Effect of theory-based contraception comics on subjective contraceptive knowledge: a pilot study.

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.