Facilitating shared decision-making about contraception with adolescents

Helping adolescents learn about contraception is important for promoting shared decision-making about reproductive health. Yet decision-making can be overwhelming amidst an increasingly vast health information environment—or “infosphere”—driven by the expansion of the internet. This is particularly true for adolescents who have 1) high rates of social media use; 2) low levels of contraceptive knowledge; and 3) limited skillsets and lack of supportive relationships to help navigate sensitive health information online. Clinicians who care for adolescents can fill a critical gap in helping patients engage in shared decision-making about contraception. Yet studies show that clinicians often avoid extensive engagement when discussing patient-identified internet information due to lack of time and training. As young people are increasingly exposed to health information online, research is needed to understand how clinicians can support adolescent patients’ emerging development and contraceptive choices, particularly as they integrate components of their digital health infosphere into the contraceptive decision-making process. Discussion of a patient’s infosphere can be incorporated into adolescent-tailored patient-centered contraceptive counseling (PCCC), an approach that centers shared decision-making. To help pediatricians provide PCCC that incorporates adolescents’ digital infospheres, our objectives are: 1) collect and review content and communication strategies related to the adolescent digital contraception infosphere, including conducting a relevant qualitative content analysis of social media sites; 2) develop a Counseling about Contraception Digital Information (CCDI) framework and training module to help clinicians incorporate adolescents’ online information-seeking into PCCC; and 3) use mixed methods to evaluate pediatrician-reported acceptability, appropriateness, and self-efficacy related to the CCDI module within the context of a larger training pilot called Adolescent-Centered Counseling and Empowerment Skills for Success (ACCESS). This project fills a crucial gap by conducting, to our knowledge, the first content analysis of adolescent-focused contraception information online. Furthermore, the study will develop a modern, adolescent-adapted, and stakeholder-informed PCCC training for clinicians that addresses this population’s digital contraception infosphere. This study has potential future adaptations in many other areas of health that are also impacted by complex digital infospheres.