Online contraception fictions outweigh facts: Study

TikTok has become a major source of contraception information for young Australians.
 
However, a new study out of La Trobe University reveals much of the content is unreliable and of poor quality, putting pressure on young people to discern fact from fiction. 
 
Further, the study also shows significant distrust in health professionals among the content creators.
 
TikTok has around two billion users worldwide and about 9.7 million in Australia.
 
The La Trobe researchers analysed 100 TikTok videos on contraceptive health that have amassed nearly five billion views and 14.6 million likes.
 
Only 10% of the videos were created by health professionals. The rest came from influencers and general uploaders sharing personal experiences or opinions, or self-described ‘hormonal health coaches’ or wellness educators with significant reach. 
 
The study reveals 53% of the content creators reviewed rejected hormonal birth control, while about 34% expressed distrust in health professionals.
 
Lead researcher, Dr Caroline de Moel-Mandel from La Trobe University’s School of Psychology and Public Health told newsGP the study results are ‘fascinating’, but not unexpected.
 
‘On one hand, yes, I was surprised, but also it was the reason why we did this study. I anticipated that that would happen,’ she said
 
‘It’s important for GPs to be aware that young adults obtain their information from social media platforms, and that that information might be untrue’.
 
Dr de Moel-Mandel said many of the content creators promote natural contraception methods, such as fertility tracking, without mentioning the limitations and variables of such methods, including hormonal fluctuations and partner cooperation.
 
‘Importantly, they fail to mention that these methods are generally ineffective when used on their own,’ she said.
 
‘This kind of misinformation, combined with a growing distrust in healthcare professionals can result in unsafe decisions and ultimately, unplanned pregnancies.’
 
In the videos analysed, 25 general creators, two hormonal health coaches and seven health educators expressed a distrust in health professionals and/or hormonal contraception.
 
The statements of distrust are predominantly based on creators’ advice, opinions or personal experiences.
 
Dr de Moel-Mandel said a common complaint among the content creators in the study is ‘not being heard’ by their clinicians.
 
‘There is this ongoing desire to avoid hormones in your body, to go natural,’ she said.
 
‘Then, in a consultation with the health professional, who tends to focus on safety and effectiveness more than anything else, they did not feel heard and sometimes even felt pressured into choosing hormonal options, even if they didn’t want to use it.
 
‘So, personal choices being compromised, and even the right to make informed decisions were not there anymore, so it was all about those negative experiences.’
 
She encourages GPs to ‘work through that scepticism and resistance’ from patients during consultations.
 
‘So, when they meet young people, they address those biases and also provide good information about the effectiveness of alternative [contraception] methods.’
 
Study co-author and La Trobe lecturer in public health, Megan Bugden, echoes Dr de Moel-Mandel’s view.
 
‘We encourage health professionals to rebuild trust through shared decision-making on contraceptive options, which may increase patient satisfaction and mitigate unreliable information posted online,’ she said.
 
‘Young people deserve accurate information to make informed contraceptive health decisions, regardless of background or resources.’  
 
Much of the bias towards online misinformation is due to TikTok’s ‘recommendation algorithm’, which uses a person’s interaction data to suggest videos and keep them engaged with the platform.
 
This algorithm, however, can limit users’ exposure to previously viewed information content and, in turn, restrict access to alternative views, thereby reinforcing existing beliefs and perpetuating the misinformation.
 
However, Dr de Moel-Mandel said there is opportunity for GPs to disrupt the TikTok echo chamber, by working with influencers to create evidence-based content that resonated with the desired audience.
 
Given 69% of TikTok users fall between the ages of 18 and 34 years, the platform offers an opportunity to reach this cohort with safe and effective reproductive health information. 
 
‘From a public health perspective, the fact that those influencers have such a great reach, if we can work together and provide accurate contraceptive education and information on those platforms, I think that will be really good … especially if it’s relatable,’ Dr de Moel-Mandel said.
 
‘The fact that social media is accessible to all individuals no matter where people live, even in areas where health services are not so easily accessible, it can play a really big role, to have that extra resource available to young people.’
 
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