Table 4.

The refined programme theory

	IF	THEN	BECAUSE
Refined programme theory	IF digital technologies provide (1) enlarged spaces of engagement and dialogue between adolescents; (2) access to SRH information for adolescents, even for those services that are illegal; and (3) anonymity and confidentiality, THEN this leads to increased engagement with digital SRH and SRHR information BECAUSE of a sense of safety (not being judged) and access to SRH information on adolescents’ “own terms”
	IF adolescents have access to information and services adapted to their needs through digital technologies, THEN they will be able to make an informed decision regarding their sexual and reproductive health and well-being and to demand better care, leading to an individual ‘s improved sexual and reproductive health and rights outcomes BECAUSE of a better understanding of SRH and SRHR issues through increased individual agency and self-determination
Outlier clauses, for which there was scant evidence in the review, and which indicate gaps in current evidence	If adolescents have access to information and services adapted to their needs through digital technologies, then this will lead to emergent collective action and demand for accountability and more inclusive decision-making (a seat at the table) leading to a challenge to the status quo and social change
	Co-production of digital technologies will produce a digital engagement space with a diversity of perspectives and enhanced ownership among, leading to adolescents’ empowerment and self-determination
	Production of digital technologies and related content needs to be tailored according to the setting in which the adolescents reside and their subgroup characteristics. These include rural or urban contexts; urban informal settlements or poor neighbourhoods; age; whether the target group is marginalized and have limited access to digital technologies; and which social media are already in use
Rival clauses, which are in opposition to clauses of the refined programme theory above	Digital technologies are shaped by the prevailing culture and gender norms, and reflect dominant social hierarchies, potentially perpetuating these
	Digital technologies and connectivity are proprietary; they depend on an internet provider providing services to a poor neighbourhood or access to ICT devices, owned by multiple people or a household in poor settings
	Digital technologies can be traced; digital technology is increasingly used by states for surveillance of communities and specific groups, marginalized groups for example men having sex with men might be subject to surveillance or have their privacy compromised