Intervention does not improve contraceptive communication between teenagers
A study in the journal contraception concluded that performing the SpeakOut intervention remotely did not improve communication, knowledge, or contraceptive use among the participating adolescents or their peers.1
The intervention combines structured counseling, online resources, and text reminders to encourage adolescents to share their experience of using intrauterine contraception (IUC) or an implant with their peers.
“Despite the decline in teenage pregnancy rates in the United States, rates remain higher than any other developed country,” said senior author Kathleen Tebb, PhD, professor of pediatrics and adolescent medicine at the University of California at San Francisco. “We know that adolescent peers play an important role in influencing attitudes and behavior, and that social communication influences decision-making about contraception.”
However, Tebb found that teens are often misinformed about contraception and that information from their peers is more negative than positive.
“But not much research or attention has been devoted to contraceptive peer-to-peer communication interventions; So we started this study to fill this gap, ”said Tebb Contemporary obstetrics / gynecology®.
The study included 520 female adolescents, ages 15-19, who were recruited via social media from 21 states and the District of Columbia between February and July 2019.
Primary participants were randomly assigned to receive SpeakOut or an alertness control on alcohol use. Each participant in turn recruited secondary female peers and formed clusters of up to 5 peers for a total of 581 peers.
The study’s primary outcome regarding contraceptive use by secondary participants was similar between the two groups at both 3 and 9 months post-intervention.
Compared to controls, however, the primary participants who received SpeakOut were less likely to discontinue contraception within 9 months, although the difference was not statistically significant: for IUC 4.8% for SpeakOut vs. 7.8% for the controls (P. = 0.11) and for implants each 7.8% vs. 9.8% (P. = 0.45).
But SpeakOut failed to increase contraceptive communication among peers: 86% communication rate for SpeakOut vs. 88% for controls (P. = .57).
However, the vast majority of secondary participants were aware of the hormonal intensive care unit, copper IUC, and implant 3 months after enrollment in the study, regardless of the intervention the primary participants received.
“We were surprised that the SpeakOut intervention did not improve knowledge, communication, or use of contraception in adolescents,” said Tebb. In contrast, our team’s pilot study conducted in 8 Planned Parenthood clinics in California showed SpeakOut, if hand-delivered, the use of contraceptives by peers increased at the 3-month follow-up examination. This difference could be due to the fact that contraceptive use by peers was initially high in our current study, so a “ceiling effect” likely limited our ability to see an intervention effect. “
According to Tebb, teens still need access to accurate, evidence-based and confidential information and contraception services.
“While SpeakOut remote access did not improve communication, knowledge, or contraceptive use among the participants and their colleagues in our study, additional research is needed to understand this finding, particularly because knowledge of contraception was inadequate in both study groups was, ”said Tebb. “Efforts to help teenagers communicate about contraception and ensure that teenagers have accurate information about the full range of contraceptive methods, including highly effective reversible contraceptives, need refining.”
Although peers are an important source of information about contraception, “health care providers continue to play a critical role,” Tebb said. “Additional innovative and complementary strategies are needed to improve adolescents ‘knowledge of the full range of contraceptive methods and to support adolescents’ use of the desired contraceptives.”
Tebb and her research team achieved some success with an interactive and individually tailored computer intervention prior to the visit. Health-E Du / Salud iTu, Educate and support adolescents in the choice of contraceptives and facilitate the provision of patient-centered contraception services.
Tebb does not report any relevant financial information.
1. Tebb KP, Dehlendorf C, Rodriguez F, et al. Promote contraceptive communication between teenagers Express Intervention, a randomized cluster study. contraception. Published online September 11, 2021. doi: org / 10.1016 / j.contraception.2021.08.018