The role of social norms on adolescent family planning in rural Kilifi county, Kenya
Despite Kenya's encouraging progress in increasing access to modern contraception among youth, several barriers remain preventing large-scale efforts to reduce demand-side unmet need for family planning. Shifting social norms around the use and acceptability of modern contraception may represen...
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| Veröffentlicht in: | PloS one 2023-02, Vol.18 (2), p.e0275824-e0275824 |
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| description | Despite Kenya's encouraging progress in increasing access to modern contraception among youth, several barriers remain preventing large-scale efforts to reduce demand-side unmet need for family planning. Shifting social norms around the use and acceptability of modern contraception may represent a potent target for future interventions. However, the structure of normative influence on individual modern contraceptive use among youth needs to be determined. Therefore, our aim was to estimate the influence of individual and group-level normative influence on modern contraceptive use among adolescents from two villages in rural Kenya.
Trained enumerators collected data from individuals aged 15-24 who provided oral informed consent, or parental informed consent, in two villages in rural Kilifi county. Participants completed a questionnaire related to modern contraceptive use and were asked to nominate one to five people (referents) with whom they spend free time. The enumerators photographed each individual who nominated at least one referent using Android phones and matched them with their nominated referents. Using this social network data, we estimated group-level normative influence by taking an average of referents' modern contraception use. We then explored associations between descriptive norms, injunctive norms, and network modern contraceptive use on individual modern contraceptive use, controlling for known confounders using logistic regression models. We also conducted sensitivity analyses to test a pattern of differential referent influence on individual modern contraceptive use.
There was a positive association between pro-modern contraception descriptive and injunctive norms and individual modern contraception use (adjusted Odds Ratio (aOR) = 1.29, 95% confidence interval (CI) = 1.05-1.6, and aOR = 1.31, CI = 1.06-1.62, respectively). Network modern contraceptive use was associated with individual use in the bivariate model (aOR = 2.57, CI = 1.6-4.12), but not in the multivariable model (aOR = 1.67, CI = 0.98-2.87). When stratified by sex and marital status, network modern contraceptive use was associated with individual modern contraceptive use among female participants (aOR = 2.9, CI = 1.31-6.42), and unmarried female participants (aOR = 5.26, CI = 1.34-20.69), but not among males. No interactive effects between norms variables were detected. Sensitivity analyses with a different estimate of network modern contraceptive use showed similar result |
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Trained enumerators collected data from individuals aged 15-24 who provided oral informed consent, or parental informed consent, in two villages in rural Kilifi county. Participants completed a questionnaire related to modern contraceptive use and were asked to nominate one to five people (referents) with whom they spend free time. The enumerators photographed each individual who nominated at least one referent using Android phones and matched them with their nominated referents. Using this social network data, we estimated group-level normative influence by taking an average of referents' modern contraception use. We then explored associations between descriptive norms, injunctive norms, and network modern contraceptive use on individual modern contraceptive use, controlling for known confounders using logistic regression models. We also conducted sensitivity analyses to test a pattern of differential referent influence on individual modern contraceptive use.
There was a positive association between pro-modern contraception descriptive and injunctive norms and individual modern contraception use (adjusted Odds Ratio (aOR) = 1.29, 95% confidence interval (CI) = 1.05-1.6, and aOR = 1.31, CI = 1.06-1.62, respectively). Network modern contraceptive use was associated with individual use in the bivariate model (aOR = 2.57, CI = 1.6-4.12), but not in the multivariable model (aOR = 1.67, CI = 0.98-2.87). When stratified by sex and marital status, network modern contraceptive use was associated with individual modern contraceptive use among female participants (aOR = 2.9, CI = 1.31-6.42), and unmarried female participants (aOR = 5.26, CI = 1.34-20.69), but not among males. No interactive effects between norms variables were detected. Sensitivity analyses with a different estimate of network modern contraceptive use showed similar results.
Social norms are multilevel phenomena that influence youth modern contraceptive use, especially among young women in rural Kenya. Unmarried women with modern contraceptive users in their social network may feel less stigma to use contraception themselves. This may reflect gendered differences in norms and social influence effects for modern contraceptive use. Future research should investigate group-level normative influence in relation to family planning behaviors.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0275824</identifier><identifier>PMID: 36730329</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescence ; Adolescent ; Adolescents ; Behavior ; Biology and Life Sciences ; Birth control ; Bivariate analysis ; Children & youth ; Confidence intervals ; Consent ; Contraception ; Contraception Behavior ; Contraceptive Agents ; Contraceptives ; Coronaviruses ; COVID-19 ; Data collection ; Demographic aspects ; Engineering and Technology ; Evaluation ; Family ; Family planning ; Family Planning Services ; Female ; Fertility ; Girls ; Health aspects ; Humans ; Infertility ; Influence ; Informed consent ; Kenya ; Male ; Marriage ; Medical research ; Medicine and Health Sciences ; Methyltestosterone ; Norms ; Pandemics ; People and Places ; Perceptions ; Pregnancy ; Regression analysis ; Regression models ; Reproductive health ; School dropouts ; Sensitivity analysis ; Smartphones ; Social aspects ; Social networks ; Social Norms ; Social organization ; Social Sciences ; Statistical analysis ; Teenagers ; Villages ; Women ; Womens health ; Young adults</subject><ispartof>PloS one, 2023-02, Vol.18 (2), p.e0275824-e0275824</ispartof><rights>Copyright: © 2023 Lahiri 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.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Lahiri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Lahiri et al 2023 Lahiri et al</rights><rights>2023 Lahiri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c575t-bb8b13696778f53de306087af52155f8b7e93dafe86ed7b7f02306e1e574e8f73</cites><orcidid>0000-0001-9797-9566</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894424/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894424/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2929,23871,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36730329$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Ummarino, Dario</contributor><creatorcontrib>Lahiri, Shaon</creatorcontrib><creatorcontrib>Bingenheimer, Jeffrey</creatorcontrib><creatorcontrib>Sedlander, Erica</creatorcontrib><creatorcontrib>Munar, Wolfgang</creatorcontrib><creatorcontrib>Rimal, Rajiv</creatorcontrib><title>The role of social norms on adolescent family planning in rural Kilifi county, Kenya</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Despite Kenya's encouraging progress in increasing access to modern contraception among youth, several barriers remain preventing large-scale efforts to reduce demand-side unmet need for family planning. Shifting social norms around the use and acceptability of modern contraception may represent a potent target for future interventions. However, the structure of normative influence on individual modern contraceptive use among youth needs to be determined. Therefore, our aim was to estimate the influence of individual and group-level normative influence on modern contraceptive use among adolescents from two villages in rural Kenya.
Trained enumerators collected data from individuals aged 15-24 who provided oral informed consent, or parental informed consent, in two villages in rural Kilifi county. Participants completed a questionnaire related to modern contraceptive use and were asked to nominate one to five people (referents) with whom they spend free time. The enumerators photographed each individual who nominated at least one referent using Android phones and matched them with their nominated referents. Using this social network data, we estimated group-level normative influence by taking an average of referents' modern contraception use. We then explored associations between descriptive norms, injunctive norms, and network modern contraceptive use on individual modern contraceptive use, controlling for known confounders using logistic regression models. We also conducted sensitivity analyses to test a pattern of differential referent influence on individual modern contraceptive use.
There was a positive association between pro-modern contraception descriptive and injunctive norms and individual modern contraception use (adjusted Odds Ratio (aOR) = 1.29, 95% confidence interval (CI) = 1.05-1.6, and aOR = 1.31, CI = 1.06-1.62, respectively). Network modern contraceptive use was associated with individual use in the bivariate model (aOR = 2.57, CI = 1.6-4.12), but not in the multivariable model (aOR = 1.67, CI = 0.98-2.87). When stratified by sex and marital status, network modern contraceptive use was associated with individual modern contraceptive use among female participants (aOR = 2.9, CI = 1.31-6.42), and unmarried female participants (aOR = 5.26, CI = 1.34-20.69), but not among males. No interactive effects between norms variables were detected. Sensitivity analyses with a different estimate of network modern contraceptive use showed similar results.
Social norms are multilevel phenomena that influence youth modern contraceptive use, especially among young women in rural Kenya. Unmarried women with modern contraceptive users in their social network may feel less stigma to use contraception themselves. This may reflect gendered differences in norms and social influence effects for modern contraceptive use. Future research should investigate group-level normative influence in relation to family planning behaviors.</description><subject>Adolescence</subject><subject>Adolescent</subject><subject>Adolescents</subject><subject>Behavior</subject><subject>Biology and Life Sciences</subject><subject>Birth control</subject><subject>Bivariate analysis</subject><subject>Children & youth</subject><subject>Confidence intervals</subject><subject>Consent</subject><subject>Contraception</subject><subject>Contraception Behavior</subject><subject>Contraceptive Agents</subject><subject>Contraceptives</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Data collection</subject><subject>Demographic aspects</subject><subject>Engineering and Technology</subject><subject>Evaluation</subject><subject>Family</subject><subject>Family planning</subject><subject>Family Planning Services</subject><subject>Female</subject><subject>Fertility</subject><subject>Girls</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Infertility</subject><subject>Influence</subject><subject>Informed consent</subject><subject>Kenya</subject><subject>Male</subject><subject>Marriage</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Methyltestosterone</subject><subject>Norms</subject><subject>Pandemics</subject><subject>People and Places</subject><subject>Perceptions</subject><subject>Pregnancy</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Reproductive health</subject><subject>School dropouts</subject><subject>Sensitivity analysis</subject><subject>Smartphones</subject><subject>Social aspects</subject><subject>Social networks</subject><subject>Social Norms</subject><subject>Social organization</subject><subject>Social Sciences</subject><subject>Statistical analysis</subject><subject>Teenagers</subject><subject>Villages</subject><subject>Women</subject><subject>Womens 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lahiri, Shaon</au><au>Bingenheimer, Jeffrey</au><au>Sedlander, Erica</au><au>Munar, Wolfgang</au><au>Rimal, Rajiv</au><au>Ummarino, Dario</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of social norms on adolescent family planning in rural Kilifi county, Kenya</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-02-02</date><risdate>2023</risdate><volume>18</volume><issue>2</issue><spage>e0275824</spage><epage>e0275824</epage><pages>e0275824-e0275824</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Despite Kenya's encouraging progress in increasing access to modern contraception among youth, several barriers remain preventing large-scale efforts to reduce demand-side unmet need for family planning. Shifting social norms around the use and acceptability of modern contraception may represent a potent target for future interventions. However, the structure of normative influence on individual modern contraceptive use among youth needs to be determined. Therefore, our aim was to estimate the influence of individual and group-level normative influence on modern contraceptive use among adolescents from two villages in rural Kenya.
Trained enumerators collected data from individuals aged 15-24 who provided oral informed consent, or parental informed consent, in two villages in rural Kilifi county. Participants completed a questionnaire related to modern contraceptive use and were asked to nominate one to five people (referents) with whom they spend free time. The enumerators photographed each individual who nominated at least one referent using Android phones and matched them with their nominated referents. Using this social network data, we estimated group-level normative influence by taking an average of referents' modern contraception use. We then explored associations between descriptive norms, injunctive norms, and network modern contraceptive use on individual modern contraceptive use, controlling for known confounders using logistic regression models. We also conducted sensitivity analyses to test a pattern of differential referent influence on individual modern contraceptive use.
There was a positive association between pro-modern contraception descriptive and injunctive norms and individual modern contraception use (adjusted Odds Ratio (aOR) = 1.29, 95% confidence interval (CI) = 1.05-1.6, and aOR = 1.31, CI = 1.06-1.62, respectively). Network modern contraceptive use was associated with individual use in the bivariate model (aOR = 2.57, CI = 1.6-4.12), but not in the multivariable model (aOR = 1.67, CI = 0.98-2.87). When stratified by sex and marital status, network modern contraceptive use was associated with individual modern contraceptive use among female participants (aOR = 2.9, CI = 1.31-6.42), and unmarried female participants (aOR = 5.26, CI = 1.34-20.69), but not among males. No interactive effects between norms variables were detected. Sensitivity analyses with a different estimate of network modern contraceptive use showed similar results.
Social norms are multilevel phenomena that influence youth modern contraceptive use, especially among young women in rural Kenya. Unmarried women with modern contraceptive users in their social network may feel less stigma to use contraception themselves. This may reflect gendered differences in norms and social influence effects for modern contraceptive use. Future research should investigate group-level normative influence in relation to family planning behaviors.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36730329</pmid><doi>10.1371/journal.pone.0275824</doi><tpages>e0275824</tpages><orcidid>https://orcid.org/0000-0001-9797-9566</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2023-02, Vol.18 (2), p.e0275824-e0275824 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2771911076 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescence Adolescent Adolescents Behavior Biology and Life Sciences Birth control Bivariate analysis Children & youth Confidence intervals Consent Contraception Contraception Behavior Contraceptive Agents Contraceptives Coronaviruses COVID-19 Data collection Demographic aspects Engineering and Technology Evaluation Family Family planning Family Planning Services Female Fertility Girls Health aspects Humans Infertility Influence Informed consent Kenya Male Marriage Medical research Medicine and Health Sciences Methyltestosterone Norms Pandemics People and Places Perceptions Pregnancy Regression analysis Regression models Reproductive health School dropouts Sensitivity analysis Smartphones Social aspects Social networks Social Norms Social organization Social Sciences Statistical analysis Teenagers Villages Women Womens health Young adults |
| title | The role of social norms on adolescent family planning in rural Kilifi county, Kenya |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-15T17%3A05%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20role%20of%20social%20norms%20on%20adolescent%20family%20planning%20in%20rural%20Kilifi%20county,%20Kenya&rft.jtitle=PloS%20one&rft.au=Lahiri,%20Shaon&rft.date=2023-02-02&rft.volume=18&rft.issue=2&rft.spage=e0275824&rft.epage=e0275824&rft.pages=e0275824-e0275824&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0275824&rft_dat=%3Cgale_plos_%3EA735606399%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2771911076&rft_id=info:pmid/36730329&rft_galeid=A735606399&rfr_iscdi=true |