An interactive website to aid young women's choice of contraception: feasibility and efficacy RCT

Content and quality of YouTube regarding women's health: a scoping review

PURPOSE

This scoping review investigated the content and quality of YouTube videos on women's health.

METHODS

A literature search of the Cochrane Library, PubMed, Embase, CINAHL, ERIC, and RISS databases was performed using the keywords "('youtube'/exp OR youtube OR 'social media'/ exp OR 'social media' OR (('social'/exp OR social) AND ('media'/exp OR media))) AND ('female health care' OR (('female'/exp OR female) AND ('health'/exp OR health) AND ('care'/exp OR care)))" from February 21 to 27, 2023. Peer-reviewed analytic studies in English or Korean that focused on women's health using YouTube were included.

RESULTS

The review identified 21 articles that covered various themes related to women's health, such as breast cancer, urinary disease, sexual health, pelvic organ prolapse, the human papillomavirus vaccine, Papanikolaou smears, contraception, women's health information during the coronavirus disease 2019 pandemic, obstetric epidural anesthesia, and placenta accreta. However, the overall quality of the content was low, inaccurate, unreliable, and misleading.

CONCLUSION

This scoping review demonstrated that YouTube videos on women's health covered diverse topics, but the quality of the content needed improvement. More reliable and high-quality videos produced by academic institutes and healthcare professionals specializing in women's health are needed for social media to be usable as a reliable source of women's health information. The high number of views and shares received by the videos underscores the importance of providing accurate and reliable information on women's health.

Effects of technology-based contraceptive decision aids: a systematic review and meta-analysis

OBJECTIVE

This study aimed to conduct a systematic review and meta-analysis of the effects of technology-based decision aids on contraceptive use, continuation, and patient-reported and decision-making outcomes.

DATA SOURCES

A systematic search was conducted in OVID MEDLINE, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, Embase, PsycINFO, and SocINDEX databases from January 2005 to April 2022. Eligible references from a concurrent systematic review evaluating contraceptive care were also included for review.

STUDY ELIGIBILITY CRITERIA

Studies were included if a contraceptive decision aid was technology-based (ie, mobile/tablet application, web, or computer-based) and assessed contraceptive use and/or continuation or patient-reported outcomes (knowledge, self-efficacy, feasibility/acceptability/usability, decisional conflict). The protocol was registered under the International Prospective Register of Systematic Reviews (CRD42021240755).

METHODS

Three reviewers independently performed data abstraction and quality appraisal. Dichotomous outcomes (use and continuation) were evaluated with an odds ratio, whereas continuous outcomes (knowledge and self-efficacy) were evaluated with the mean difference. Subgroup analyses were performed for the mode of delivery (mobile and tablet applications vs web and computer-based) and follow-up time (immediate vs >1 month).

RESULTS

This review included 18 studies evaluating 21 decision aids. Overall, there were higher odds of contraceptive use and/or continuation among decision aid users compared with controls (odds ratio, 1.27; 95% confidence interval, [1.05-1.55]). Use of computer and web-based decision aids was associated with higher odds of contraceptive use and/or continuation (odds ratio, 1.36; 95% confidence interval, [1.08-1.72]) than mobile and tablet decision aids (odds ratio, 1.27; 95% confidence interval, [0.83-1.94]). Decision aid users also had statistically significant higher self-efficacy scores (mean difference, 0.09; 95% confidence interval, [0.05-0.13]), and knowledge scores (mean difference, 0.04; 95% confidence interval, [0.01-0.07]), with immediate measurement of knowledge having higher retention than measurement after 1 month. Other outcomes were evaluated descriptively (eg, feasibility, applicability, decisional conflict) but had little evidence to support a definite conclusion. Overall, the review provided moderate-level evidence for contraceptive use and continuation, knowledge, and self-efficacy.

CONCLUSION

The use of technology-based contraceptive decision aids to support contraceptive decision-making has positive effects on contraceptive use and continuation, knowledge, and self-efficacy. There was insufficient evidence to support a conclusion about effects on other decision-making outcomes.

Participant views and experiences of sexual health research: The Contraception Choices online trial

BACKGROUND

Online sexual health research can be convenient, efficient and low cost, but there are debates about the adequacy of online informed consent, privacy, and the acceptability of different methods of follow-up.

OBJECTIVES

To explore women's views and experiences of the Contraception Choices feasibility trial procedures and the place of digital interventions for contraception decision making.

METHODS

We analysed data from two sources: (1) Qualitative interviews. Eighteen interviews were conducted with women who had taken part in the Contraception Choices pre-trial feasibility study, to evaluate recruitment and online trial procedures. (2) Free-text comments. Women in the main Contraception Choices randomised controlled trial were followed up at 3 and 6 months, and asked 'Please tell us what you liked or disliked about the website' and 'Has being in the study had any good or bad effects on your life?' A total of 387 and 414 comments were made at 3 and 6 months respectively. Data were analysed thematically.

RESULTS

Participants liked being involved in a study about contraception, although recruitment from an abortion clinic was less acceptable than in other sexual health settings. Women found the trial procedures straightforward, and expressed no major concerns about online self-registration, informed consent or online data collection. Online survey questions about contraception and fertility were acceptable, and participants liked the convenience of being followed up by email or text.

CONCLUSIONS

Participants appreciated the advantages of the online research design and did not express concerns about consent or privacy. Women would welcome digital interventions for contraception in a variety of settings.