Contraception Choices: design and development of an interactive website

Problem

Women have many concerns about contraception which can put them off choosing and using reliable methods. Long-acting contraceptive (LARC) methods such as the implant, injection and coil are much more effective than options such as the pill, but fears or misunderstandings about contraception may deter women from choosing an effective method. Women may be worried about known side effects, but many other concerns are myths or misunderstandings. Women's concerns may not surface in consultations with health professionals, especially if services are over-stretched. Increasingly women turn to the Internet for information on health and to discuss issues with others: an online intervention can offer convenient help with decisions. We describe the design and development of the Contraception Choices website which addresses powerful myths and misconceptions about contraception, and provides individually tailored recommendations for contraceptive methods.

Approach

Aim: To describe the evidence base and theoretical rationale for the design of the Contraception Choices website. ApproachWe gathered evidence from several sources to inform the website design and content: 1) A qualitative synthesis of systematic reviews of factors influencing contraceptive choice (women’s views and explanatory theoretical frameworks) 2) A meta-analysis of randomised controlled trials of interactive digital interventions for contraceptive decision-making 3) A narrative synthesis of reviews of interventions for contraceptive decision-making. 4) Views on contraception expressed on YouTube (35 videos)5) Seven focus groups with 50 women aged 15 to 30 recruited in clinic and pharmacy settings, to explore their beliefs and concerns about contraception, and their suggestions for website contentYouTube videos and qualitative data were analysed thematically. Themes from the qualitative field work and findings from the reviews of evidence were tabulated, and we discussed each theme to consider the implications for the design of the Contraception Choices website. Design ideas were presented to 25 young women, and the website design and content was adapted in the light of their views.

Findings

The most common myths and misconceptions about contraception include worries about hormones being unnatural, weight gain, altered bleeding patterns, cancer and future infertility. The Contraception Choices website addresses women’s concerns through videos of health professionals and of young women, method-specific information (including a ‘Did you know?’ section), and an interactive tool which gives tailored suggestions for contraceptive methods (‘What’s right for me?’).

Consequences

The Contraception Choices website design and rationale will be presented, highlighting the way that the intervention addresses women’s views and concerns. The website will be tested in a pilot randomised controlled trial starting in March 2017.