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The first 6 months: developing a user-informed anticipatory counselling video about the levonorgestrel intrauterine system
  1. Kelly Gilmore1,
  2. Alison Ojanen-Goldsmith2,
  3. Lisa S Callegari1,
  4. Emily M Godfrey3
  1. 1 Departments of Obstetrics and Gynecology and Health Services, University of Washington, Seattle, Washington, USA
  2. 2 Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
  3. 3 Departments of Family Medicine and Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
  1. Correspondence to Kelly Gilmore, Departments of Obstetrics and Gynecology and Health Services, University of Washington, Seattle, WA 98195, USA; kellyg18{at}


Background The levonorgestrel intrauterine system (LNG-IUS) is a contraceptive method that can cause irregular bleeding and cramping during the first 6 months of use. Expected side effects are common reasons given for LNG-IUS device discontinuation within 12 months of use. Anticipatory counselling regarding expected LNG-IUS side effects may reduce method discontinuation and improve patient satisfaction. Educational videos could improve anticipatory counselling for LNG-IUS users; however, none have been developed. This article describes the process of developing an anticipatory counselling video with input from women in the first 6 months of LNG-IUS use and from family planning (FP) experts.

Methods We used a participatory, iterative process to develop an anticipatory counselling video about the first 6 months of LNG-IUS use. We developed a preliminary draft using evidence from the published literature. We sought feedback from 11 FP experts and 49 LNG-IUS users to revise the script before creating the final video.

Results FP experts suggested balancing negative with positive information and using colloquial language. LNG-IUS users requested more detailed information on the LNG-IUS mechanism of action and expected side effects in the form of statistics, infographic animations, testimonials from LNG-IUS users, and technical as opposed to colloquial language. The final video is 6 min in length and features seven LNG-IUS users, three physicians, and infographic animations.

Conclusion Including input from FP experts and LNG-IUS users in the development process resulted in a 6-min anticipatory counselling video that will be piloted among patients on the day of their LNG-IUS insertion.

  • contraceptive counseling
  • long-acting reversible contraception
  • health education
  • anticipatory counseling
  • hormonal contraception
  • qualitative research
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  • Funding BAYER Healthcare Pharmaceuticals Inc. funded the development of this video through an Independent Investigator Research Award to the University of Washington Department of Family Medicine.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The University of Washington Human Subjects Division approved the focus groups with LNG-IUS users.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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