Improving contraceptive knowledge among young women from rural and remote areas of Australia is the focus of a study by the SPHERE Centre of Research Excellence at Monash University.
Women living in rural and remote areas of Australia are 1.4 times more likely to experience an unintended pregnancy than those living in urban areas, and adolescent pregnancies are similarly more common.
These disparities are likely due to parallel factors, including more limited access to sexual and reproductive health information and services in rural and remote communities.
Funded by the Australian Government's Department of Health and Aged Care, the EXTEND-PREFER study also received input from the Centre for Excellence in Rural Sexual Health at the University of Melbourne and the Multicultural Centre for Women's Health.
The research – now published in Sexual & Reproductive Healthcare – highlights the effectiveness of using a tailored online educational video in enhancing contraceptive knowledge and preference for effective contraceptive methods.
The study revealed the online educational video was useful in informing young women in rural and remote areas about contraceptive options and enhancing their preferences for the most effective methods. However, this preference did not translate into uptake, suggesting that structural and other barriers may be preventing women from accessing their preferred contraceptive method.
Head of Monash University's Department of General Practice and Director of SPHERE, Professor Danielle Mazza AM, is the lead author of the study. "The adverse consequences of unintended pregnancies are wide reaching, impacting women, their families and the economy. Women with an unintended pregnancy are more likely to experience depression, preterm birth, and have an infant with low birth weight," Professor Mazza said.
Professor Mazza said the study emphasised the need for a multifaceted approach to facilitating young women's access to effective methods of contraception, including long-acting reversible contraception (LARC) such as intrauterine devices and implants.
"Efforts to enhance contraceptive knowledge should be coordinated with place-based initiatives and policies that directly address the structural barriers to accessing critical sexual and reproductive health services that are unique to women in rural and remote areas such as cost, the limited number of local providers and stigma," she said.
The study involved 153 young women aged 16 to 25 years living in rural and remote communities in Australia.
"Designed to increase knowledge of all methods of contraception, including LARC as the most effective method, the research addressed many of the questions and concerns young women have about contraception, including their effectiveness and common side effects," Professor Mazza said.
"LARC methods are over 99 per cent effective at preventing pregnancy. However, use of LARCs by Australian women from rural and remote communities is relatively low, in part due to limited knowledge, stigma and misconceptions."
In the 13-minute online educational video, participating young women learned about the different contraceptive methods available in Australia, including: the presence and types of hormones found in various contraceptive methods; their effectiveness; how the contraceptive is used, inserted and removed; length of use; cost; if a prescription is needed; effects on bleeding patterns; non-contraceptive benefits; if the contraceptive provides protection against sexually transmissible infections; and common side effects.
This focus on young women from rural and remote areas formed part of the wider EXTEND-PREFER project, which included a recent paper on the experience of women from culturally diverse backgrounds that was published in BMJ Sexual & Reproductive Health, and accompanying online educational videos about contraceptive options.
This study aligns with the National Women's Health Strategy 2020-30 goal to increase the availability and uptake of LARCs and was funded by the Australian Government.
To make this resource widely available, the online video developed for the study has been distributed to women's health and general health websites, multicultural groups (with versions prepared in five languages), and social media platforms.
About SPHERE
SPHERE is the National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Women's Sexual and Reproductive Health in Primary Care – a collaborative research centre comprising national and international experts in sexual and reproductive health.
Link to research paper and videos
Read the full paper in BMJ Sexual & Reproductive Health: Evaluating the effectiveness of a tailored online educational video on the contraceptive knowledge and decision making of young women from culturally and linguistically diverse backgrounds: Findings from the Extend-Prefer study.
DOI: 10.1136/bmjsrh-2024-202236
