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Laestadius LI, Van Hoorn K, Wahl M, Witt A, Carlyle KE, Guidry JPD. Promotion of an Algorithm-Based Tool for Pregnancy Prevention by Instagram Influencers. J Womens Health (Larchmt) 2024; 33:141-151. [PMID: 37976205 DOI: 10.1089/jwh.2023.0251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Objective: Despite growing concerns that some digital algorithm-reliant fertility awareness-based methods of pregnancy prevention are marketed in an inaccurate, opaque, and potentially harmful manner online, there has been limited systematic examination of such marketing practices. This article therefore provides an empirical examination of how social media influencers have promoted the fertility tracking tool Daysy on Instagram. We investigate: (1) how the tool is framed in relation to pregnancy prevention using Health Belief Model (HBM) constructs, and (2) the promotional and disclosure practices adopted by influencers. Materials and Methods: We collected Instagram posts mentioning Daysy made between June 2018 and May 2022 using the tool CrowdTangle. Using a qualitative content analysis approach, we coded a random sample of 400 Daysy posts. This yielded 122 Instagram influencer posts promoting Daysy for pregnancy prevention that we coded for promotional content and HBM constructs. Results: Posts originated primarily from Europe (n = 62, 50.82%) and the United States (n = 37, 30.33%). Findings indicate that barriers to use (n = 18, 15.57%) and the severity of risks from unplanned pregnancy (n = 8, 6.56%) were rarely conveyed, whereas benefits of use (n = 122, 100%) and the severity of risks of hormonal contraception (n = 31, 25.41%) were covered more extensively. Only about one third of posts disclosed any formal relationship to the brand Daysy. Conclusions: With many posts emphasizing benefits and obscuring potential limitations, we argue that accurate and transparent information about the effectiveness and limitations of fertility tracking technologies is critical for supporting informed decision-making and, as such, should remain a public health priority.
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Affiliation(s)
- Linnea I Laestadius
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Kelsey Van Hoorn
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Megan Wahl
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Alice Witt
- Social and Global Studies Centre, School of Global, Urban and Social Studies, RMIT University, Melbourne, Australia
| | - Kellie E Carlyle
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jeanine P D Guidry
- Department Communication and Cognition, Tilburg University, Tilburg, Netherlands
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Barton BE, Erickson JA, Allred SI, Jeffries JM, Stephens KK, Hunter MI, Woodall KA, Winuthayanon W. Reversible female contraceptives: historical, current, and future perspectives†. Biol Reprod 2024; 110:14-32. [PMID: 37941453 PMCID: PMC10790348 DOI: 10.1093/biolre/ioad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
Contraception is a practice with extensive and complicated social and scientific histories. From cycle tracking, to the very first prescription contraceptive pill, to now having over-the-counter contraceptives on demand, family planning is an aspect of healthcare that has undergone and will continue to undergo several transformations through time. This review provides a comprehensive overview of current reversible hormonal and non-hormonal birth control methods as well as their mechanism of action, safety, and effectiveness specifically for individuals who can become pregnant. Additionally, we discuss the latest Food and Drug Administration (FDA)-approved hormonal method containing estetrol and drospirenone that has not yet been used worldwide as well as the first FDA-approved hormonal over-the-counter progestin-only pills. We also review available data on novel hormonal delivery through microchip, microneedle, and the latest FDA-approved non-hormonal methods such as vaginal pH regulators. Finally, this review will assist in advancing female contraceptive method development by underlining constructive directions for future pursuits. Information was gathered from the NCBI and Google Scholars databases using English and included publications from 1900 to present. Search terms included contraceptive names as well as efficacy, safety, and mechanism of action. In summary, we suggest that investigators consider the side effects and acceptability together with the efficacy of contraceptive candidate towards their development.
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Affiliation(s)
- Brooke E Barton
- School of Medicine, University of Washington, Seattle, WA, USA
| | - Jeffery A Erickson
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
- Translational Bioscience Program, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Stephanie I Allred
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Jenna M Jeffries
- College of Art & Science, Washington State University, Pullman, WA, USA
| | - Kalli K Stephens
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
- Translational Bioscience Program, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Mark I Hunter
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Kirby A Woodall
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Wipawee Winuthayanon
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
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Manzer JL, Berndt VK, Bell AV. Intersections between culture, contraception, knowledge and the body in the USA. CULTURE, HEALTH & SEXUALITY 2023; 25:1164-1179. [PMID: 36327491 DOI: 10.1080/13691058.2022.2141330] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Women's contraceptive use is a central feature of US culture around reproduction as evinced by high usage rates and nationwide public health efforts to further increase its use. Paradoxically, women know little about contraception within its biomedical framing, and successive public health-related educational campaigns have produced only moderate knowledge gains. Drawing on 86 in-depth interviews with a diverse sample of reproductive-age women, we set out to understand this persistent learning lag. In doing so, we found that women's limited contraceptive knowledge extended beyond simply being uneducated about various methods. Rather, these learning lags can be attributed to many women's lack of knowledge or misunderstandings about their anatomical bodies and reproductive processes. Employing feminist perspectives, we argue that these misunderstandings derive from factors beyond individual women's control. Indeed, they are rooted in cultural norms that stifle and stigmatise women's reproductive learning. Traditional public health efforts may inevitably fail to overcome these cultural barriers, perpetuating women's gaps in knowledge. Recognising the cultural dimensions of contraceptive knowledge and education reveals how critical action is needed around sexuality education in the USA as well as the limitations of on-going educational efforts.
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Ayala-Ramirez M, Grewe ME, Kaiser J, Kennedy E, Winn M, Urrutia RP. Understanding the perspective of women who use the Billings Ovulation Method®: a focus group study. BMC Womens Health 2023; 23:251. [PMID: 37161466 PMCID: PMC10170796 DOI: 10.1186/s12905-023-02398-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/27/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND The Billings Ovulation Method®(the Billings Method) is a fertility awareness-based method (FABM) of family planning that relies on the observation of patterns of fertility and infertility based on vulvar sensations and appearance of discharges. This allows people to choose when to have intercourse, depending on whether they want to avoid or achieve pregnancy. Few studies have documented user experiences with FABMs. METHODS We conducted four virtual focus groups (FGs) in May and June 2021 with current adult women users of the Billings Method. We asked questions about users' reasons for selecting a FABM and the Billings Method, positive experiences and challenges learning and using the Billings Method, and suggestions for improving the user experience. We performed a content analysis of the transcribed FGs to explore key themes from the discussions. COREQ guidelines were followed. RESULTS Twenty women between the ages of 23 and 43 participated in the FGs. Reasons women described choosing a FABM included to follow religious beliefs, to avoid side effects of hormonal contraception, and/or to learn more about their bodies. Reasons for selecting the Billings Method included perceiving it as more precise and easier to understand than other FABMs, having a scientific basis, and being recommended by family and friends. Experiences related to learning and using the Billings Method were mainly positive. They included finding the method easy to use and learn, successfully using it to either postpone or achieve a pregnancy and increasing their awareness of their bodies. Challenges for participants included the inherent learning curve for identifying sensations at the vulva and the required periods of abstinence. Participants provided suggestions and recommendations for improving users' experience, including raising awareness of the Billings Method among healthcare providers. CONCLUSIONS Users of the Billings Method expressed an overall positive experience when learning and using it for family planning and body awareness. Some challenges were identified that offer opportunities to improve how the Billings Method is taught and delivered. These findings can also enhance healthcare providers' interactions with FABM users, including those of the Billings Method.
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Affiliation(s)
- Montserrat Ayala-Ramirez
- Billings Ovulation Method Association, St. Cloud, MN, United States of America.
- Present Address: Office of Outreach and Health Disparities. One Baylor Plaza, Suite 450A, Houston, TX, 77030-3411, United States of America.
| | - Mary E Grewe
- North Carolina Translational and Clinical Sciences (NC TraCS) Institute, University of North Carolina, Chapel Hill, NC, United States of America
| | - Julie Kaiser
- Billings Ovulation Method Association, St. Cloud, MN, United States of America
| | - Emily Kennedy
- Billings Ovulation Method Association, St. Cloud, MN, United States of America
- Reply Fertility, PLLC, Cary, NC, United States of America
| | - Martha Winn
- Billings Ovulation Method Association, St. Cloud, MN, United States of America
| | - Rachel Peragallo Urrutia
- Reply Fertility, PLLC, Cary, NC, United States of America
- Department of Obstetrics and Gynecology, The University of North Carolina, Chapel Hill, NC, United States of America
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