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      YouTube and the implementation and discontinuation of the oral contraceptive pill: A mixed-method content analysis

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          Abstract

          Background

          Women living in high-quality healthcare systems are more likely to use oral contraceptives at some point in their lives. Research findings have sparked controversial discussions about contraception in the scientific community and the media, potentially leading to higher rates of method discontinuation. Understanding the underlying motives for method discontinuation is crucial for reproductive health equity and future programming interventions. To address this question, this study aims to explore women’s experiences of oral contraceptive use and discontinuation on YouTube.

          Methods

          A concurrent explanatory mixed-methods design was used to conduct content analysis of German YouTube videos. The information from 175 videos of 158 individuals was extracted through quantitative descriptive content analysis. Twenty-one individuals were included in the qualitative content analysis.

          Findings

          The body was a recurring theme in the pill biographies. Women described, for example, bodily sensations as reasons for taking and stopping the pill. They also described positive and negative side effects while taking the pill and after stopping. The most common side effects of taking the pill mentioned by YouTubers were mood swings (76/158), weight gain (45/158), headaches (33/158), and depressed mood (45/158). The symptoms after discontinuation reported most were facial skin impurities (108/158), decreased mood swings (47/158), hair loss (42/158), and weight loss (36/158). Overall, women overwhelmingly rated their discontinuation experience as positive (87/91).

          Conclusions

          The study identified key symptoms of oral contraceptive initiation and discontinuation by portraying the experiences of female YouTubers, adding valuable insights to the understanding of method initiation and discontinuation. Further research is needed to explore women’s personal experiences with method discontinuation beyond the YouTube platform.

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          Most cited references75

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          What is an adequate sample size? Operationalising data saturation for theory-based interview studies.

          In interview studies, sample size is often justified by interviewing participants until reaching 'data saturation'. However, there is no agreed method of establishing this. We propose principles for deciding saturation in theory-based interview studies (where conceptual categories are pre-established by existing theory). First, specify a minimum sample size for initial analysis (initial analysis sample). Second, specify how many more interviews will be conducted without new ideas emerging (stopping criterion). We demonstrate these principles in two studies, based on the theory of planned behaviour, designed to identify three belief categories (Behavioural, Normative and Control), using an initial analysis sample of 10 and stopping criterion of 3. Study 1 (retrospective analysis of existing data) identified 84 shared beliefs of 14 general medical practitioners about managing patients with sore throat without prescribing antibiotics. The criterion for saturation was achieved for Normative beliefs but not for other beliefs or studywise saturation. In Study 2 (prospective analysis), 17 relatives of people with Paget's disease of the bone reported 44 shared beliefs about taking genetic testing. Studywise data saturation was achieved at interview 17. We propose specification of these principles for reporting data saturation in theory-based interview studies. The principles may be adaptable for other types of studies.
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            How to Construct a Mixed Methods Research Design

            This article provides researchers with knowledge of how to design a high quality mixed methods research study. To design a mixed study, researchers must understand and carefully consider each of the dimensions of mixed methods design, and always keep an eye on the issue of validity. We explain the seven major design dimensions: purpose, theoretical drive, timing (simultaneity and dependency), point of integration, typological versus interactive design approaches, planned versus emergent design, and design complexity. There also are multiple secondary dimensions that need to be considered during the design process. We explain ten secondary dimensions of design to be considered for each research study. We also provide two case studies showing how the mixed designs were constructed.
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              Health message framing effects on attitudes, intentions, and behavior: a meta-analytic review.

              Message framing has been an important focus in health communication research, yet prior meta-analyses found limited support for using framing to increase persuasiveness of health messages. This meta-analysis distinguished the outcomes used to assess the persuasive impact of framed messages (attitudes, intentions, or behavior). One hundred eighty-nine effect sizes were identified from 94 peer-reviewed, published studies which compared the persuasive impact of gain- and loss-framed messages. Gain-framed messages were more likely than loss-framed messages to encourage prevention behaviors (r = 0.083, p = 0.002), particularly for skin cancer prevention, smoking cessation, and physical activity. No effect of framing was found when persuasion was assessed by attitudes/intentions or among studies encouraging detection. Gain-framed messages appear to be more effective than loss-framed messages in promoting prevention behaviors. Research should examine the contexts in which loss-framed messages are most effective, and the processes that mediate the effects of framing on behavior.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Formal analysis
                Role: Supervision
                Role: Supervision
                Role: Supervision
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                24 May 2024
                2024
                : 19
                : 5
                : e0302316
                Affiliations
                [1 ] Institute for Medical Sociology and Rehabilitation Science, Charité Universitätsmedizin Berlin, Berlin, Berlin, Germany
                [2 ] Medical Faculty, Institute of Medical Sociology, Institute of Medical Sociology (IMS), Martin Luther University Halle Wittenberg, Interdisciplinary Centre for Health Sciences, Halle (Saale), Saxony-Anhalt, Germany
                [3 ] Osnabrück University, School of Human Sciences, Osnabrück, Lower Saxony, Germany
                [4 ] Institute for Gender Research in Medicine (GiM), Charité Universitätsmedizin Berlin, Berlin, Berlin, Germany
                [5 ] Department of Sport and Health Sciences, Technical University of Munich, Munich, Bavaria, Germany
                Wits University: University of the Witwatersrand Johannesburg, SOUTH AFRICA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0001-6094-5143
                Article
                PONE-D-24-01385
                10.1371/journal.pone.0302316
                11125465
                38787833
                8381eb16-57f2-41e3-8c05-a7989e58ad37
                © 2024 Niemann et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 13 January 2024
                : 1 April 2024
                Page count
                Figures: 1, Tables: 4, Pages: 22
                Funding
                Funded by: Open Access Publication Fund of the Martin-Luther-University Halle-Wittenberg
                Award Recipient :
                This publication was supported by the Open Access Publication Fund of the Martin Luther University Halle-Wittenberg. The funders did not influence the data analysis and the results.
                Categories
                Research Article
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Contraception
                Female Contraception
                Biology and Life Sciences
                Anatomy
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                Medicine and Health Sciences
                Anatomy
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                Psychology
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                Clinical Medicine
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                Epidemiology
                Medical Risk Factors
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                Drugs
                Contraceptives
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                Bioengineering
                Biotechnology
                Medical Devices and Equipment
                Contraceptives
                Engineering and Technology
                Bioengineering
                Biotechnology
                Medical Devices and Equipment
                Contraceptives
                Medicine and Health Sciences
                Medical Devices and Equipment
                Contraceptives
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Contraception
                Custom metadata
                Full data are available from the corresponding author or the Institute for Medical Sociology at the Martin-Luther-University Halle-Wittenberg ( medizinische-soziologie@ 123456medizin.uni-halle.de ) upon reasonable request.

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