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Try out PMC Labs and tell us what you think. Learn More. Few U. Twenty-four interviews and three focus groups comprising 14 participants were conducted in with a diverse sample of women aged 15—45 recruited from family planning clinics and the community in San Francisco. Half of participants had used IUDs. Women were asked about their social communication concerning contraceptives, particularly IUDs, and about the content of the information they had received or given.
Transcripts were analyzed using a modified grounded theory approach to identify themes of interest. Women reported that communication with female friends and family members was a valued means of obtaining information about contraceptives, and that negative information which often was incorrect was more prevalent and memorable than positive information in such communication.
Women heard about negative experiences with IUDs from social contacts and television commercials; clinicians were a major source of positive information. Misinformation and negative information about IUDs are prevalent in social communication, and the information transmitted through social networks differs from the information never-users wish to receive.
Findings support the creation of peer-led interventions to encourage IUD users to share positive personal experiences and evidence-based information. Unintended pregnancy remains an important public health problem in the United States, contributing to poor outcomes for women and children at substantial societal cost.
IUDs are at least as effective as female sterilization, yet are a fully reversible method of contraception. Little research has been done in the developed world, however, to investigate how social networks influence attitudes toward and use of Free live sex chat in Steinauer methods in general, and of IUDs in particular.
In qualitative studies, women have reported that although social networks and the media frequently provide misinformation about contraceptive methods, 1318 — 20 they consider information received through social contacts more trustworthy than information from medical providers.
From April to Julywomen aged 15—45 were recruited from two San Francisco family planning clinics that serve a racially and ethnically diverse population of low-income patients. To include the experiences of women not actively seeking family planning services, we also recruited women via flyers posted at local bus stops and community centers.
The research team monitored recruitment in order to ensure that the sample was racially and ethnically diverse, included women of various ages and had roughly equal s of current IUD users and never-users. Women were eligible to participate if they had ever been sexually active with men, spoke English, were not pregnant or seeking pregnancy, and had never been told by a clinician that they were unable to conceive. In addition, IUD users had to Free live sex chat in Steinauer been using the method for at least a month, to allow time for them to process their experiences as users. Study procedures were approved by the institutional review board of the University of California, San Francisco.
The participation rate was not formally tracked. Approximately one-sixth of women who were approached in clinics declined to participate, citing scheduling conflicts such as work or child care obligations. To recruit participants at clinics, a female research assistant approached women who were waiting to see a clinician and asked if they were interested in learning more about a birth control research study. If the patient was interested, the research assistant conducted an eligibility screening; if eligible, the woman provided written informed consent before taking part in a half-hour semistructured interview or a one-hour focus group facilitated by the study coordinator.
For potential participants recruited from community settings, eligibility screening was conducted over the phone, and written informed consent was obtained at the time of the interview or focus group. We intentionally included at least one current IUD user in each focus group, which allowed us to simulate real-world social communication and observe how current users presented their experiences to peers and what questions never-users had for experienced users. Before each interview or discussion, participants completed a brief demographic questionnaire.
Recruitment was staggered between interviews and focus groups: After we had conducted several interviews, recruitment efforts shifted to a focus group and then back again. The interview and focus group discussion guides were structured around a common core of identical questions.
They began with prompts regarding social communication about contraception in general and about preferences for learning more about new contraceptive methods. In this study, we defined social communication as any nonclinical source of information, including friends, family, acquaintances and the media. All questions were open-ended, and facilitators used follow-up probes to explore emerging themes. Analysis occurred in tandem with data collection; the latter concluded when thematic saturation was reached. The interview and focus group transcripts were analyzed using NVivo 10 software. We chose a modified grounded theory approach 25 to analyze the data because it gave us the flexibility to focus on ideas that emerged during data collection and analysis, and we devised a coding structure based both on preexisting themes of interest e.
After independently coding several transcripts, the members of the research team met to revise the coding structure as indicated by emerging themes. We drafted memos to document our thoughts about newly identified themes throughout data collection and analysis, and added and revised coding as needed in an iterative manner. Each transcript was independently coded by at least two research team members, who compared their coding and met with the principal investigator to discuss and resolve any discrepancies.
Thirty-eight women participated in the study; 24 completed a one-on-one semistructured interview, and 14 participated in one of the three focus groups.
Approximately half of women were parous. All women had used some type of contraception; half had ever used an IUD. We present the organized thematically in the order in which they were discussed. When quoting participants, we identify them by their age and IUD experience, except for focus group participants, whose characteristics were not linked to discussion transcripts. All interview participants were asked to recall the last time they had had a conversation about birth control with someone other than a doctor or nurse.
Sixteen of these 24 women named a female friend or acquaintance as their most recent contraceptive discussant; five others named a female family member, such as their mother or sister. Only three participants named a boyfriend or husband as the person with whom they had most recently discussed contraception; of these women, just one had specifically discussed the IUD with her partner.
When asked how they were affected when friends told them good or bad things about a contraceptive method, participants said that negative stories were more memorable and influential than those about women who had successfully used a method. For Free live sex chat in Steinauer, a story of someone who experienced an adverse effect or unwanted pregnancy with a method was considered more memorable than a story of someone who successfully used birth control to avoid pregnancy. Free live sex chat in Steinauer one participant explained, one assumes that birth control will work well, so unexpected adverse events are more noteworthy:.
Another participant explained how hearing about a negative aspect of a contraceptive method helps her rule out that method when weighing options:. You want the perfect thing. Participants valued and trusted a personal recommendation from a friend. The desired setting for a conversation about contraception was in person, in a private or semiprivate setting with a close friend.
Although our discussion guide focused on communication in nonclinical settings, many women who said that they would like to hear about a method from a friend who had used it also said that they would seek additional information and validation from a health care provider.
In fact, some women described their female clinician as playing the dual role of trusted clinician and experienced IUD user when the provider disclosed her own IUD use. Women felt that it was appropriate for providers to share their experiences and stated that clinician self-disclosure positively influenced their decision to use IUDs. One woman reported that learning that her clinician was an IUD user made her more confident in choosing the method:.
Television commercials were the most commonly mentioned source of negative information, cited by 10 participants. The content of the commercials, described by some women as lawsuit advertisements targeting the levonorgestrel IUD, prompted some women to consider having their IUD removed and influenced never-users to rule out the method. In some cases, the participant had seen the commercial herself; in others, she had been contacted by a friend or family member who had seen the commercial. The stark contrast between information received from a clinician and that received from nonclinical sources is illustrated by the following comments of a focus group participant:.
I went [to the clinic], and [my doctor] recommended the Mirena. Additional sources of negative information regarding IUDs included friends cited by 11 participantsmothers five participants and other female family members nine participants. Mothers, aunts and other female relatives were sources of negative information related to the Dalkon Shield:.
I think she called it the Dalkon Shield or something back in the day. One participant said that although she had heard about a pregnancy experienced by a woman using a levonorgestrel IUD, this did not dissuade her from trying the method herself:.
She told me that she went through a pregnancy with the Mirena. And she said it was risky, or whatever, so I did think about it before I got it done. While negative social communication tended to concern a rare event happening to an individual woman, positive social communication typically focused on method characteristics. A focus group participant shared the story of how she first learned about the benefits of IUDs from a close friend who used the method:.
And I have a whole life ahead of me before I want to get pregnant. You should get the IUD. Some women relayed stories of friends who decided to get an IUD on the basis of their recommendation, and some had accompanied a friend to her insertion appointment. Another IUD user recommended the levonorgestrel IUD when a friend complained about the weight she had gained while using an injectable contraceptive:. She blew up. I might try that. And then [another] friend asked her. Three former IUD users who had had their devices removed because of side effects stated that they had shared their negative experiences with friends and family.
Users said that their most frequent approach when recommending the method to friends was to describe how effective it is at preventing pregnancy:. Both questions were asked in focus groups and interviews. Never-users also wanted to ask users if their partners could feel the IUD four never-users, four users and if users experienced any side effects eight never-users, two users or changes in their menstrual cycle six never-users, eight users. Or do you feel it?
Does your partner feel it? Some never-users expressed concern about the safety of having a foreign body inside their uterus:.Free live sex chat in Steinauer
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Women’s Social Communication About IUDs: A Qualitative Analysis