Measurement of Social Norms Affecting Modern Contraceptive Use: A Literature Review

Abstract

As a critical building block to developing social norms interventions to support healthy family planning and other reproductive health behaviors, we conducted a literature review to identify and evaluate social norm measures related to modern contraceptive use. Of 174 articles reviewed in full, only 17 studies met our criteria for inclusion. Across these articles, no single measure of norms was used in more than one study; failure to specify the boundaries of who was engaging in and influencing the behaviors of interest contributed to the variation. Most of the studies relied on cross-sectional data, only included condom use as their contraceptive use outcome, used individual- or interpersonal-level behavior change theories rather than social-level theories, and assumed a reference group, all of which limit the quality of the norm measures. We make several recommendations to bring greater consistency and comparability to social norm measures.

Mapping the patchwork: Exploring the subnational heterogeneity of child marriage in India

“…As an alternative, researchers can generate data with behavioral or attitudinal measures across more crude social units from which social ties can be inferred, such as across residents of the same village or neighborhood to determine whether there is inter-cluster variation. High levels of variation across these spatial units can be viewed as evidence of variability in norms, and may indeed capture collective, or community, norms ( Mackie et al, 2015 ; Shakya et al, 2019 ; Costenbader, Lenzi, Hershow, Ashburn, & McCarraher, 2017 ; Lapinski & Rimal, 2005 ; Sedlander & Rimal, 2019 ; Shulman & Levine, 2012 ). This same principle holds true for spatial heterogeneity.…”

Getting to intent: Are social norms influencing intentions to use modern contraception in the DRC?

“…Currently, there are a growing number of interventions designed to counter such social norms [14]. However, to date, the evidence base upon which these interventions are being designed and evaluated is small, resulting largely from the fact that the measurement of social norms has lagged behind [15, 16]. In partnership with a team of global health experts—Georgetown’s Institute for Reproductive Health (IRH), FHI 360, Johns Hopkins Global Early Adolescent Study (GEAS), Population Services International (PSI), Save the Children, and Tearfund—the Passages Project is working to establish an evidence base on scalable social norm change approaches that reduce stigma and myths related to FP use, increase male engagement in FP, reduce sexual and GBV, and improve gender-equitable attitudes and behaviors.…”

Beyond Individual-Level Theorizing in Social Norms Research: How Collective Norms and Media Access Affect Adolescents' Use of Contraception

“…The study of norms has been gaining significant momentum recently, one of the key findings from that work, as revealed by a systematic review of the norms literature, is the almost exclusive focus of studies at the individual level, with little attention being paid to factors at the sociocultural levels [14], [15], [16]. Authors of that review call for studies that conceptualize and assess contraceptive use norms beyond the individual level; this article responds to that call.…”