicine; Barry Katz, Ph.D., director of biostatistics; Bobbie Van Der Pol, Ph.D., from the Division of Infectious Diseases, and Qunfeng Dong, Ph.D., from bioinformatics at IU-Bloomington. Also participating is George Weinstock, PhD., a molecular geneticist at Washington University in St. Louis.