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Analyzing User Reviews of the First Digital Contraceptive: Mixed Methods Study
KTH, School of Electrical Engineering and Computer Science (EECS), Human Centered Technology, Media Technology and Interaction Design, MID.ORCID iD: 0000-0003-2154-6945
Institute of Design, AHO Oslo School of Architecture and Design, Oslo, Norway.ORCID iD: 0000-0002-9884-0205
KTH, School of Electrical Engineering and Computer Science (EECS), Human Centered Technology, Media Technology and Interaction Design, MID.ORCID iD: 0000-0001-9472-3805
2023 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 25, p. e47131-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: People in Western countries are increasingly rejecting hormone-based birth control and expressing a preference for hormone-free methods. Digital contraceptives have emerged as nonhormonal medical devices that make use of self-tracked data and algorithms to find a user's fertile window. However, there is little knowledge about how people experience this seemingly new form of contraception, whose failure may result in unwanted pregnancies, high health risks, and life-changing consequences. As digital contraception becomes more widely adopted, examining its user experience is crucial to inform the design of technologies that not only are medically effective but also meet users' preferences and needs. OBJECTIVE: We examined the user experience offered by Natural Cycles-the first digital contraceptive-through an analysis of app reviews written by its users worldwide. METHODS: We conducted a mixed methods analysis of 3265 publicly available reviews written in English by users of Natural Cycles on the Google Play Store. We combined computational and human techniques, namely, topic modeling and reflexive thematic analysis. RESULTS: For some users of digital contraception, the hormone-free aspect of the experience can be more salient than its digital aspect. Cultivating self-knowledge through the use of the technology can, in turn, feel empowering. Users also pointed to an algorithmic component that allows for increased accuracy over time as long as user diligence is applied. The interactivity of the digital contraceptive supports mutual learning and is experienced as agential and rewarding. Finally, a digital contraceptive can facilitate sharing the burden of contraceptive practices or highlight single-sided responsibilities while creating points of friction in the required daily routines. CONCLUSIONS: Digital contraception is experienced by users as a tamed natural approach-a natural method contained and regulated by science and technology. This means that users can experience a method based on a digital product as "natural," which positions digital contraceptives as a suitable option for people looking for evidence-based nonhormonal contraceptive methods. We point to interactivity as core to the user experience and highlight that a digital contraceptive might allow for collaboration between partners around contraceptive practices and responsibilities. We note that the user diligence required for the digital contraceptive to provide accurate and frequent data is sometimes not enough. Future research could look at designing (and redesigning) digital contraceptives with primary users and intimate partners, enhancing the experience of tamed naturalness; exploring how trust fluctuates among involved actors and in interactions with the technology; and, ultimately, designing more inclusive approaches to digital contraception.

Place, publisher, year, edition, pages
JMIR Publications Inc. , 2023. Vol. 25, p. e47131-
Keywords [en]
computational methods, digital contraception, digital health, health informatics, intimate health, natural language processing, NLP, reproductive health, user experience, women’s health
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:kth:diva-340324DOI: 10.2196/47131ISI: 001106863300002PubMedID: 37962925Scopus ID: 2-s2.0-85176897703OAI: oai:DiVA.org:kth-340324DiVA, id: diva2:1816332
Note

QC 20231129

Available from: 2023-12-01 Created: 2023-12-01 Last updated: 2024-06-18Bibliographically approved

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Ciolfi Felice, MarianelaJuul Sondergaard, Marie LouiseBalaam, Madeline

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