Behind the Feathers: Evaluation of until You're Ready, Avoidthestork.Com©, a Surround Campaign to Prevent Adult Unintended Pregnancy

Theoretical Background and research questions/hypothesis: Very few interventions have been developed and evaluated to encourage consistent and appropriate contraceptive use among adult women who do not wish to become pregnant, despite approximately 50% of all pregnancies to women ages 18-30 being unintended. This presentation discusses the evaluation of a humor-based campaign (Until You’re Ready, AvoidtheStork.com©) to encourage 18-30 year old women to use contraceptives if they are not planning a pregnancy. The theory-driven campaign was based on two years of extensive formative research (focus group participants = 130, in-depth interviews = 48, telephone survey = 2,210), concept testing (focus groups = 152), and piloting (intercepts = 281, online survey = 516, telephone = 1,452). The campaign used traditional and non-traditional media in a surround strategy to ensure that women encountered messages throughout their day. The campaign was implemented statewide for one year.

Methods: The multi-pronged evaluation provided for triangulation of data. Statewide surveillance data provided unintended pregnancy rates, online surveys with college students addressed knowledge, attitudes and behavior of that population, Google analytics and other online tracking mechanisms assessed website traffic and online campaign buzz, Medicaid and Blue Cross/Blue Shield health insurance claims data provided information about reproductive health services utilization, and a statewide posttest telephone survey of 18-30 year-old women provided data on attitudes, knowledge, and other behavioral health constructs, including past contraceptive behavior and intentions. For this presentation, we focus on the statewide telephone survey conducted in the summer of 2011 and touch on the results of other evaluation strategies. A stratified disproportionate random digit dial sampling technique was used to reach a probability-based sample of households (N = 1,391). The sample was weighted to best reflect the state’s population of 18-30 year-old women.

Results: Approximately 72% of the sample reported having seen or heard AvoidtheStork. Examining the reported exposure individuals against the unexposed, a number of important campaign-related differences emerge. Most significantly, exposed individuals reported higher intentions to use contraceptives and being more able to use contraceptives consistently and appropriately every time they have sex. Attitudinal differences also existed, such as those who reported being exposed to the campaign thought contraceptives are worth using regardless of cost and using contraceptives does not make sex seem too planned. Exposed individuals also showed increased knowledge about the effectiveness of some contraceptives. Changes in normative perception were also documented, such as women who reported seeing the campaign believed that more of their single friends used contraceptives when they did not wish to become pregnant. Examining the impact of the number of campaign channels respondents reported seeing, those that reported seeing or hearing the campaign through more channels showed increased levels of communication with their best friends about various topics including when they want to get pregnant and what they would do it if they became pregnant.

Conclusions: Across all methods of evaluation the campaign results are positive and appear to support the importance of a surround strategy when addressing a complex health behavior, such as contraceptive use.

Implications for research and/or practice: The presentation will conclude with implications for future campaigns.