Promoting teen-to-teen contraceptive communication with the SpeakOut intervention, a cluster randomized trial.

Kathleen P Tebb, Christine Dehlendorf, Felicia Rodriguez, Margaret Fix, Daniel J Tancredi, Reiley Reed, Claire D Brindis, Eleanor Bimla Schwarz

Journal: Contraception 2022;105():80-85

PMID: 34520728

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVES

To improve teen contraceptive use, the SpeakOut intervention combines structured counseling, online resources, and text reminders to encourage teens to share their experiences using intrauterine contraception (IUC) or an implant with peers.

STUDY DESIGN

To evaluate the effectiveness of remote delivery of the SpeakOut intervention in increasing teen contraceptive use, we conducted a cluster randomized trial involving female adolescents who were recruited online. Primary participants (n = 520) were randomly assigned to receive SpeakOut or an attention control; each primary participant recruited a cluster of up to 5 female peers as secondary participants (n = 581). We assessed contraceptive communication, knowledge, and use, at baseline, 3 and 9 months after participants enrolled. We examined differences between study groups, controlling for clustering by primary participant and baseline characteristics.

RESULTS

The trial's primary outcome, contraceptive use by secondary participants, was similar between groups at both 3 and 9 months postintervention. Compared to controls, primary participants receiving SpeakOut tended to be less likely to discontinue contraception within 9 months (4.8% vs 7.8%, p = 0.11 for IUC; 7.8% vs 9.8%, p = 0.45 for implants), but this did not reach statistical significance. SpeakOut failed to increase contraceptive communication; regardless of study group, most secondary participants reported peer communication about contraception (86% vs 88%, p = 0.57). Most secondary participants were aware of the hormonal IUC (91.4% vs 90.4%, p = 0.72), copper IUC (92.9% vs 88.6%, p = 0.13), and implant (96.5% vs 96.1%, p = 0.83) 3 months after enrolling, regardless of the intervention their primary participant received. However, contraceptive knowledge remained incomplete in all study groups.

CONCLUSION

Remote delivery of the SpeakOutintervention did not improve contraceptive communication, knowledge or use among participating teens or their peers.

IMPLICATIONS

Efforts to support teen-to-teen contraceptive communication and ensure that teens have accurate information about the full range of contraceptive methods, including highly effective reversible contraceptives, require refinement.

Address: Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States.; Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, United States.; Center for Healthcare Policy and Research, University of California, Sacramento, CA, United States.; Center for Healthcare Policy and Research, University of California, Sacramento, CA, United States; Davis Department of Pediatrics, University of California, Sacramento, CA, United States.; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States.; Center for Healthcare Policy and Research, University of California, Sacramento, CA, United States. Electronic address: [email protected].

DOI: 10.1016/j.contraception.2021.08.018

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MeSH Terms: Adolescent, Communication, Contraception, Contraceptive Agents, Counseling, Female, Humans, Intrauterine Devices