Debunking myths about contraceptive safety among women in Kingston, Jamaica: Pilot randomized controlled trial

Objectives: (1) To create a short motion graphic video to debias women, using evidence from cognitive psychology, of 2 common myths about safety of intrauterine devices (IUDs) and implants in Jamaica; and (2) to conduct a pilot study to evaluate video effectiveness. Study design: We conducted a series of 3 focus group discussions among target users to inform the development process of the script, story, character, and look of the intervention video. We randomized young, female nonusers of long-acting contraception at risk of pregnancy at a public clinic in Kingston in 2018-2019 to watch either the intervention (n = 113) or control video (n = 112). We used logistical regression to evaluate perceptions of method safety, naturalness, and uptake after 3 months of follow up. Results: Almost all (n = 220; 97.8%) participants completed the 3-month interview. More women in the intervention arm perceived IUDs to be safe (59.1%) compared to the control arm (43.6%; p = 0.02). Perceived implant safety increased from enrollment to follow up in the intervention and control arms (10.9 and 2.7 percentage-point increases, respectively); however, the difference between arms at follow up was not statistically significant (p = 0.57). This appeared to be due to arm imbalances at enrollment. Study arms did not differ at follow up in perceived IUD naturalness (p = 0.36) or implant naturalness (p = 0.68). Conclusions: Findings from a pilot study of a video intervention suggest that using debiasing strategies from cognitive psychology has the potential to address misconceptions about contraceptive safety. A larger trial with adequate power is warranted. (C) 2021 Elsevier Inc. All rights reserved.