Available online 15 November 2023

Author links open overlay panel, , , , ABSTRACTObjective

Long-active contraceptives (LARC) are the most effective contraceptive method to decrease pregnancy rates among adolescents and young adults (AYA). Get It? (www.getitnobaby.com) is an innovative peer-based digital intervention that aims to increase LARC awareness and use among AYA. The purpose of this study is to describe the impact of Get It? on LARC awareness and use among AYA after exposure.

Methods

A randomized controlled trial was conducted between two different BCM Teen Health Clinics. Using a block randomization method, clinics were randomized to either the intervention or control group by week. Baseline and post-intervention surveys were conducted in addition to a 6-month post-intervention chart review to determine the primary outcome of LARC uptake and secondary outcomes including other LARC-specific behaviors and LARC attitudes.

Results

A total of 233 AYA agreed to participate in the study, of which 134 were randomized to the control group and 99 to the intervention group. Initiation of LARC discussion with the provider was significantly higher in the intervention group than in the control group. Additionally, LARC uptake within 6 months after study was almost significantly higher in the intervention group than in the control group. Finally, intervention group respondents exhibited strong positive attitudes towards Get It? with regards to specific intervention components.

Conclusion

This study supports Get It? as a tool to educate and motivate AYA girls to use the most effective form of birth control available to them. The digital format of this novel peer-based approach also contributes to the potential of this educational intervention by decreasing barriers to both dissemination and uptake. We recommend a larger multi-institutional study to confirm these results and determine the most efficient method of dissemination to reach at-risk AYA prior to coitarche.

Section snippetsBACKGROUND

While the birth rate among adolescents and young adults (AYA) in the United States has declined significantly over the last three decades, the rate is still much higher than the rate of most industrialized countries1. Socioeconomic determinants contribute to much higher pregnancy and birth rates in non-white AYA, especially Hispanic and Native American AYA2,3. Geographical differences also persist, with Texas having one of the highest teenage pregnancy rates in the country, at 22.4 births per

METHODS

After obtaining approval from the Baylor College of Medicine (BCM) Institutional Review Board, research activities were conducted from March 2022 to March 2023. AYA were approached in the waiting room of two BCM Teen Health Clinics and offered participation in the study. Exclusion criteria included previous LARC use, AYA younger than 13 or older than 24 years old, and males. Before beginning research activities, participants read and signed a written consent form in a private clinic room.

RESULTS

A total of 233 AYA agreed to participate in the study, of which 134 were randomized to the control group and 99 to the intervention group. Of these 233 participants, 67% were Hispanic, 24% were Black, 3% were White, <1% were Asian, and <1% identified themselves as other. There was no significant difference in racial distribution between the control and intervention groups (Table 1). There was no significant difference between the (1) average age of respondents in the control group (17±5 years)

DISCUSSION

As the first RCT to investigate a peer-based LARC-specific educational intervention targeting AYA, this study is important because LARC is the most effective form of contraception for AYA18,19. Not only did Get It? elicit predominantly positive attitudes in viewers (table 2), but it also was associated with increased LARC uptake and a significant increase in LARC attitudes (table 1). Although LARC uptake was not significantly different between the control and intervention groups, exposure to

Uncited References

27

REFERENCES (28)“Teen Pregnancy Rates by State 2023.” https://worldpopulationreview.com/state-rankings/teen-pregnancy-rates-by-state...L. Shuger, “Teen Pregnancy and High School Dropout: What Communities Can Do to Address These Issues—Full Report | Power...J.F. PeipertContinuation and satisfaction of reversible contraception

Obstet. Gynecol.

(May 2011)

R.H. AseltineA reconsideration of parental and peer influences on adolescent deviance

J. Health Soc. Behav.

(Jun. 1995)

View full text

© 2023 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.