Keep Calm and LARC On: A theory-based long-acting reversible contraception (LARC) access campaign

Abstract

Background: In South Carolina, almost half of all pregnancies among women in their twenties are unintended. Advocates for Youth partnered with researchers and students at a public university to design and pilot a theory-based communication campaign to increase awareness and uptake of a full range of contraceptive options among young women. The health belief model and diffusion of innovations theory served as conceptual frameworks throughout data collection, analysis and campaign development.

Methods: This community-based participatory action research project included formative audience research to assess knowledge, attitudes, and behaviors related to contraceptive methods among young women. A qualitative content analysis of the top 25 U.S. consumer magazines (83 articles) evaluated coverage of contraception and how these articles persuade women to think about contraceptive methods. Student researchers moderated three peer-to-peer focus group discussions (n = 19) among women ages 19–22. In-depth individual interviews (n = 9) with users of long-acting reversible contraception (LARC), including the intrauterine device and the implant, informed the development of video blogs.

Results: Participants favored the effectiveness of LARC methods, while reacting negatively to a ‘foreign object’ in their bodies. Findings suggest that physicians lack knowledge about LARC and resist prescribing these methods. These findings were used by researchers to develop campaign strategies, communication channels and messages, including ‘Keep Calm and LARC On’. An anonymous web-based survey (n = 248) evaluated the campaign’s effectiveness. Based on campaign messages, 19% of participants reported obtaining a LARC method.

Conclusions: This study offers practical recommendations to health communicators to develop formative research, segment audiences, and implement theory-based campaign strategies and messages.

Keywords:

• Contraception
• Diffusion of innovations
• Focus groups
• Qualitative research

Acknowledgements

A College of Charleston grant for Innovative Teaching and Learning in the Liberal Arts and Sciences provided funding for formative research and implementation of the campaign. The authors would like to acknowledge the following student research assistants for their contribution to the development and implementation of the health communication campaign: Natalie Cancel, Rebecca Davis, Aurora Fegley, Jade Griffith, Kate Healey, Erika LeGendre, Whitney Martin, Elizabeth Saady, and Megan Severn.

Additional information

Notes on contributors

Beth Sundstrom

Author information

Beth Sundstrom (Ph.D., University of Maryland; M.P.H., Brown University) is an assistant professor of communication and public health at the College of Charleston in Charleston, SC. She is also a faculty affiliate in the Women's and Gender Studies program and a member of the graduate faculty, University of Charleston, SC. Her research interests include health communication, social marketing, and women's health. She teaches undergraduate and graduate courses in health communication, social marketing, and public health. She has professional experience in public relations and continues to consult in strategic health communication.

Deborah Billings

Deborah Billings (Ph.D., University of Michigan) is the director of choose well: the South Carolina contraceptive access campaign, an initiative of Advocates for Youth and the New Morning Foundation. She is also an adjunct associate professor of maternal & child health at the UNC Gillings School of Global Public Health and an adjunct assistant professor at the Arnold School of Public Health at the University of South Carolina. Her research interests include sexual and reproductive health and rights globally, public policy and law and the intersection of human rights and public health.

Kathryn E. Zenger

Kathryn E. Zenger (M.P.H., University of South Carolina) is the manager of research, evaluations, and grants for the New Morning Foundation, a non-partisan, long-term initiative to improve young people's reproductive health education, counseling, and clinical services throughout South Carolina. Her professional research interests include: reproductive and sexual health and rights, teen pregnancy prevention, adolescent risk behavior, public health policy and advocacy, and social justice.