Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States.
Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, United States.
Contraception. 2022 Jan;105:80-85. doi: 10.1016/j.contraception.2021.08.018. Epub 2021 Sep 12.
To improve teen contraceptive use, the SpeakOut intervention combines structured counseling, online resources, and text reminders to encourage teens to share their experiences using intrauterine contraception (IUC) or an implant with peers.
To evaluate the effectiveness of remote delivery of the SpeakOut intervention in increasing teen contraceptive use, we conducted a cluster randomized trial involving female adolescents who were recruited online. Primary participants (n = 520) were randomly assigned to receive SpeakOut or an attention control; each primary participant recruited a cluster of up to 5 female peers as secondary participants (n = 581). We assessed contraceptive communication, knowledge, and use, at baseline, 3 and 9 months after participants enrolled. We examined differences between study groups, controlling for clustering by primary participant and baseline characteristics.
The trial's primary outcome, contraceptive use by secondary participants, was similar between groups at both 3 and 9 months postintervention. Compared to controls, primary participants receiving SpeakOut tended to be less likely to discontinue contraception within 9 months (4.8% vs 7.8%, p = 0.11 for IUC; 7.8% vs 9.8%, p = 0.45 for implants), but this did not reach statistical significance. SpeakOut failed to increase contraceptive communication; regardless of study group, most secondary participants reported peer communication about contraception (86% vs 88%, p = 0.57). Most secondary participants were aware of the hormonal IUC (91.4% vs 90.4%, p = 0.72), copper IUC (92.9% vs 88.6%, p = 0.13), and implant (96.5% vs 96.1%, p = 0.83) 3 months after enrolling, regardless of the intervention their primary participant received. However, contraceptive knowledge remained incomplete in all study groups.
Remote delivery of the SpeakOutintervention did not improve contraceptive communication, knowledge or use among participating teens or their peers.
Efforts to support teen-to-teen contraceptive communication and ensure that teens have accurate information about the full range of contraceptive methods, including highly effective reversible contraceptives, require refinement.
为了提高青少年的避孕措施使用率，SpeakOut 干预措施结合了结构化咨询、在线资源和短信提醒，以鼓励青少年分享他们使用宫内节育器 (IUC) 或植入物的经验。
为了评估远程提供 SpeakOut 干预措施对增加青少年避孕措施使用率的有效性，我们进行了一项涉及在线招募的女性青少年的集群随机试验。主要参与者（n=520）被随机分配接受 SpeakOut 或对照；每个主要参与者招募最多 5 名女性同伴作为次要参与者（n=581）。我们在参与者登记后的基线、3 个月和 9 个月评估了避孕沟通、知识和使用情况。我们通过主要参与者和基线特征的聚类控制，比较了研究组之间的差异。
试验的主要结果，即次要参与者的避孕措施使用率，在干预后 3 个月和 9 个月时两组之间相似。与对照组相比，接受 SpeakOut 的主要参与者在 9 个月内停止避孕的可能性较小（IUC 为 4.8%比 7.8%，p=0.11；植入物为 7.8%比 9.8%，p=0.45），但未达到统计学意义。SpeakOut 未能增加避孕沟通；无论研究组如何，大多数次要参与者报告了关于避孕的同伴沟通（86%比 88%，p=0.57）。大多数次要参与者在 3 个月后知道激素 IUC（91.4%比 90.4%，p=0.72）、铜 IUC（92.9%比 88.6%，p=0.13）和植入物（96.5%比 96.1%，p=0.83），无论他们的主要参与者接受了哪种干预。然而，所有研究组的避孕知识仍然不完整。
远程提供的 SpeakOut 干预措施并未提高参与青少年及其同伴的避孕沟通、知识或使用情况。
支持青少年之间的避孕沟通，并确保青少年获得关于完整避孕方法的准确信息，包括高效可逆的避孕方法，需要进一步改进。
