What is the place of interactive decision-aids for contraception in primary care?

Problem

An estimated 40% of pregnancies are unplanned globally, and this has a huge impact on health, wealth, and the environment. Women may not be aware of the range of different contraception methods available, and frequently have questions and concerns which are not be raised and addressed in consultation. Aim: To analyse women’s views of the Contraception Choices website, and explore the place of digital interventions for contraception choice in primary care

Approach

We conducted a systematic literature review, analysed YouTube videos, and held focus groups and interviews with young women, to explore barriers and facilitators to contraception choice, uptake and use. This information (women’s perspectives, evidence-based information about contraception, and behaviour change theory) informed the content of the Contraception Choices website www.contraceptionchoices.org. We conducted qualitative interviews after women had had access to the Contraception Choices website (n=18 interviews). We used a semi-structured topic guide to explore their views of the website, and views of the place of digital interventions in contraception care. We audio-recorded and transcribed the interviews, and analysed data thematically.

Findings

The Contraception Choices website was designed in collaboration with young women. The website is an interactive digital intervention (IDI) which aims to increase satisfaction with choice of contraception method and encourage uptake of more effective methods of contraception. The site addresses the benefits and drawbacks of 12 different methods, and provides tailored suggestions for contraception which address women’s concerns and preferences. The website features videos, succinct text, infographics, and an interactive decision aid which offers three tailored contraception method recommendations.Women liked the website, trusted the information, and appreciated honesty about the pros and cons of contraception. They liked the convenience of online access, and said that the website gave them more confidence to discuss contraception with health professionals. The website helped to address doubts and concerns, and prompted reflection about contraception choice. Women felt that the website would be useful before, during or after consultations.

Consequences

Digital interventions can play a part in facilitating informed choice of contraception method, to empower women to make decisions to enhance their health and well-being.