How effective are online groups at disseminating contraceptive information?

Online communication provides an empowering environment for the exchange of accurate and useful contraceptive information, when based on real user experiences, according to the results of a blinded, randomized controlled trial in the journal Contraception. 

“Some women may face barriers to considering the full range of contraceptive methods because of lack of knowledge or perceptions of social norms that do not support the use of specific methods,” said principal investigator Christine Dehlendorf, MD, director of the Person-Centered Reproductive Health Program at the University of California, San Francisco. “We were interested in understanding whether online social communication between users of an intrauterine device (IUD) and non-users could decrease barriers to women contemplating use of this method, including lack of information and perceptions of negative social norms about IUDs.”

Methods
The study enrolled 488 women aged 18 to 45 who were living in the United States and had never used an IUD. Subjects participated in one of 70 groups of an online program called Birth Control Connect between October 2015 and April 2016. The women were randomized to either online discussion groups with IUD users (intervention group; n = 174) or to online discussion groups without IUD users (control group; n = 314).

Each study participant joined a nine-member, online discussion group for 2 weeks. The discussion groups for the intervention participants comprised four satisfied IUD users and five IUD non-users, whereas the control participants consisted of nine IUD non-users. 

Findings
The study found increased positive attitudes towards the IUD in the intervention arm: a 0.65-point increase (on a scale of 0-10) between pre- and post-surveys, versus only a 0.05 mean point increase in the control arm (P= 0.03 for a hormonal IUD, with a trend in the same direction for a non-hormonal IUD). 

Informational support also increased in both groups, but participants in the intervention arm were more likely to self-report that they gained a better appreciation of what it would be like to have an IUD: 70.3% vs. 51.3%, respectively (P< 0.01). Similarly, 63.3% of intervention participants, compared to 51.3% of control participants, reported gaining new IUD information from their respective groups (P= 0.03). 

However, there were no differences in correct responses to knowledge items or information-seeking between the two groups.

Conclusions
“We did not find any impact on use of IUDs, which is not surprising, given the short time line of the study,” Dr. Dehlendorf told Contemporary OB/GYN. “But the findings about normative attitudes and information support are more consistent with a patient-centered approach focusing on people’s ability to consider the full range of contraceptive options that may be acceptable to them, and suggest the value of social communication interventions to decrease barriers to contraceptive use.”

Development and dissemination of online social communication programs devoted to contraception use has the potential to expand awareness about and increase women’s ability to consider a greater number of contraceptive options, according to Dr. Dehlendorf.

“Future interventions can build upon our findings to design online peer-based communications that foster conversation about the full range of options and represent a broader range of experiences with method use, to allow for access to methods that are most aligned with individual values and preferences,” she said.

In addition, interventions aimed at harnessing social communication about user experiences with lesser-known contraceptive methods, including newly approved methods, through structured online conversations may be worthwhile.