A simple experiment to improve adherence for taking the oral contraceptive pill: An exploratory study of behavioural mechanisms

Abstract

Objectives: Full adherence is imperative to ensure the prevention of unintended pregnancies, which have serious health and financial impacts on women. Previous research has identified the importance of cues (habit-based) and providing information from a credible source (non-habit-based) in facilitating adherence. Design: A 6 week experiment was developed to increase adherence to the pill (primary outcome) as well as increase habit strength for taking the pill (secondary outcome). Methods: A sample of Australians who menstruate (N = 77, Mage = 25.18, SD = 3.49) were randomly assigned to one of four conditions: (1) a control group, (2) receiving information from a credible source, (3) implementing a daily cue, and (4) receiving both the information and instructions to implement a cue. At baseline and six-weeks, participants completed two measures of adherence to the pill, and a measure of habit strength. Results: Mixed-model ANOVAs revealed no significant changes in adherence to the pill across conditions, over time. There was a significant increase in habit strength over time (η2 =.11), across all conditions (η2 =.11). However, these changes did not significantly differ by condition (p =.071). Conclusions: These findings suggest participating in an experiment, regardless of condition, may make taking the pill more salient and thus increase habit strength. It also suggests that providing information from a credible source nor associating taking the pill with a daily cue substantially increased adherence. However, adherence was positively skewed and therefore these findings need to be further explored with individuals with lower adherence.