Pilot #2 of Social Network Intrauterine Contraceptive (IUC) Intervention
Condition: Attitudes
Study type: Interventional

Summary: 
      This study has two goals: 1) to test an approach to helping women who use intrauterine
      contraception (IUC) spread the word about this type of long-lasting, highly effective birth
      control method among their friends and family and; 2) to test ways of getting in touch with
      these women's friends and family so that investigators can track whether this approach is
      effective at spreading birth control information through social groups.
    

Detailed description: 
      Pilot of peer IUC intervention:

      Investigators will assess the feasibility and acceptability of a low-cost intervention
      implemented at a clinic providing family planning care. The intervention was first piloted in
      the an earlier phase of this study (ClincalTrials.gov ID: NCT01965743) which is currently in
      the analysis phase. Based off of participant feedback from this first pilot, investigators
      have revised and optimized the intervention which investigators will be testing again here at
      a new clinic and with a new population.

      New IUC users as well as experienced IUC users will be recruited as "dissemination agents" to
      provide information about the option of IUC to their peers. Ten to sixteen IUC users will be
      recruited from a family planning clinic to receive the intervention.The intervention which
      will be delivered by a clinic staff member to new or existing IUC users includes handing her
      a packet of pamphlets, encouraging her to sign up for a series of SMS messages, and informing
      her about the intervention's website. The content on the intervention across all media forms
      consists of a brief education about IUC and development of interpersonal skills for IUC
      users, including how to initiate conversations about reproductive health issues and their
      personal experience with IUC in social settings.

      Investigators will conduct baseline and 3 month quantitative surveys as well as 3-month
      qualitative interviews of dissemination agents to asses the feasibility and impact of the
      intervention on IUC knowledge, attitudes and social communication practices. As described in
      more detail below, investigators will also enroll the social contacts of dissemination agents
      to measure the effect of the intervention on their IUC knowledge and attitudes.

      At the completion of dissemination agent enrollment and intervention implementation in
      clinic, investigators will also conduct a focus group with clinic staff about the feasibility
      of implementing the intervention in the clinical setting.

      Test of snowball sampling for social network analysis:

      The social contacts of dissemination agents will be recruited via one of two snowball
      sampling methods: baseline or follow up recruitment methods. Dissemination agents will be
      randomized into each recruitment arm. In both recruitment arms, dissemination agents will
      list at baseline and at 3 month follow up their female social contacts between the ages of
      15-45 with whom they feel comfortable talking about birth control with.

      In the baseline recruitment arm, the dissemination agents within the first 2 weeks of being
      enrolled will ask their listed social contacts if they are interested in joining a study
      about birth control and for permission for the dissemination agent to share their contact
      info with the study staff. Study staff will then reach out to the social contacts whom have
      shared their contact information with us to ask if they would like to enroll in the study.
      Social contacts who choose to enroll will complete a baseline survey as well as another
      follow up survey 3 months from when their respective dissemination agent enrolled.

      In the follow up recruitment arm, dissemination agents at 3 months from their enrollment will
      recruit in the same manner as the baseline arm their social contacts. They will be asked to
      recruit all social contacts listed at baseline and any additional ones added at 3 months.
      Social contacts who enroll will complete 1 survey at the time of their enrollment.

      In both arms, dissemination agents will receive a small "finder's fee" for each social
      contact with whom the study is able to make contact with and confirms that she gave the
      dissemination agent permission to share her contact info.

      Investigators will assess which recruitment method is most effective at enrolling members of
      the dissemination agents' social network and whether social contacts in the baseline arm had
      more conversations about IUC with their dissemination agents between baseline and follow up
      due to the presence of recruitment conversations happening concurrently.

      A randomly selected sub-set of social contacts in both arms will be selected to complete a
      more detailed qualitative interview after quantitative data collection is complete. To
      minimize any potential Hawthorne effect, social contacts will initially be blinded as to the
      specific aims being assessed, and will be debriefed at the end of the study.

      This pilot study will provide the data necessary to prepare for a randomized controlled trial
      of this intervention.
    

Intervention name(s): Contraception Information Packet
Intervention type(s): Behavioral
Intervention description(s): The intervention will consist of brief education about IUC and development of interpersonal skills, including how to initiate conversations about reproductive health issues in social settings and debunking common IUC myths.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Keywords: intrauterine contraception (IUC); social networks; social influence; diffusion of innovation; intrauterine device (IUD); LARC