Birth Control Connect: A randomized trial of an online group to disseminate contraceptive information

Abstract

Objective: We sought to test whether participation in an online group including IUD users influenced IUD-related knowledge, attitudes, and behavior among IUD non-users, as a proof-ofconcept evaluation of information dissemination for less commonly used or novel contraceptives. Study design: We conducted a blinded, randomized controlled trial on the effect of online communication with IUD users within an online program called Birth Control Connect. Participants were women age 18-45 living in the United States who had never used an IUD. We invited participants randomized to the intervention to join two-week, nine-member discussion groups including four satisfied IUD users and five IUD non-users; we invited control participants to groups including nine IUD non-users. We performed chi-squared tests on IUD knowledge, information-seeking, informational support and use in immediate post-surveys, and t-tests comparing change in IUD attitudes and frequency of logins to discussion groups. Results: We invited 488 IUD non-users and enrolled them into 70 groups between October 2015 and April 2016. We found increased positive attitudes towards the IUD in the intervention arm (0.65-point increase between pre-and post-surveys, versus 0.05 mean change for control arm, p = 0.03 for hormonal IUD, with a trend in the same direction for the non-hormonal IUD). Informational support also increased, with 70.3% of intervention arm participants self-reporting that they gained a better idea of what the IUD would be like, compared to 51.

Attitudes Toward the Copper IUD in Sweden: A Survey Study

“…Attention is directed at the evaluation of the reliability of different sources of knowledge and at any mentions of unestablished, systemic side effects, as well as at any correlations between negative attitudes toward or experiences of the IUD and sociodemographic characteristics or levels of trust in sources of information. This is in line with research highlighting the need to study factors influencing women's contraceptive choices, including women's experiences of and attitudes toward contraceptives (16,21,62), not least due to the noted importance of informal social communication for such choices (70).…”

“…Previous findings that social networks have importance for choices of and attitudes toward contraceptives (16,22,28,29,70), that women often use a combination of sources of information about the copper IUD (16,22), and that some women consider accounts about the IUD provided via social contacts to be more reliable than information provided by healthcare professionals (22,30,32) find some support in the present study. Those with negative attitudes and unwillingness toward future use of the copper IUD, as well as those referring to systemic side effects, reported having taken part of the information about risks associated with the IUD from healthcare providers as well as from CAM sources and other individuals to a larger degree than those not reporting negative attitudes or experiences or mentioning unestablished side effects.…”

“…Moreover, while many studies on attitudes toward IUDs emphasize the importance of countering negative stories, expressed via social networks not least online, through countering misinformation (22,30,32) and relaying positive experiences of the IUD (22,70), several survey respondents called for more or improved information, including updated research from healthcare professionals (17).…”

“…A motivation for emphasizing the importance of communicating positive information about the IUD is the observation that negative stories or experiences tend to be regarded as more noteworthy and memorable and have a greater effect on prospective user attitudes than positive ones (22,70). While this is likely true, IUD discontinuation has been associated with not feeling sufficiently informed about potential side effects (14,77), with feeling that experienced side effects were minimized by healthcare providers, and not feeling listened to or respected in the clinical encounter, for example, when requesting IUD removal (78).…”

Population attitudes toward contraceptive methods over time on a social media platform

“…19 Studies have also shown that sharing information about long-acting reversible contraception (LARC) on social media has increased individual preferences for LARC methods. 20,21 Despite the literature demonstrating the presence and influence of contraception-and sexual health-related content on social media sites, large-scale comparison of attitudes toward individual contraceptive methods on social media has yet to be undertaken. Twitter, a social networking site with over 330 million monthly users worldwide, is an ideal platform for studying contraceptive attitudes, owing to its widespread use and influence.…”