Online education

Culture-Based Adaptation of LARC Education

Adapting LARC Education Based on Culture | Image credit: © (JLco) Julia Amaral – © (JLco) Julia Amaral –

Online education on long-acting reversible contraceptives (LARCs) needs to adapt to different cultural and linguistically diverse (CALD) backgrounds, according to a recent study published in . Australian Journal of Health Promotion.

Women with a CALD background often use less effective contraceptive methods, increasing the risk of unintended pregnancies. Unwanted pregnancies can have social, emotional, and medical consequences, along with socioeconomic problems.

LARCs, which include intrauterine devices and subcutaneous hormone implants, are the most effective contraceptives for preventing unwanted pregnancies. Studies show that watching online educational videos may increase a young woman’s interest in her LARC.

There is little data on how online educational videos about LARC should be modified for women with CALD backgrounds or whether videos about LARC in their current state would work for women in these populations. Researchers conducted a study to determine what systemic factors and barriers to LARC should be addressed in the context of CALD.

Participants included women aged 18 to 44 from Middle Eastern, Indian and Chinese backgrounds. This is because the 2012 Australian Census showed that these cultural groups are among the most populous non-English speaking groups. All study participants were able to speak English.

Recruitment was done through targeted social media ads across 10 Facebook groups. These groups were frequented by the demographics studied. People who click on your ad will see a description, a privacy survey, and a consent form.

We collected qualitative data using semi-structured telephone interviews based on the Andersen healthcare utilization model. This allowed the researchers to determine the personal and organizational factors and barriers to her LARC that could be discussed in the instructional video.

NVivo12 software was used for interview transcription and data extraction was performed by an independent investigator. Thematic analysis begins with a comprehensive and proactive reading of data to generate code and refine themes.

Six women from each cultural group were interviewed. Seventy-two percent of study participants were under the age of 30, and 78% lived in Victoria. In the data she identified three themes. Tailoring content to address cultural issues, optimizing delivery approaches, and delivering to others involved in reproductive decision-making.

Cultural issues to be addressed include general knowledge of menstruation, ineffectiveness of natural contraceptive methods, ability of LARC to be used covertly, costs and approaches to access, LARC leading to abortion or hormones affecting the body. It contained the misconception that it would damage the

Approaches to optimize delivery include translation into ethnic languages, educational delivery by co-cultural female doctors, and dissemination through schools and culturally specific web platforms. Others involved in reproductive decision-making include colleagues, partners, parents and community leaders.

These findings demonstrate a prejudice against LARC in the CALD background. With more covert ways to access the LARC, it is possible that women in these groups could gain access to her LARC without her friends or family knowing.

The data also demonstrate the importance of costs and subsidy delivery methods for women with a CALD background, conveying the importance of disseminating information about costs and methods of accessing LARC. In a culture with myths that hormones are inherently evil, LARC education must emphasize hormone safety to counter these myths.

Different adaptations were required depending on the culture. Investigators concluded that the online intervention should be translated, made available to men and women of all ages, and include personal anecdotes about Chinese women’s use of LARC.


Liu R, Mazza D, Lee CK, Subasingha AK. What should women know about long-acting reversible contraception? Perspectives of women from culturally and linguistically diverse backgrounds. Health Promotion J Australia 2023.doi:10.1002/hpja.743

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