Shih, J. L. et al. (Eds.) (2019).

Proceedings of the 27th International Conference on Computers in

Education. Taiwan: Asia-Pacific Society for Computers in Education

A Mobile Web Application with Interactive

Learning Story and Personalized
Recommendation and Notification for Sexual
Health Education in Ethnic Adolescents
Suphaphan CHANSIRIa & Charoenchai WONGWATKITb*
a
School of Nursing, Mae Fah Luang University, Thailand
b
School of Information Technology, Mae Fah Luang University, Thailand
*[email protected]

Abstract: In mountainous border areas, most hill tribe and ethnic adolescents encounter poverty
and limited access to good quality of education and healthcare services. They are confronting
the severity and high rate of Unplanned Pregnancy (UP) and Sexually Transmitted Diseases
(STDs) population due to their sexual misconception, risky behaviors, contextual belief, and
negative attitudes, and improper pedagogical instructions and materials. In this study, the Akha
ethnic group in Thailand was considered as they are facing the highest number of UP and STDs
among other hill tribes in the northern region of Thailand. Therefore, the authors aim to address
these critical issues by proposing a mobile learning application for enhancing their
understanding of Sexual Health Education (SHE), STDs and UP prevention through a designed
interactive learning story with context-based storytelling. The students can get personalized
recommendation of first-aid instruction and nearby contact points based on their search queries
of symptom, conditions, or keywords. Moreover, the application can analyze their responses
during learning for giving personal notifications based on their sexual behaviors, and remind
the users regularly for having safe sex. Before this application is successfully developed, this
study firstly carried out the contextual analysis of their needs and requirement in order to design
the associated content for interactive learning story, to propose a system structure and design
and to present a mechanism for personalized recommendation and notification. The evaluation
was later conducted with similar groups of samples and experts towards the proposed interactive
learning story and application prototyping. The findings show that the proposed mobile
application received satisfied attitudes and perceptions on both learning content and story, and
mobile learning experience, while some suggestions are constructive for completing this mobile
application development. The investigations of learning effects on students in formal and
informal learning environments are to be studied.

Keywords: Mobile web application, personalized recommendation and notification, interactive

learning story, sexual health education, ethnic adolescents

1. Introduction

Sexual Health Education (SHE) provides young people to sexually healthy, increased student’s
knowledge, skills and behaviors associated with the reduction of unplanned/intended pregnancy,
Sexually Transmitted Diseases (STDs) and HIV. SHE had a positive impact on safer sexual behavior,
could delay initiation of sexual intercourse, decreased frequency of sexual intercourse, decreased
number of sexual partners, and increased use of condom and contraception (UNESCO, 2018). Those
who have a good understanding of SHE, they tend to pursue and accomplish study in school and college.
In the workplace, they can work with different gender with empathy. In family, SHE can help improve
parent-child communication about sex-related information and perceptions and knowledge of parents,
they could guild their children and protect themselves from sexual risk (Dinaj-Koci et al., 2015). In the
broad scale, more population with SHE can help reduce risk of unplanned pregnancy, abortion, and
STDs.
Unplanned Pregnancy (UP) and STDs bring negative impacts to the world’s society and
economy. In the past decade, UP situation around the world has decreased on average (Bearak,
Popinchalk, Alkema, & Sedgh, 2018); however, this situation in Thailand, especially in adolescents, is
still critical. Most adolescents in Thailand have limited knowledge and misconception of birth control
and unsafe sex (UNICEF Thailand, 2016). Those who have STDs have dramatically shifted twice in
the past decade, mostly found in adolescents (Bureau of Reproductive Health, 2019). It provides a range
of unpleased effects ranging from physical, psychological and social aspects to morbidity in health.
Untreated infection can result in pelvic inflammatory disease and can rapidly spread to others (Holmes
et al., 2008). Those who are HIV infected are required to get a series of costly treatments and drop study
eventually. These sexual-related situations and diseases affect the quality of teenagers’ lives.
In hill tribes and ethnicity groups in Thailand, most adolescents encounter several limitations
and problems due to the limited use of Thai national language; meanwhile, they have uncomfortable
discussion/consultation with parents. Therefore, it gives this significant burden to the teachers at
schools. There are a really limited number of teachers who are ready to teach the sexual topics; in the
meantime, only limited hours are provided, while the students have weak intention to learn due to the
non-engaging learning materials and all materials are not in their local language. Eventually, they tend
to ask friends and look for information on the Internet, which result in improper understanding or
misconceptions of sexual health understanding (Ministry of Education, 2016).
In the past decade, it has been proved that mobile technology plays a crucial role in addressing
learning gaps in broad contexts. It can present a meaningful way of mobile learning in different formats
and styles (Pachler, 2009). It can simplify difficult learning topics with animations, cartoon, graphics
with a creative story to bring more attention and understanding to learn anytime. Moreover, students
can interact with the mobile devices differently from a simple click, pinching, zooming, to speaking or
eye gazing. Also, mobile devices can provide personalized features that can individually respond and
address different conditions, e.g., analytics, notification, recommendation, alert. This makes mobile
learning more meaningful to the students. Mobile learning has been applied successfully in various
topics across multiple disciplines, e.g., Maths, Science, Computer, History, and Health (Chang, Lai, &
Hwang, 2018; Hsu, Hwang, & Chang, 2013). Many findings reveal that mobile learning can help
improve learning motivation, attitude, and achievements.
Based on this perspective, therefore, this study aims to address the above-mentioned issues of
SHE, STDs and UP prevention, especially in an ethnicity group of Thailand, by employing a number
of mobile learning advantages. In particular, a mobile learning application is proposed for Akha
adolescents in Thailand with a careful design of interactive learning story. An overall framework of the
application and the personalized features are highlighted. To reach this aim, this paper is directed with
four research objectives: 1) to understand the actual context of ethnic adolescents in learning sexual
health and mobile experience, 2) to design an interactive learning story that connect with their context
and curriculum, 3) to design a mobile application with personalization features that respond to their
experience and learning styles, and 4) to evaluate the proposed interactive learning story and mobile
application prototyping. The findings of this paper aim to gain insights and a more in-depth
understanding of the proposed mobile application for further development.

2. Related Study

2.1 Sexual Health Education, Sexually Transmitted Diseases and Unplanned Pregnancy

Sexual Health Education (SHE) plays an essential role in enabling quality of personal life, career,
family, and society. It is mandatory to have a basic understanding of sexual changes, development, and
hygiene; also, how to delay first sexual intercourse at an early age, how to have safe sex, how to not
addict to sex and how to prevent unplanned pregnancy with proper methods. SHE were divided into
eight content areas, namely 1) relationship; 2) values, right, culture and sexuality; 3) understanding
gender; 4) violence and staying safe; 5) skills for health and well-being; 6) the human body and
development; 7) sexuality and sexual behavior; 8) sexual and reproductive health (UNESCO, 2018).
Many countries around the world have taught SHE both inside and outside classrooms. In
school, SHE has been included in all levels of the curriculum starting from primary school (UNESCO,
2015). Teachers tend to give instructions related to students’ age, capability, and social contexts with
many pedagogical strategies (SIECUS, 2004). On the other hands, learning SHE outside school can be
different. In family, parents frequently avoid discussing this due to limited understanding, social belief,
negative attitude (Breuner & Mattson, 2016). Besides, students can access social media, friends, and
other media. Students most of the times cannot identify which information is proper due to their literacy.
With these learning flaws and curiosity, youngsters tend to have a try of having sexual intercourse
without proper prevention and lead to the risk of UP and STDs eventually (UNESCO, 2015).
In Thailand educational system, SHE has been included in the national core curriculum from
primary to high schools. Many reports have shown that SHE is merely involved by students’ interaction
or discussion. Students are not encouraged to learn this essential content; consequently, they hold a
misconception, do not have sufficient knowledge and understanding, and cannot apply in their daily
life. Some sexual behaviors are associated with unhealthy. These are risky to UP and STDs. Moreover,
most classrooms arrange to learn SHE in a mixed gender environment in which most students are not
willing to ask and discuss, where the assessment is often operated in the form of paper-based
examination which may not reflect their skills (Ministry of Education, 2016).
In Thailand, the situations of STDs and UP are critical, meaning that most young people have
a weak understanding and limited knowledge to apply in their lives. Therefore, this study emphasizes
on two core content areas for ethnic adolescents: the human body and development, and sexual and
reproductive health.

2.2 Mobile Learning with Personal Notification and Recommendation

In the past decade, mobile learning has become more important as it enables more effective personal
learning anytime anywhere (Hwang & Wu, 2014). It has been widely proved to be one of the
technology-enhanced learning approaches that enhance the learning possibilities and performance; in
the meantime, it elevates self-efficacy of learning. With the advancement of mobile technology, the
device supports several output and input interactions. Besides, mobile learning has increasingly
developed in various platforms, ranging from application, website, game, augmented reality, virtual
reality and recent mixed reality (Guse et al., 2012; Liu & Tsai, 2013).
Many studies have continuously investigated the effects of mobile learning on different aspects.
Regarding learning performance, the students who learned with mobile-supported learning can
outperform than those who learned with traditional fixed-station learning software or traditional
classroom learning (Furió, Juan, Seguí, & Vivó, 2015). Moreover, mobile learning has been widely
developed to enhance learning in a broad level and context, ranging from typical classrooms, practicing
skills, to context-aware instructions; in addition to that, these applications are used in many courses
(Sung, Hwang, & Chang, 2016). Furthermore, learning with the collaboration of peers has become more
necessary in this 21st learning era. In recent years, many studies found that the students not only achieve
more with this learning platform, but also improve their collaborative, problem-solving and critical
thinking skills (Kuo, Hwang, & Lee, 2012).
Mobile learning is even more powerful when it comes with personalized features in order to
tailored provide the accurate, timely, useful experience according to the individual differences of
conditions, background, and status (Hwang, Yang, & Wang, 2013). Personalized notification can alert,
notify or give caution promptly at a certain time regarding the conditions or situation. Besides that,
recommendation can analyze the previous/ongoing profile and status and provide a tailored guideline
or instruction to address or enhance the success with a clear message. Personalized recommendation
can be presented in two major formats: sequence and non-sequence. With personalized features, mobile
learning is more impactful that can individually address the differences of individual users.
Based on this perspective, this study would adopt the benefits of mobile technology that not
only presents the learning materials and activities but also gives personalized notification and
recommendation. It aims to provide an engaging, successful mobile learning experience to the students.

3. Contextual Analysis and Content Validation

3.1 Demographic and Background of Ethnic Adolescents

The Ethnic or hill tribe people are a group of people who mostly lived in the mountainous border areas
in the north of Thailand. Six main groups are remaining: Akha, Lahu, Kmong, Yao, Lisu, and Karen,
each has its language, culture, and belief, which are different from those of the Thai. The Ethnic or hill
tribe people face many barriers to access health care services (Apidechkul, Laingoen, & Suwannaporn,
2016). Moreover, only a few people can continue their education into high school and university, after
a free school supports by government on primary and secondary education.
In this study, the context of Akha was considered as it is the most density among other Ethnic
groups in Thailand. Akha people predominately lives in Chiang Rai Province with totally 245 villages
in 2016; 12,714 households, and 73,810 populations (36,389 males and 37,421 females). From research
studies, Akha adolescents have a high risk of UP and STDs due to two main reasons. First, their risky
behavior with alcoholic drink and drug addiction which lead to unconsciousness; moreover, it is found
that over 40% of adolescents have sex before 16 years old. Second, most Akha family are in poverty
and low-educated. Furthermore, Akha adolescents most infect STDs, e.g., HIV/AIDs than other ethnic
or hill tribe groups (Apidechkul, 2016).

3.2 Need Assessment and Requirements

In order to understand the actual context of teenagers in Akha group, the authors went to visit them in
the community in order to assess their understanding and attitudes concerning three dimensions: (1)
their understanding and attitudes towards sexual health, sexually transmitted diseases and unplanned
pregnancy prevention, and (2) their learning experience with the support of mobile devices, and (3)
their learning preferences. Both one-on-one and group interviews with voice recordings have been used
by following a series of open-ended and close-ended questions. Note that each student with the parents’
permission agreed to participate in this research willingly, while their data is kept anonymously.

Figure 1. Need Assessment with Ethnic Adolescents.

After the recordings have been transcribed, the authors have found several issues. For example,
most of them have minimal knowledge of STDs while having no ideas of how to prevent them in
advance. They could not express what should do if unplanned sex occurred; besides, most of them have
misconceptions of contraceptive pills. In terms of the learning experience with mobile technology, they
in common have limited experience with computer and mobile learning, even they all have personal
mobile phones with Internet access. They further revealed that most of the mobile usage spend on social
media, chatting, entertainment, and other applications.
In addition to that, they shared their views of learning these mentioned topics with mobile
devices. They preferred to gain more understanding with this personal mode of learning with visual
illustrations, while they can look for suggestions without hesitation. In the meantime, interactive content
is needed to engage their learning. Importantly, they called for the notifications or alerts to be prompted
at a proper time. Therefore, based on these interviews, the authors would consider them in designing
the application that is appropriated for Akha adolescents.

3.3 Content and Validation

Based on the interview and requirement analysis, the authors have structured the content into three
major topics: (1) Sexual health and hygiene, (2) Unplanned pregnancy and prevention, (3) STDs and
prevention.
In the first topic, it runs with two characters with ethnic outfit and sound. The students can learn
the learning story based on their selected gender, including what changes happen on the body physically
and mentally, how to have sexual hygiene; in the meantime, there are several prompts to let the students
think or concern in relevant to their experience. In the second topic, the ethnic characters will introduce
the effects of unplanned pregnancy on different aspects, followed by taking the students to meet with
the doctors in local village who are sharing the knowledge of how birth happens, how to control birth,
what techniques are suitable for ethnic context with demonstration. The students are required to get
involved in the learning story. In the third topic, the story presents most found STDs, e.g., Gonorrhea,
Syphilis, Vaginitis, Genital Herpes, and HIV, by taking the students to see the cause, symptoms, and
first-aid instructions. Also, the students can be aware of the negative impacts if these diseases arise
without proper treatment; meanwhile, they learn how to prevent these diseases. While learning, the
students are silently collected for their sexual behavior and risk for further analysis and notification
personally.
After the content has been designed, the validation process was carried out by one doctor and
one nurse on content accuracy, understandability, and proper use of wording and graphics, and one
information technology professional for the possibility of mobile design and development. The
validation was done independently by following the guideline, checklist, and questions designed by the
authors.

4. Learning Design and System Architecture

4.1 Overall System Framework

Interactive Learning Module Learning Repository

Learning Storytelling
Media and
Mobile Web-based Learning Interface

Materials
Interactive Animated Story
Admin Web Interface

Interactive Prompts Prompts

Recommendation and Notification Web Analytics

Module

Searchable Information
Responses

First-Aid Recommendation

Learning
Notification Profile

Figure 2. An Overall Framework of the Mobile Application.

Based on the requirement analysis in the previous section, the mobile application has been designed for
two user roles: student and admin. As shown in Figure 2, the system has two major modules that operate
seamlessly with the database. In the Interactive learning module, this is the module where students can
learn the content which was designed to be interactive with storytelling, animation, and prompts (details
and associations visualized in the next section). The media and prompts are stored in the learning
repository. While learning, students’ learning profile and responses are automatically recorded for the
web analytics; moreover, this data is used for the analysis of recommendation and notification module
(the mechanism presented later). In this particular module, the students can search for the want-to-know
knowledge while the app can provide first-aid instruction. Such that, the application can send a
personalized notification to the students correspondingly. With web analytics, the admin can view the
usage and learning profile for further investigations.
4.2 Interactive Learning Story Design

There are three learning topics in this application. First, sexual health (SH), gives an understanding of
how changes happen to the body physically and mentally. Second, unplanned pregnancy (UP) and
prevention, including the contraceptive pill, condom. Third, sexually transmitted diseases (STDs), e.g.,
Gonorrhea, Syphilis, Vaginitis, Genital Herpes, and HIV. Each learning topic is associated with certain
literacy, as shown in Figure 3 with color indication. After the content association is done, it proceeds to
make interactive learning story by considering three components: character design, storytelling and
scenarios, and situations. The learning story is designed to be an interactive motion graphic with the
characters in a local outfit and local sound option. With context-simulated atmosphere design, it brings
the storytelling more relevant to the students’ real context with surrounding scenarios and situations.
With this design, the students can learn interactively by interacting with the ongoing story, prompts,
and responses in order to gain more sexual health literacy.
on ts es
cti mp ons
e ra Pro Re
sp
Sexual Health Literacy Int

Understanding Awareness
Interactive Learning
Story
Prevention &
Protection
Character

Storytelling

Sexual Sexually Transmitted Unplanned

Health Diseases Pregnancy Scenarios

Figure 3. Learning Design and Interactive Story Association.

4.3 Personalized Recommendation and Notification

Mobile Notification Interface

Mobile Web-based Learning Interface

Searching Input Location Input

Recommendation
Searching API
Mechanism

Searching Result Personalized

Recommendation
Notification API

Unplanned
Pregnancy First-Aid Instruction

Sexually Transmitted Contact and

Diseases Nearby Hospital

Figure 4. Personalized Recommendation and Notification Agent.

In this application, there is a personalized feature of recommendation and notification that can help
support the learning more straightforward but powerful. The students can give the query of keywords
or symptoms relevant to STDs or UP as a search input. The searching API can then analyze and look
for the results showing practices and examples with visual graphics and a brief explanation for better
understanding; in the meantime, this input runs to the recommendation mechanism for generating the
basic first-aid instruction with nearby contact and hospital for further consultation. Nevertheless, based
on the search, the system triggers the notification API and can send the notifications to students based
on conditions provided via a mobile notification interface, while the recommendation is presented on
the learning interface.
5. Evaluation and Results

5.1 Interactive Learning Story

In this section, a simple evaluation of interactive learning story design was conducted with ten similar
participants (students) and five professional experts.
All participants were given a complete story design with full interaction embedded on the
mobile application, sample screenshots shown in Figure 5 with a brief description. After evaluating the
learning story, the participants rated their satisfaction on twenty items of 5-point Likert Scale
questionnaire covering four dimensions of multimedia with character, visual, motion design, layout,
composition and sound components (MTA), storytelling of the learning topics (STL), attention and
retention on learning story (AnR), and learning flow and perception (LFP), and open-ended feedback
and suggestion. The questionnaire was tested for internal consistency and reliability before the
evaluation (Cronbach’s alpha = 0.74).

Two characters of
doctors are introduced
more on topic 2
(unplanned pregnancy
protection). The story
runs with the curiosity of
local girl.

The story introduces the

Mee-Ju (left), an Akha girl, and Ar-
characters in local Akha
Pha (right), an Akha boy, introduce
costume on topic 1,
learning topics for female and male
sexual health
fundamentals. adolescents with local sound. Click
to learn the story.

Figure 5. Screenshots of Interactive Learning Story.

Table 1
Evaluation Results of Interactive Learning Story
Dimensions Similar participants Experienced and professionals t
(N = 10) (N = 5)
M ± SD Interpretation M ± SD Interpretation
MTA 4.78 ± 1.23 Very satisfied 4.32 ± 0.32 Satisfied 0.808**
STL 4.84 ± 0.89 Very satisfied 4.71 ± 0.54 Very satisfied 0.297
AnR 4.21 ± 0.35 Satisfied 3.86 ± 0.61 Neutral 1.431*
LFP 4.40 ± 1.73 Satisfied 4.54 ± 0.45 Very satisfied 0.175
* p < 0.05, ** p < 0.01

As shown in Table 1, it was found that the interactive learning story were ranged between
satisfied and very satisfied in general, similar participants between satisfied: M = 4.21, SD = 0.35 and
very satisfied: M = 4.84, SD = 0.89 and experts between neutral: M = 3.86, SD = 0.61 and very satisfied:
M = 4.71, SD = 0.54. The students provided significantly higher satisfaction than the experts on MTA
(t = 0.808, p < 0.01) and AnR (t = 1.431, p < 0.05). This result indicate that the design of interactive
learning story is accepted for using with the students to enhance their understanding of SHE, STDs and
UP prevention.

5.2 System Prototyping

Besides, a user testing of the mobile application was conducted with 27 similar participants (male= 12,
female = 15) to understand their user experience.
All participations were experienced with a proposed mobile application on the interactive
prototyping, sample screenshots shown in Figure 6 with a brief description. After evaluating the mobile
application, the participants rated their satisfaction on 16 items of 5-point Likert Scale questionnaire
covering four dimensions: mobile navigation (NVG), transition and motion (TaM), consistency in
theme and pattern (DPT), and elements and composition (EaC), and open-ended feedback and
suggestion. The questionnaire was tried for internal consistency and reliability before the testing
(Cronbach’s alpha = 0.81).

The application keeps records of The user can type in the

the continuity in taking query relevant to sexual
contraceptive pills for certain health’s symptoms,
consecutive days for the most conditions or the topic to
effectiveness. This requires user to know.
give the response on mobile prompt

The application shows the

location of hospitals in
The app shows the search
different districts across the results with first-aid
province where you can get a instruction and guidelines on
consult and help. The contact different conditions, e.g., sex
The application sends a
and address information is in the past 24hrs, between 24
personalized notification to
given. and 72hrs, or more than
regularly remind and prepare
for sex safety. 72hrs.

Figure 6. Screenshots of Mobile Application Prototyping.

It was found that the users’ mobile experience ranged between satisfied and very satisfied levels
on all dimensions in both male (satisfied: M = 4.26, SD = 0.39 and very satisfied: M = 4.73, SD = 0.62)
and female (satisfied: M = 4.43, SD = 0.52 and very satisfied: M = 4.74, SD = 0.12). Female students
have better experience than males on all aspects except NVG (Male: M = 4.73, SD = 0.52 and Female:
M = 4.68, SD = 0.44). This can imply that the mobile application can help students to learn with good
learning experience on the proposed application.

Table 2
User Testing Results on the Interactive Prototyping of Mobile Application
Dimensions Similar participants [Male] Similar participants [Female] t
(N = 12) (N = 15)
M ± SD Interpretation M ± SD Interpretation
NVG 4.73 ± 0.62 Very satisfied 4.68 ± 0.44 Very satisfied 0.245
TaM 4.26 ± 0.39 Satisfied 4.43 ± 0.52 Satisfied 0.939
DPT 4.35 ± 0.44 Satisfied 4.49 ± 0.63 Satisfied 0.652
EaC 4.60 ± 0.57 Very satisfied 4.74 ± 0.12 Very satisfied 0.930

5.3 Qualitative Feedback

Based on the analysis of open-ended questions from evaluation, the results have been summarized on
two evaluation topics, each with four dimensions. As shown in Table 3, the participants shared their
feedback and suggestion meaningfully both positive (+) and more expectation (-) points.
The results here would give more insights and reflect their real feeling towards this mobile
application. The positive points will be strengthened throughout the application, where some comments
can be improved with more consideration. However, some features can be further developed in the
future studies.

Table 3
Summary of Qualitative Feedback from Evaluation
 Interactive Learning Story System Prototyping
MTA + It’s interesting. I want to learn more. + I can use it with clear navigation. I NVG
+ The outfit and graphic are similar to can do.
the actual environment of ethnicity. + I know what to go next or go home.
- I think the perspective of graphic is - Some areas I don’t know the status.
not that good.
STL + The story is easy to follow. + The transition from page to page is TaM
+ Wording and character run the story universal.
very friendly. + The motion of monitoring graphic is
- I can’t select the scene I want to learn as expected.
AnR - I expect more sound effect that excite + The UI and pattern are consistent. DPT
me to learn. + The icon, symbols are.
- I want to play with friends. - Give more descriptions
LFP + Friendly and local language are very + Composition and layout are solid and EaC
good. structures.
- It might be more interesting with - Look for tips on each part.
sound from different local persons

6. Conclusion and Discussion

6.1 Conclusion

Owing to the severity of unplanned pregnancy and STDs in ethnic adolescents, this study endeavors to
address such issues with the advantages of mobile learning. In particular, Akha adolescents are mainly
concerned with this research as they have the highest number of UP and STDs compared to other ethnic
groups in Thailand. Based on need assessment and requirement analysis in the real context, the design
of learning story and functions of the mobile application have been developed accordingly. In this study,
the authors have designed an interactive learning story to be localized with their context based on
storytelling and interactive learning to enabling them more understanding of the SHE, UP and STDs.
Moreover, the users can look for nearby contact information and first-aid instruction based on their
search query. They can also receive personal reminders for safe sex based on their responses and sexual
behavior, which are silently collected during the learning process. The findings of this study enable this
proposed mobile application to be developed for real use in a distant target. Hence, this research aims
to increase awareness of strengthening sexual health literacy for a better quality of lives in ethnicity.

6.2 Discussion and Future Study

In this study, the evaluation results reveal several interesting points to be discussed. First, sound
perception and attitude towards an interactive learning story. It is due to the design of considering user’s
interaction, and chunking information into smaller portions to be learned and absorbed. More
importantly, the local context of ethnicity has been employed in making learning more relevant to the
users’ environment. This makes learning more authentic and helps reduce the learning gap between the
newly proposed learning and learners (Lombardi & Oblinger, 2007). Regarding the evaluation of mobile
application on the prototyping platform, the results could not entirely reflect the actual learning
experience due to the limitation of presentations with visuals, motions, and interactions. This may affect
the mobile user experience while giving an evaluation. However, their constructive feedback could be
considered for making this application more fruitful, which is an essential process in software
development (Morales, Igler, Böhm, & Chitchaipoka, 2015). In terms of ratings, the experts tended to
give lower scores due to their substantial experience and sophisticated perspectives; however, they
agree that this mobile application can help users to learn better through their inquiry of learning.
Although this study has conducted a significant step of this research, it still needs more
improvements and further investigations. For system developers, they have to consider the appropriate
approach for software development, front-end and back-end methodology, APIs, and frameworks.
Further investigations need to verify the system performance, including search, notification and
recommendation speed and correctness. Comparison studies with other platforms, classrooms,
roleplaying, and offline e-learning are necessary.

Acknowledgements

This work is granted by Center of Excellence for The Hill-Tribe Health Research of Mae Fah Luang
University and National Research Council of Thailand. The authors would like to acknowledge the
support from Mae Fah Luang University. Also, special thanks direct to Wawee Wittayakom School
and Office of the Non-Formal and Informal Education, Chiang Rai, Thailand.

References

Apidechkul, T. (2016). A 20-year retrospective cohort study of TB infection among the Hill-tribe HIV/AIDS
populations, Thailand. BMC Infectious Diseases, 16(1), 1–14.
Apidechkul, T., Laingoen, O., & Suwannaporn, S. (2016). Inequity in Accessing Health Care Service in Thailand
in 2015: A Case Study of the Hill Tribe People in Mae Fah Luang District, Chiang Rai, Thailand. Journal
of Health Research, 30(1), 67–71.
Bearak, J., Popinchalk, A., Alkema, L., & Sedgh, G. (2018). Global, regional, and subregional trends in
unintended pregnancy and its outcomes from 1990 to 2014: estimates from a Bayesian hierarchical model.
The Lancet Global Health, 6(4), e380–e389.
Breuner, C. C., & Mattson, G. (2016). Sexuality Education for Children and Adolescents. Pediatrics, 138(2).
Bureau of Reproductive Health. (2019). Annual report 2018.
Chang, C.-Y., Lai, C.-L., & Hwang, G.-J. (2018). Trends and research issues of mobile learning studies in nursing
education: A review of academic publications from 1971 to 2016. Computers & Education, 116, 28–48.
Dinaj-Koci, V., Deveaux, L., Wang, B., Lunn, S., Marshall, S., Li, X., & Stanton, B. (2015). Adolescent Sexual
Health Education: Parents Benefit Too! Health Education and Behavior, 42(5), 648–653.
Furió, D., Juan, M. C., Seguí, I., & Vivó, R. (2015). Mobile learning vs. traditional classroom lessons: A
comparative study. Journal of Computer Assisted Learning.
Guse, K., Levine, D., Martins, S., Lira, A., Gaarde, J., Westmorland, W., & Gilliam, M. (2012). Interventions
using new digital media to improve adolescent sexual health: A systematic review. Journal of Adolescent
Health, 51(6), 535–543.
Holmes, K., Sparling, P., Stamm, W., Plot, P., Wasserhelt, J., & Corey, L. (2008). Sexually transmitted diseases.
Hsu, C. K., Hwang, G. J., & Chang, C. K. (2013). A personalized recommendation-based mobile learning
approach to improving the reading performance of EFL students. Computers and Education, 63, 327–336.
Hwang, G.-J., & Wu, P.-H. (2014). Applications, impacts and trends of mobile technology-enhanced learning: a
review of 2008–2012 publications in selected SSCI journals. Int. J. Mobile Learning and Organisation J.
Mobile Learning and Organisation.
Hwang, G.-J., Yang, L.-H., & Wang, S.-Y. (2013). A concept map-embedded educational computer game for
improving students’ learning performance in science courses. Computers and Education, 69, 121–130.
Kuo, F.-R., Hwang, G.-J., & Lee, C.-C. (2012). A hybrid approach to promoting students’ web-based problem-
solving competence and learning attitude. Computers & Education, 58(1), 351–364.
Liu, P. H. E., & Tsai, M. K. (2013). Using augmented-reality-based mobile learning material in EFL English
composition: An exploratory case study. British Journal of Educational Technology, 44(1), 1–4.
Lombardi, B. M. M., & Oblinger, D. G. (2007). Authentic Learning for the 21st Century : An Overview. Educause
Learning Initiative (ELI).
Ministry of Education. (2016). Review of Comprehensive Sexuality Education in Thailand. Review of
Comprehensive Sexuality Education in Thailand.
Morales, R., Igler, B., Böhm, S., & Chitchaipoka, P. (2015). Context-aware mobile language learning. In Procedia
Computer Science.
Pachler, N. (2009). Mobile Learning. Mobile Learning.
SIECUS. (2004). Guidelines for Comprehensive Sexuality Education: Kindergarten-12th Grade. Education.
Sung, H. Y., Hwang, G. J., & Chang, Y. C. (2016). Development of a mobile learning system based on a
collaborative problem-posing strategy. Interactive Learning Environments.
UNESCO. (2015). Comprehensive sexuality education a global review.
UNESCO. (2018). International technical guidance on sexuality education. UNESCO.
UNICEF Thailand. (2016). Situation Analysis of Adolescent Pregnancy in Thailand. Synthesis report 2015.