Abstract
Introduction: In South Carolina, 50% of all pregnancies are unintended. Intrauterine devices (IUDs) and the implant are recommended as top-tier contraceptive options for all women and adolescents. The Whoops Proof S.C. campaign was evaluated to determine if women (ages 18 to 29) who do not intend to become pregnant in the next year report greater awareness of and positive regard for IUDs and the implant after exposure to a multi-channel campaign. Methods: A pair-matched group pretest–posttest quasi-experimental design was utilized. A total of 1,439 women responded to the pretest survey (May–July 2016) and 1,534 responded to the posttest survey (October–November 2016) in four South Carolina counties. Statistical analysis include paired-sample and independent t-tests and one-way ANOVA tests for variance. Results: At posttest, intervention county participants were significantly more likely to recall messaging and to report receiving contraceptive information from Whoops Proof S.C (t(1533)= − 8.466, p < .0001). Participants who saw ads more than once per week reported a significant increase in awareness of IUDs and the implant (F(6,1532) = 5.571; p < .001). Participants in intervention counties reported a significant increase in positive attitudes toward IUDs (t(616) = − 1.740; p = .041) and the implant (t(603)= − 1.665; p = .048). Discussion: The Whoops Proof S.C. campaign offers strategies to campaign planners and health care providers to optimize exposure and recall frequency to increase awareness of and positive regard for highly effective contraceptive methods. Campaign planners should test messages and focus on communication channels to increase engagement and avoid saturation.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
Power analysis calculated using G*Power 3.1.9.2. Power calculation assumes required significance level α = 0.05, statistical power 1 − β = 0.95, and population effect size = 0.5.
References
ACOG. (2015). Increasing access to contraceptive implants and intrauterine devices to reduce unintended pregnancy. Committee Opinion, 642. http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/Increasing-Access-to-Contraceptive-Implants-and-Intrauterine-Devices-to-Reduce-Unintended-Pregnancy.
Andersen, P. A., Buller, D. B., Voeks, J. H., Walkosz, B. J., Scott, M. D., Cutter, G. R., & Dignan, M. B. (2008). Testing the long-term effects of the Go Sun Smart worksite health communication campaign: A group-randomized experimental study. Journal of Communication, 58(3), 447–471. https://doi.org/10.1111/j.1460-2466.2008.00394.x.
Anderson, N., Steinauer, J., Valente, T., Koblentz, J., & Dehlendorf, C. (2014). Women’s social communication about IUDs: A qualitative analysis. Perspectives on Sexual and Reproductive Health, 46(3), 141–148. https://doi.org/10.1363/46e1814.
Bajos, N., Leridon, H., Goulard, H., Oustry, P., & Job-Spira, N. (2003). Contraception: from accessibility to efficiency. Human Reproduction, 18(5), 994–999. https://doi.org/10.1093/humrep/deg215.
Black, K., Lotke, P., Buhling, K. J., & Zite, N. B. (2012). A review of barriers and myths preventing the more widespread use of intrauterine contraception in nulliparous women. The European Journal of Contraception and Reproductive Health Care, 17(5), 340–350. https://doi.org/10.3109/13625187.2012.700744.
Blunt-Vinti, H. D., Thompson, E. L., & Griner, S. B. (2018). Contraceptive use effectiveness and pregnancy prevention information preferences among heterosexual and sexual minority college women. Women’s Health Issues, 28(4), 342–349. https://doi.org/10.1016/j.whi.2018.03.005.
Brucker, C., Karck, U., & Merkle, E. (2008). Cycle control, tolerability, efficacy and acceptability of the vaginal contraceptive ring, NuvaRing: Results of clinical experience in Germany. The European Journal Of Contraception & Reproductive Health Care, 13(1), 31–38. https://doi.org/10.1080/13625180701577122.
Dehlendorf, C., Ruskin, R., Grumbach, K., Vittinghoff, E., Bibbins-Domingo, K., Schillinger, D., & Steinauer, J. (2010). Recommendations for intrauterine contraception: A randomized trial of the effects of patients’ race/ethnicity and socioeconomic status. American Journal of Obstetrics and Gynecology, 203(4), 319.e1–319.e8. https://doi.org/10.1016/j.ajog.2010.05.009.
DeMaria, A. L., Sundstrom, B. L., Moxley, G. E., & Meier, S. (2017). Predicting women’s responses to contraceptive campaign messages. Health Behavior and Policy Review, 4(1), 87–96. https://doi.org/10.14485/HBPR.4.1.10.
Downing, R. A., LaVeist, T. A., & Bullock, H. E. (2007). Intersections of ethnicity and social class in provider advice regarding reproductive health. American Journal of Public Health, 97(10), 1803–1807. https://doi.org/10.2105/AJPH.2006.092585.
Eisenberg, D. L., Secura, G. M., Madden, T. E., Allsworth, J. E., Zhao, Q., & Peipert, J. F. (2012). Knowledge of contraceptive effectiveness. American Journal of Obstetrics and Gynecology, 206(6), 479.e1–479.e9. https://doi.org/10.1016/j.ajog.2012.04.012.
Everett, B. G., McCabe, K. F., & Hughes, T. L. (2017). Sexual orientation disparities in mistimed and unwanted pregnancy among adult women. Perspectives on Sexual & Reproductive Health, 49(3), 157–165. https://doi.org/10.1363/psrh.12032.
Finer, L. B., Jerman, J., & Kavanaugh, M. L. (2012). Changes in use of long-acting contraceptive methods in the United States, 2007–2009. Fertility and Sterility, 98(4), 893–897. https://doi.org/10.1016/j.fertnstert.2012.06.027.
Finer, L. B., & Zolna, M. R. (2011). Unintended pregnancy in the United States: Incidence and disparities, 2006. Contraception, 84(5), 478–485. https://doi.org/10.1016/j.contraception.2011.07.013.
Finer, L. B., & Zolna, M. R. (2016). Declines in unintended pregnancy in the United States, 2008–2011. New England Journal of Medicine. Retrieved from http://www.nejm.org/doi/full/ https://doi.org/10.1056/NEJMsa1506575.
Frost, J. J., Singh, S., & Finer, L. B. (2007). Factors associated with contraceptive use and nonuse, United States, 2004. Perspectives on Sexual and Reproductive Health, 39(2), 90–99. https://doi.org/10.1363/3909007.
Gilliam, M. L., Neustadt, A., Kozloski, M., Mistretta, S., Tilmon, S., & Godfrey, E. (2010). Adherence and acceptability of the contraceptive ring compared with the pill among students: A randomized controlled trial. Obstetrics & Gynecology, 115(3), 503–510. https://doi.org/10.1097/AOG.0b013e3181cf45dc.
Gipson, J. D., Koenig, M. A., & Hindin, M. J. (2008). The effects of unintended pregnancy on infant, child, and parental health: A review of the literature. Studies In Family Planning, 39(1), 18–38.
Goldberg, S. K., Reese, B. M., & Halpern, C. T. (2016). Original article: Teen pregnancy among sexual minority women: Results from the National Longitudinal Study of Adolescent to Adult Health. Journal of Adolescent Health, 59, 429–437. https://doi.org/10.1016/j.jadohealth.2016.05.009.
Guttmacher Institute. (2013). Unintended pregnancy in the United States. Retrieved from http://www.guttmacher.org/pubs/FB-Unintended-Pregnancy-US.html#2.
Guttmacher Institute. (2015a). Contraceptive use in the United States. Guttmacher Institute. Retrieved from http://www.guttmacher.org/pubs/fb_contr_use.html#2.
Guttmacher Institute. (2015b). State facts about unintended pregnancy: South Carolina. Guttmacher Institute. Retrieved from http://www.guttmacher.org/statecenter/unintended-pregnancy/SC.html.
Jones, R. K., & Dreweke, J. (2016). Countering conventional wisdom: New evidence on religion and contraceptive use. Guttmacher Institute. Retrieved from https://www.guttmacher.org/report/countering-conventional-wisdom-new-evidence-religion-and-contraceptive-use.
Keefe, M. (2012). The Iowa initiative to reduce unintended pregnancies. Webinar: Presented at the NWX-OS-OGC-RKVL.
Khajehpour, M., Simbar, M., Jannesari, S., Ramezani-Tehrani, F., & Majd, H. A. (2013). Health status of women with intended and unintended pregnancies. Public Health, 127, 58–64.
LaCaille, L. J., Schultz, J. F., Goei, R., LaCaille, R. A., Dauner, K. N., de Souza, R., … Regal, R. (2016). Go! Results from a quasi-experimental obesity prevention trial with hospital employees. BMC Public Health, 16(171). https://doi.org/10.1186/s12889-016-2828-0.
Moreau, C., Bohet, A., Hassoun, D., Ringa, V., & Bajos, N. (2014). IUD use in France: Women’s and physician’s perspectives. Contraception, 89(1), 9–16. https://doi.org/10.1016/j.contraception.2013.10.003.
Mowery, B. D. (2011). The Paired t-Test. Pediatric Nursing, 37(6), 320–321.
Reger, B., Cooper, L., Booth-Butterfield, S., Smith, H., Bauman, A., Wootan, M. G., … Greer, F. (2002). Wheeling walks: A community campaign using paid media to encourage walking among sedentary older adults. Preventive Medicine, 35, 285–292. https://doi.org/10.1006/pmed.2002.1074.
Rietveld, T., & van Hout, R. (2017). The paired t test and beyond: Recommendations for testing the central tendencies of two paired samples in research on speech, language and hearing pathology. Journal of Communication Disorders, 69, 44–57. https://doi.org/10.1016/j.jcomdis.2017.07.002.
Russo, J. A., Miller, E., & Gold, M. A. (2013). Myths and misconceptions about long-acting reversible contraception (LARC). Journal of Adolescent Health, 52(4), 14–21. https://doi.org/10.1016/j.jadohealth.2013.02.003. Supplement, .
Ryder, K. (2014). Long-acting reversible contraception (LARC): a reproductive justice concern? Feminist Collections: A Quarterly of Women’s Studies Resources, 35(1–2), 15.
Schwarz, E. B., Smith, R., Steinauer, J., Reeves, M. F., & Caughey, A. B. (2008). Measuring the effects of unintended pregnancy on women’s quality of life. Contraception, 78, 204–210. https://doi.org/10.1016/j.contraception.2008.04.120.
Scott, M. D., Buller, D. B., Anderson, P. A., Cutter, G. R., Dignan, M. B., & Walker, B. J. (2008). Go Sun Smart. Communication Education, 57(4), 423. https://doi.org/10.1080/03634520802047378.
Secura, G. M., Allsworth, J. E., Madden, T., Mullersman, J. L., & Peipert, J. F. (2011). The contraceptive CHOICE project: Reducing barriers to long-acting reversible contraception. American Journal of Obstetrics and Gynecology, 203(2), 115.e1–115.e7. https://doi.org/10.1016/j.ajog.2010.04.017.
Smith, A., & Anderson, M. (2018). Social media use in 2018. Pew Research Center. Retrieved from http://www.pewinternet.org/2018/03/01/social-media-use-in-2018/.
Spies, E. L., Askelson, N. M., Gelman, E., & Losch, M. (2010). Young women’s knowledge, attitudes, and behaviors related to long-acting reversible contraceptives. Women’s Health Issues, 20(6), 394–399. https://doi.org/10.1016/j.whi.2010.07.005.
Stoddard, A., McNicholas, C., & Peipert, J. F. (2011). Efficacy and safety of long-acting reversible contraception. Drugs, 71(8), 969–980. https://doi.org/10.2165/11591290-000000000-00000.
Sundstrom, B., Baker-Whitcomb, A., & DeMaria, A. L. (2015). A qualitative analysis of long-acting reversible contraception. Maternal and Child Health Journal, 19(7), 1507–1514. https://doi.org/10.1007/s10995-014-1655-0.
Sundstrom, B., Billings, D., & Zenger, K. E. (2016). Keep calm and LARC on: A theory-based long-acting reversible contraception (LARC) access campaign. Journal of Communication in Healthcare: Strategies, Media and Engagement in Global Health, 9, 49–59. https://doi.org/10.1080/17538068.2016.1143165.
Sundstrom, B., DeMaria, A. L., Meier, S., Jones, A., & Moxley, G. E. (2015). It makes you rethink your choice of the pill: Theory-based formative research to design a contraceptive choice campaign. Journal of Health Communication, 20(11), 1346–1354. https://doi.org/10.1080/10810730.2015.1018650.
Trussell, J., Henry, N., Hassan, F., Prezioso, A., Law, A., & Filonenko, A. (2013). Burden of unintended pregnancy in the United States: Potential savings with increased use of long-acting reversible contraception. Contraception, 87(2), 154–161. https://doi.org/10.1016/j.contraception.2012.07.016.
US Census Bureau. (2012, 2016). U.S. Census Bureau QuickFacts: South Carolina. Retrieved September 13, 2018, from https://www.census.gov/quickfacts/fact/table/sc/EDU685216.
West, S. G., Duan, N., Pequegnat, W., Gaist, P., Des Jarlais, D. C., Holtgrave, D., … Mullen, P. D. (2008). Alternatives to the randomized controlled trial. American Journal of Public Health, 98(8), 1359–1366. https://doi.org/10.2105/AJPH.2007.124446.
Winner, B., Peipert, J. F., Zhao, Q., Buckel, C., Madden, T., Allsworth, J. E., & Secura, G. M. (2012). Effectiveness of long-acting reversible contraception. The New England Journal of Medicine, 366(21), 1998–2007. https://doi.org/10.1056/NEJMoa1110855.
Acknowledgements
The authors would like to recognize the New Morning Foundation (through the Choose Well Initiative) for financially supporting this research. We would also like to acknowledge Power to Decide, the campaign to prevent unplanned pregnancy (previously the National Campaign for Teen and Unplanned Pregnancy) and Riggs Partners, including Courtney Fleming, Kevin Smith, and Will Weatherly for their significant contributions to this research.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Sundstrom, B., Billings, D., Smith, E. et al. Evaluating the Whoops Proof S.C. Campaign: A Pair-Matched Group Pretest–Posttest Quasi-experimental Study. Matern Child Health J 23, 1036–1047 (2019). https://doi.org/10.1007/s10995-018-02729-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-018-02729-6