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Figure.  Preferred and Actual Sources of Contraceptive Information Among Thanks, Birth Control Survey Respondents Stratified by Age Group (N = 1150)

SNS indicates social networking site.

Table.  Unadjusted and Adjusted Logistic Regression Models for Actual Source of Contraceptive Information and Association With Having Sufficient Information to Make Contraceptive Decision (N = 1150)a
1.
American Academy of Pediatrics. The importance of access to comprehensive sex education. Published February 15, 2024. Accessed March 29, 2024.
2.
Atkins  DN, Bradford  WD.  The effect of state-level sex education policies on youth sexual behaviors.   Arch Sex Behav. 2021;50(6):2321-2333. doi:
3.
Khurana  A, Bleakley  A.  Young adults’ sources of contraceptive information: variations based on demographic characteristics and sexual risk behaviors.  DzԳٰپDz. 2015;91(2):157-163. doi:
4.
Santelli  JS, Kantor  LM, Grilo  SA,  et al.  Abstinence-only-until-marriage: an updated review of U.S. policies and programs and their impact.   J Adolesc Health. 2017;61(3):273-280. doi:
5.
Cooke-Jackson  A, Rubinsky  V, Gunning  JN.  "Wish I would have known that before I started using it": contraceptive messages and information seeking among young women.   Health Commun. 2023;38(4):834-843. doi:
6.
Lindberg  LD, Kantor  LM.  Adolescents’ receipt of sex education in a nationally representative sample, 2011-2019.   J Adolesc Health. 2022;70(2):290-297. doi:
Research Letter
Public Health
ٱ𳾲13, 2024

Adolescents and Young Adults’ Sources of Contraceptive Information

Author Affiliations
  • 1University of California Berkeley
  • 2The University of Texas at Austin
  • 3University of Washington School of Public Health, Seattle
  • 4Power to Decide, Washington, DC
  • 5Rutgers School of Public Health, Newark, New Jersey
JAMA Netw Open. 2024;7(9):e2433310. doi:10.1001/jamanetworkopen.2024.33310
Introduction

Access to accurate contraceptive information is crucial for adolescents and young adults’ (AYA) sexual and reproductive well-being, fostering informed decision-making and bodily autonomy.1 Inadequate education and knowledge are associated with misperceptions of method risks, improper use, and discontinuation.2-4

AYAs’ contraceptive information sources vary, along with their quality and acceptability.3,5 With inequitable access to school-based sex education, online misinformation, and increasing health care restrictions,1,2,5,6 understanding AYAs’ receipt of contraceptive information is crucial. This study examines AYAs’ preferred and actual sources of contraceptive information and assesses associations with reporting sufficient contraceptive information.

Methods

This cross-sectional study used deidentified secondary data and was exempt from institutional review; the original survey design and data collection were reviewed and approved by the Biomedical Research Alliance of New York institutional review board. This report followed the Strengthening the Reporting of Observational Studies in Epidemiology () reporting guideline.

We used self-reported data from the 2023 Thanks, Birth Control Survey, administered online via Ipsos KnowledgePanel to AYAs aged 15 to 29 years assigned female at birth (AFAB). Minors were recruited through a parent, and all participants provided information consent or assent electronically. Fifty-three percent of participants reported ever having penile-vaginal sex (sample overview in eAppendix in Supplement 1). Participants reported preferred source(s) of contraceptive information (preferred sources) and their past-year contraceptive information source(s) (actual sources).

We examined the distribution of preferred and actual sources and conducted multivariable logistic regression to evaluate associations between participants reporting sufficient information to decide which contraceptive method was right for them (“sufficient information,” yes vs no/not sure) and actual information sources. Models were stratified by age (<18 years, 19-24 years, or 25-29 years) and adjusted for ever having sex. All analyses were conducted from February to June 2024 in Stata version 18.0 (StataCorp) using probability weights to represent the US population’s age, sex, race, census region, metropolitan status, and household income. Two-sided P < .05 was considered statistically significant.

Results

Among a total of 1150 survey participants, 21% were aged less than 18 years, 44% were 18 to 24 years, and 35% were 25 to 29 years; 14% were Black, 24% were Hispanic, 51% were White, 6% were multiracial, and 5% were non-Hispanic other (race self-reported via survey). There were discrepancies between AYAs’ preferred and actual sources of contraceptive information and variations by age (Figure). Clinicians were the most commonly preferred source (68% among <18 years, 84% among 18-24 years, 87% among 25-29 years), but less common as actual sources (33% among  <18 years, 43% among 18-24 years, 50% among 25-29 years). More older participants reported websites as a preferred than actual source (36% vs 18% among 18-24 years, 38% vs 17% among 25-29 years). Although 59% of participants younger than 18 reported parents as a preferred source, only 36% received information from parents. Social networking sites, though less commonly preferred (6% among <18 years, 12% among 18-24 years, and 10% among 25-29 years), were the second-most common actual source for respondents aged 18 years or older (28% among 18-24 years, 18% among 25-29 years). Approximately one-third of participants did not receive contraceptive information in the past year (30% among <18 years, 35% among 18-24 years, 36% among 25-29 years).

Participants’ actual source was associated with having self-reported sufficient information about contraception (Table). Participants had greater odds of reporting sufficient information if their source was a clinician compared with other sources or no source. Younger participants (aged <18 years) with parents as an actual source also had greater odds of reporting sufficient information. Schools, peers, websites, and social networking sites were not associated with sufficient information.

Discussion

This study’s results suggest discrepancies between preferred and actual sources of contraceptive information for AFAB AYAs in the US. Findings underscore the role of clinicians in supporting informed contraceptive decision-making among AYAs. Clinicians were the most commonly preferred source, and receiving information from them was associated with having sufficient information to choose a contraceptive method; however, clinicians were the source with the largest discrepancy between preferred and actual use. Limitations include potential selection bias due to the parental consent requirement for minor participants and recall bias for past year information sources. Findings highlight the continued value of parents and clinicians as sources of contraceptive information and suggest a need to improve information in digital spaces. Clinician engagement in online health education may be one strategy to help AYAs access preferred contraceptive information.

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Article Information

Accepted for Publication: July 17, 2024.

Published: September 13, 2024. doi:10.1001/jamanetworkopen.2024.33310

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2024 Pleasants E et al. vlog Open.

Corresponding Author: Elizabeth Pleasants, DrPH, MPH, University of California Berkeley, 2121 Berkeley Way W, Berkeley, CA 94704 (b_pleasants@berkeley.edu).

Author Contributions: Drs Pleasants and Steiner had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Pleasants, Whitfield, Pleasure, Larsen, Steiner, Lindberg.

Drafting of the manuscript: All authors.

Critical review of the manuscript for important intellectual content: All authors.

Statistical analysis: Whitfield, Pleasure.

Administrative, technical, or material support: Pleasants, Whitfield, Johnson, Steiner.

Supervision: Pleasants, Lindberg.

Conflict of Interest Disclosures: Dr Whitfield reported being a part-time consultant for Power to Decide who collected these data. Dr Lindberg reported personal fees from Power To Decide outside the submitted work. No other disclosures were reported.

Data Sharing Statement: See Supplement 2.

References
1.
American Academy of Pediatrics. The importance of access to comprehensive sex education. Published February 15, 2024. Accessed March 29, 2024.
2.
Atkins  DN, Bradford  WD.  The effect of state-level sex education policies on youth sexual behaviors.   Arch Sex Behav. 2021;50(6):2321-2333. doi:
3.
Khurana  A, Bleakley  A.  Young adults’ sources of contraceptive information: variations based on demographic characteristics and sexual risk behaviors.  DzԳٰپDz. 2015;91(2):157-163. doi:
4.
Santelli  JS, Kantor  LM, Grilo  SA,  et al.  Abstinence-only-until-marriage: an updated review of U.S. policies and programs and their impact.   J Adolesc Health. 2017;61(3):273-280. doi:
5.
Cooke-Jackson  A, Rubinsky  V, Gunning  JN.  "Wish I would have known that before I started using it": contraceptive messages and information seeking among young women.   Health Commun. 2023;38(4):834-843. doi:
6.
Lindberg  LD, Kantor  LM.  Adolescents’ receipt of sex education in a nationally representative sample, 2011-2019.   J Adolesc Health. 2022;70(2):290-297. doi:
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