Seeing things differently: Expert and consumer mental models evaluating combined oral contraceptives

Relationship between classic indicators of health behaviour and contraceptive choices in women in Flanders

BACKGROUND

In this study we shed light on ongoing trends in contraceptive use in Flanders (Belgium). Building on the fundamental cause theory and social diffusion of innovation theory, we examine socio-economic gradients in contraceptive use and the relationship to health behaviours.

METHODS

Using the unique and recently collected (2020) ISALA data, we used multinomial logistic regression to model the uptake of contraceptives and its association to educational level and health behaviour (N:4316 women).

RESULTS

Higher educated women, and women with a healthy lifestyle especially, tend to use non-hormonal contraceptives or perceived lower-dosage hormonal contraceptives that are still trustworthy from a medical point of view. Moreover, we identified a potentially vulnerable group in terms of health as our results indicate that women who do not engage in preventive health behaviours are more likely to use no, or no modern, contraceptive method.

DISCUSSION

The fact that higher educated women and women with a healthy lifestyle are less likely to use hormonal contraceptive methods is in line with patient empowerment, as women no longer necessarily follow recommendations by healthcare professionals, and there is a growing demand for naturalness in Western societies.

CONCLUSION

The results of this study can therefore be used to inform policy makers and reproductive healthcare professionals, since up-to-date understanding of women's contraceptive choices is clearly needed in order to develop effective strategies to prevent sexually transmitted infections and unplanned pregnancies, and in which women can take control over their sexuality and fertility in a comfortable and pleasurable way.

Evaluating the Mental Models Approach to Developing a Risk Communication: A Scoping Review of the Evidence

Risk communication is fundamental in ensuring people are equipped with the knowledge needed to navigate varied risks. One generally well-regarded framework for the development of such communications is the mental models approach to risk communication (MMARC). Developed during the 1990s, the MMARC has been applied to a range of health, technological, and environmental risks. However, as yet, we know of no attempt to collate and review articles that evaluated communications developed using the MMARC. This article took a first step at addressing this gap by conducting a scoping review that aimed to begin to explore the fidelity with which the approach has been applied, explore whether there appeared to be sufficient studies to warrant a future systematic review, and identify future research questions. Although the initial search found over 100 articles explicitly applying the MMARC, only 12 of these developed a risk-related communication that was tested against a control (and thus included in the current review). All studies reported a positive effect of the MMARC versus control communication for at least some of the outcome measures (knowledge being the most prevalent). However, there was wide variation between studies including type of control, outcomes assessed, and only five studies reported adopting a randomized design. The review highlights both the need for greater fidelity in the way future studies operationalize the MMARC approach, and suggests that a full-scale systematic review of the MMARC literature appears justified, especially given the possibility of a large gray literature in this area.

Public health messages about perinatal marijuana use in an evolving policy context

BACKGROUND

Marijuana is a commonly used substance in pregnancy in the United States. It is unknown what public health messages about perinatal marijuana use are being disseminated in the changing policy landscape.

METHODS

The authors systematically searched 51 state and 5 federal public health agencies' Web sites in February 2016 for information about perinatal marijuana use. Of these, 1 federal agency and 10 state agencies had published information about perinatal marijuana use. Content analysis was performed by 2 investigators, with excellent interrater reliability (mean κ = 0.87).

RESULTS

Most content was targeted to the public, although 3 agencies had content targeted to health care providers. Common messages about health effects included adverse outcomes in infants and children exposed in utero and that marijuana can be passed via breast milk to infants. Eight sites mentioned health effects of marijuana use during breastfeeding, 5 included resources to stop using marijuana, 5 mentioned implications of marijuana use for infant safety, and 3 mentioned potential legal consequences.

CONCLUSIONS

The volume of public health messages about perinatal marijuana use is low, content of messages differs across state agencies, and perinatal marijuana is seldom addressed in content published by federal agencies.