Abstract
Objectives
We assessed the effect on subjective knowledge of a pilot educational comic decision
aid about contraceptive methods.
Study design
We designed four comics (www.birthcontroltales.com), each about a different contraceptive method choice. The comics employ a theoretical
framework, and the methods addressed were injection, intrauterine device, implant
and combined hormonal contraceptives (including pill, patch and ring). The study population
included young women presenting to a college student health clinic whose preferred
language is English. Participants had not used the contraceptive method described
in the comic and viewed the comics in color printed copy. We assessed contraception
subjective knowledge using a pretest/posttest six-question survey with Likert scale
responses before and after exposure to the comics. Surveys conducted during the participants'
visit also measured participant satisfaction with the comic and participant sexual
history.
Results
A total of 120 individual participants divided into groups of 30 each viewed one of
four separate comics. Across the four groups, the difference in the pretest/posttest
scores of the six-question subjective knowledge survey indicated a 72% average increase
(p value<.001).
Conclusion
Comics about contraceptive methods can be a communications tool that increases subjective
knowledge of contraceptive methods. Comics that model contraceptive choice decision
processes can increase individual subjective knowledge of the contraceptive method
mechanism, effect, usage, side effects, feasibility and benefits. Possessing subjective
knowledge of contraceptive methods can influence contraceptive initiation and use
and therefore has potential implications for changing contraceptive attitudes and
behavior.
Implications
Contraceptive method comics should be further examined in other clinic settings with
broader demographic populations to glean the effect on patient decision and contraceptive
behavior. Integration of the comics into a contraceptive counseling practice can be
assessed in an observational trial. Additionally, studies should also consider testing
long-term patient behavior, and both patient and provider satisfaction.
Keywords
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Article info
Publication history
Published online: March 13, 2019
Accepted:
February 20,
2019
Received in revised form:
February 11,
2019
Received:
October 22,
2018
Footnotes
☆Disclosure: This work was supported by a grant from the Society of Family Planning.
☆☆The authors report no conflict of interest.
★The findings from this work were presented/will be presented at: 1. Theory based educational comic for intrauterine device information: Perspectives of primary care providers. Poster presentation at North American Society of Pediatric and Adolescent Gynecology, Chicago, April 2017. 2. Comics for Contraception Education: Harnessing Power of Narrative Communication. Oral presentation at Stanford Medicine x Ed- Palo Alto, California, April 2017. 3. Development and pilot testing of theory-based comic for intrauterine device information. Poster presentation at American College of Obstetricians and Gynecologists Annual Clinical Meeting, San Diego, May 2017. 4. Comic for contraceptive implant information: A pre–post test quasi-experimental study. Poster presentation at Forum (Society of Family Planning Annual Meeting). Atlanta, October 2017. 5. Comics for contraception education in young adults: results from a quasi-experimental study: Presented at the European Society of Contraception Congress, Budapest, Hungary, May 2018.
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