Background
Unplanned pregnancies have a big impact on the health and well-being of women, their families, and their communities. Social networking sites (SNSs) such as Facebook and Instagram are popular globally, but their potential in helping to improve contraceptive use has not been fully explored.
Objectives
To evaluate the effectiveness of using SNSs to promote the uptake of and adherence to contraception in reproductive-age women.
Search methods
We ran an electronic search in January 2018 on several online databases and key conferences to identify relevant studies that used SNSs to improve contraceptive use in reproductive-age women.
Selection criteria
To be included, studies must have used an SNS (either alone or with another method), and have followed the women involved for at least three months after the intervention.
Data collection and analysis
Two authors independently screened titles, abstracts and full-text studies, and extracted data from included studies. A third author was assigned to resolve areas of disagreement.
Main results
We reviewed 461 titles, abstracts and full-text articles and found only two studies that met the inclusion criteria. Both studies were conducted in the USA and had a high risk of bias. The first study divided women into two groups; one group received access to a website containing highly accurate medical information about contraception for the public called Bedsider.org, while the other group was exposed to nothing. The study found no differences between the groups in how consistently women used a contraceptive method, or their knowledge of how well each method prevented pregnancy. However, this study did find that more women in the group exposed to Bedsider.org used a highly effective contraceptive method one year later.
The second study used a closed Facebook page exposing women to either sexual health content or news articles that avoided sexual health information in order to determine the impact on condom use. The study found no difference between groups in how consistently condoms were used six months postintervention or their intention to use condoms in the future.
Authors' conclusions
We found little scientific evidence available to support whether SNSs improve contraceptive use or continuation among women.
Despite the prevalence of SNSs, we found little scientific evidence to support the use of SNSs to improve contraceptive use or adherence among women.
Social networking sites (SNSs) have great potential as a platform for public health interventions to address the unmet need for contraception.
To evaluate the effectiveness of interventions using SNSs to promote the uptake of and adherence to contraception in reproductive-age women.
We searched CENTRAL, MEDLINE, Embase, and six other databases on January 2018. We also searched Google Scholar, key conference proceedings, checked the reference lists of included studies, and contacted study authors to identify additional studies.
We considered randomised controlled trials (RCTs) and non-randomised interventional studies (NRS) in women of reproductive age. SNSs requiring a social profile within a bounded or restricted-access system of shared connections were included. We also included trials that utilised SNSs only or as an adjunct to an intervention. Studies had to have a follow-up outcome assessment of at least three months.
Two authors independently screened titles, abstracts and full-text studies, and extracted data from included studies. A third author was assigned to arbitrate areas of disagreement. Authors assessed risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions. We were unable to conduct a meta-analysis due to the heterogeneity of the study designs and outcome measures.
Of the 461 unique records found, only two studies met our inclusion criteria. Both studies were conducted in the USA and were at high risk of bias. One RCT included 2284 women exposed to a web-based SNS or nothing. The groups were no different post intervention in their self-reported consistency of contraceptive use or knowledge of the relative effectiveness of different methods. There was a small but significant increase in the use of more effective methods (long-acting reversible methods) at 12 months' follow-up.
The second study, a cluster RCT with 1578 women, used a closed Facebook page showing sexual health content compared to a modified Facebook news page that avoided sexual health content. They found no differences in the use of condoms at last act of sexual intercourse at six months or the intention to use condoms between the intervention and control groups.