Feasibility and acceptability of Let's Talk Digital, a blended learning family strengthening and sexual reproductive health intervention for adolescents and their caregivers in South Africa.

The majority of adolescent participants completed most eLearning modules and attended the required number of live sessions.

• 86% of adolescents completed most modules and attended at least five live sessions
• The program consisted of 27 interactive smartphone-based eLearning modules and seven in-person live sessions
• 150 adolescents were enrolled across rural and peri-urban Mpumalanga, South Africa
• The study population was predominantly female

The majority of caregiver participants also completed most eLearning modules and attended the required number of live sessions.

• 76% of caregivers completed most modules and attended at least five live sessions
• 143 families were enrolled in total
• Caregivers and adolescents received tailored content through audience-specific eLearning modules
• Completion rates were lower for caregivers than for adolescents (76% vs. 86%)

Participants reported high usability, peer endorsement, and perceived benefits from the Let's Talk Digital intervention.

• Findings were assessed through post-intervention surveys and in-depth interviews
• Comprehension and acceptability remained strong despite language, connectivity, and device challenges
• A mixed-methods design was used, combining quantitative monitoring with qualitative assessments of usability, engagement, and perceived benefits
• Peer endorsement was specifically noted as a positive outcome reported by participants

Language, connectivity, and device-related challenges were identified barriers to participation, but did not substantially undermine comprehension or acceptability.

• The study was conducted in rural and peri-urban Mpumalanga, a low-resource setting
• Despite these barriers, comprehension and acceptability remained strong
• The blended learning model combined digital and in-person components to address such challenges
• Data-free access was identified as a critical factor enabling participation

Data-free access and financial incentives were critical drivers of enrollment, averaging R845 (approximately $47 USD) per family pair.

• Incentives averaged R845/$47 per family pair
• Data-free access to the smartphone modules was highlighted as essential for participation in a low-resource setting
• These findings highlight the importance of sustained public-private partnerships and government support
• Enrollment challenges in low-resource settings were a key feasibility consideration

Let's Talk Digital is reported to be the first digitally mediated, family-based adolescent sexual health intervention studied in sub-Saharan Africa.

• The authors state: 'To our knowledge, this is the first study in sub-Saharan Africa of a digitally mediated, family-based adolescent sexual health intervention'
• LTD is a hybrid digital adaptation of Let's Talk, an existing family-strengthening and sexual health program
• The intervention was designed for adolescents and their caregivers in South Africa
• The blended learning model uses seven in-person live sessions combined with 27 interactive smartphone-based eLearning modules

The authors recommend further research to assess the efficacy, cost-effectiveness, and scalable delivery models of Let's Talk Digital.

• The current study was limited to feasibility and acceptability outcomes
• Findings suggest LTD 'can promote intervention completion and deliver core skills to improve adolescent well-being in low-resource settings'
• The study used a mixed-methods design but did not include a control group or efficacy outcomes
• Scalability and cost-effectiveness were identified as key areas for future investigation