Perspectives on Sexual and Reproductive Health最新文献

{"title":"The Decline of Abortion in Spain Over the Last Decade.","authors":"Miguel Requena, Mikolaj Stanek","doi":"10.1111/psrh.70036","DOIUrl":"https://doi.org/10.1111/psrh.70036","url":null,"abstract":"<p><strong>Objective: </strong>To analyze how shifts in population composition and variations in the behavior of different sociodemographic groups have changed abortion practices in Spain between 2011 and 2021.</p><p><strong>Methods: </strong>We used data from the Voluntary Terminations of Pregnancies register and Spanish Population and Housing Censuses to examine abortion rates and demographic characteristics of women aged 12-52. We used Poisson regression models and the Oaxaca-Blinder decomposition technique to estimate the contributions of shifts in population structure and variations in behaviors to changes in abortion rates.</p><p><strong>Results: </strong>We found that 40% of the decline was due to changes in sociodemographic characteristics. Specifically, the relative reduction in the number of younger women in the population and the increase in women's education levels significantly contributed to the decline in abortion rates, while the influx of immigrant women offset some of this reduction. The reduction not explained by these factors was attributed to behavioral changes, with significant reductions in the likelihood of undertaking an abortion also occurring among women under 35, immigrants from non-high-income countries, and lower-educated women.</p><p><strong>Conclusions: </strong>The study highlights the importance of including changes in the sociodemographic composition of populations in analyses of shifts in abortion rates. It also shows that behavioral changes are not uniform, and that the primary driver of change in abortion rates in Spain is the reduction in abortion rates among the subgroups that had the highest initial rates, leading to a gradual flattening of the differences between women of different ages, education levels, and migratory backgrounds.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Health Behaviors and Outcomes Among Middle-Aged and Older Disabled Adults in Britain.","authors":"Yoshiko Sakuma, Bernice Lin, Eneyi Kpokiri, Junead Khan, Huachun Zou, Joseph D Tucker, Tom Shakespeare, Hannah Kuper, Dan Wu","doi":"10.1111/psrh.70034","DOIUrl":"https://doi.org/10.1111/psrh.70034","url":null,"abstract":"<p><strong>Background: </strong>Sexual health is crucial for well-being, yet research often overlooks middle-aged and older adults, as well as those with disabilities. This study explores the sexual health of disabled middle-aged and older adults in Britain.</p><p><strong>Objective: </strong>We aim to explain sexual behaviors and outcomes among disabled adults aged 45-74 in Britain.</p><p><strong>Methods: </strong>We conducted a secondary quantitative analysis using data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a British population-representative survey. The study did not focus on a specific type of disability but rather included people who consider themselves to have a long-standing illness that limits their activity. The analysis incorporated variables on sexual behaviors and outcomes: bivariate analyses and multiple logistic regressions stratified by sex compared behaviors and outcomes by disability status.</p><p><strong>Results: </strong>Of 7082 participants included, 1906 were classified as being with limiting disability status. Adjusting for sociodemographic differences, compared to nondisabled individuals, those with limiting disability status adults were less likely to engage in sex in the last 4 weeks (aOR: 0.60, CI: 0.51-0.71) or be in a steady relationship (aOR: 0.69, CI: 0.59-0.80) and were more likely to report poorer sexual health outcomes, including having experienced coerced sex attempts (aOR:1.83, CI:1.48-2.27), had coerced sex (aOR: 1.64, CI:1.33-2.01), had their sex life affected by health in the last year (aOR: 5.08, CI:4.27-6.05), and sought help for their sex lives (aOR:1.73, CI:1.38-2.17).</p><p><strong>Conclusions: </strong>Middle-aged and older disabled adults in Britain are less likely to be sexually active, yet more likely to experience negative sexual health outcomes. The increased health-seeking behaviors and their vulnerability highlight the necessity for tailored sexual health services, extending into middle age and older adulthood.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Interval Pregnancy Following Delivery in Catholic-Affiliated Versus Non-Catholic-Affiliated Hospitals Among Patients Insured Through the Medicaid Program.","authors":"Allison Liu, Valeria Hernandez, Debra Stulberg, Phil Schumm, Manoradhan Murugesan, Ashley McHugh, Annie Dude","doi":"10.1111/psrh.70021","DOIUrl":"10.1111/psrh.70021","url":null,"abstract":"<p><strong>Background: </strong>As the number of U.S. Catholic-affiliated hospitals increases, more patients who receive care at Catholic hospitals may face restrictions to reproductive healthcare services, including postpartum contraception and sterilization. Little is known about how Catholic hospital affiliation affects the likelihood of a short-interval pregnancy following a delivery. A short interpregnancy interval is associated with poor obstetric outcomes in subsequent pregnancies.</p><p><strong>Methods: </strong>In this retrospective study of Medicaid claims data, we examined if an index delivery at a Catholic-affiliated hospital was associated with a short-interval pregnancy among patients in nine states (2010-2014). We used Cox proportional hazards regression to compare the time to subsequent pregnancy for those who delivered at Catholic-affiliated hospitals versus non-Catholic-affiliated hospitals. We also estimated the likelihood of a subsequent pregnancy by 6, 12, and 18 months following an index delivery.</p><p><strong>Results: </strong>We matched 1,197,898 index births to a provider and the religious affiliation of the delivery hospital. Across all nine states, 20.9% (249,764) of deliveries were at Catholic hospitals. After adjusting for maternal age, maternal race and ethnicity, and rural residence, subjects who delivered in a Catholic hospital had a 5% increased adjusted odds of conception by 18 months (95% confidence interval: 1.04-1.07; adjusted odds ratio: 1.07, 95% confidence interval: 1.05-1.10 by 6 months and adjusted odds ratio: 1.06, 95% confidence interval: 1.05-1.08 by 12 months for Catholic vs. non-Catholic hospitals).</p><p><strong>Discussion: </strong>Medicaid enrollees who deliver at Catholic hospitals are at increased risk for short-interval pregnancies.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"321-328"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Do You Know What Birth Control Actually Does to Your Body?\": Assessing Contraceptive Information on TikTok.","authors":"Caroline de Moel-Mandel, Arielle Donnelly, Megan Bugden","doi":"10.1111/psrh.70025","DOIUrl":"10.1111/psrh.70025","url":null,"abstract":"<p><strong>Introduction: </strong>Social media platforms have rapidly become key sources of contraceptive health information, shaping the beliefs and behaviors of individuals of reproductive age. Yet, it has become increasingly difficult to distinguish accurate content from misleading information, potentially leading to higher unintended pregnancy rates. Given the limited insights into the quality and reliability of contraceptive information on TikTok, this cross-sectional study aimed to systematically evaluate popular TikTok content on contraception created by various users to identify and analyze misinformation.</p><p><strong>Method: </strong>Between August and September 2023, we analyzed 100 videos from the top five hashtags related to contraception methods (#birthcontrol, #contraception, #thepill, #naturalbirthcontrol, and #cycletracking) to assess the characteristics of the health information presented and their quality, using the DISCERN tool.</p><p><strong>Results: </strong>The TikTok videos collectively received 4.85 billion views. Only 10% were created by medical professionals. Overall, the content showed poor reliability and quality, indicating a prominent presence of contraceptive health misinformation. Furthermore, there was a concerning trend favoring natural contraceptive methods over hormonal options, often without appropriate risk disclosures, accompanied by a growing distrust in health professionals.</p><p><strong>Discussion: </strong>The rise of contraceptive misinformation on social media is re-shaping patient-provider relationships and impacting contraceptive beliefs. TikTok offers an excellent public health opportunity to disseminate accurate contraceptive information accessible to all individuals, regardless of their background or resources. To address the observed distrust in health professionals, it is essential to improve contraceptive care quality and promote shared decision-making, which would likely increase satisfaction with contraceptive choices and mitigate negative narratives online.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"358-367"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Parent-Based Sexual Health Education on Parent-Adolescent Communication and Adolescent Sexual Behavior: A Systematic Review and Meta-Analysis.","authors":"Birhanu Gutu, Abela Mahimbo, Nikki Percival, Daniel Demant","doi":"10.1111/psrh.70029","DOIUrl":"10.1111/psrh.70029","url":null,"abstract":"<p><strong>Background: </strong>Parent-based sexual education interventions have a positive impact on adolescent sexual and reproductive health. However, despite these positive outcomes, there is a lack of comprehensive research to understand the effectiveness of these programs across different communities and demographics.</p><p><strong>Methods: </strong>We conducted a systematic search of databases from January 2013 to April 2023 and identified 51 published studies conducted globally on the effects of parent-based sexual education. We conducted meta-analyses to understand the pooled effect of interventions on parent-adolescent communication outcomes and adolescent sexual and reproductive behaviors.</p><p><strong>Results: </strong>This review includes 51 studies. Most of the included studies (n = 36, 68.6%) were conducted in high-income countries; 17 (33.3%) involved only mothers, and 37 (72.5%) stated they were based on theoretical frameworks. The systematic review showed that interventions on sexual communication had mixed effects on parent and adolescent-related outcomes. The meta-analysis, however, showed positive effects on parent-reported sexual health communication frequency, adolescent-reported sexual health communication frequency, parental attitude, and parental self-efficacy, Cohen's d = 0.32, 0.26, 0.38, and 0.41, respectively.</p><p><strong>Conclusion: </strong>Parent-based sexual health education interventions positively impact various aspects of parent-adolescent sexual health communication and behavior, suggesting the effectiveness of the intervention in different social, cultural, and economic contexts. The lack of research in low- and middle-income nations and limited paternal participation highlights the need for further research.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"374-422"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Women Feel Unprepared for the Experience of an Intrauterine Device Insertion: Findings From an Australian Study.","authors":"Cassandra Caddy, Meredith Temple-Smith, Jacqueline Coombe","doi":"10.1111/psrh.70023","DOIUrl":"10.1111/psrh.70023","url":null,"abstract":"<p><strong>Objective(s): </strong>The experience of pain during intrauterine insertion can be highly variable, ranging from none to severe. The objective of this study was to explore the experience of intrauterine device (IUD) insertion from the perspective of contraceptive users.</p><p><strong>Study design: </strong>We conducted a qualitative study using individual semi-structured Zoom interviews with women living in Australia. We recruited participants from a larger study exploring the information needs of contraceptive users. We audio-recorded and transcribed interviews and thematically analyzed the data.</p><p><strong>Results: </strong>Eighteen women described their experiences of IUD insertion. Although most participants described mild to moderate pain, some described severe pain exceeding their expectations and reported being unprepared for this experience. In some cases, these experiences had unexpected short and long-term consequences such as impacts on intimate relationships and fear of other gynecological procedures.</p><p><strong>Conclusion: </strong>Intrauterine device users should be informed of the range of pain experiences that may occur during insertion, including the risk of a vasovagal reaction, and all pain management options available to them. Experiences of pain during insertion did not appear to deter contraceptive users' continued IUD use or planned future use.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"368-373"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I Don't Even Understand How They Function\": Contraception Information, Motivation, and Behavioral Skills Among Women Experiencing Homelessness.","authors":"Ashvita Garg, Annalynn M Galvin, Anelise Diener, Stacey B Griner, Idara N Akpan, Erika L Thompson","doi":"10.1111/psrh.70024","DOIUrl":"10.1111/psrh.70024","url":null,"abstract":"<p><strong>Background: </strong>Women experiencing homelessness have higher rates of unintended pregnancies than stably housed women. Given that some of this may be attributed to nonuse or inconsistent use of contraception, we explored the behavioral cognitions for contraceptive use among women experiencing homelessness. The Information-Motivation-Behavioral Skills (IMB) model can examine health behavior cognitions, while acknowledging the macro-level context. Therefore, this study explored the IMB characteristics related to contraception use among women experiencing homelessness.</p><p><strong>Methods: </strong>We conducted interviews (n = 19) among pregnancy-capable women 18-45 years old experiencing homelessness. We recruited women between 2019 and 2020 in North Texas. Interviews were thematically analyzed based on the IMB framework.</p><p><strong>Results: </strong>The mean age of women in the study sample was 33.4 years (SD = 7.6). In the information construct, most women were aware of different contraceptive methods; however, many desired to learn more about the side effects. For motivation, most women had a positive attitude toward their current contraception, but their motivation to use a type of contraceptive method depended on side effects and comfort with the method. Additionally, their trusted social connections influenced their contraception decisions. When examining behavioral skills, uncertainty of being able to obtain contraception was a barrier, especially with macro-level context related to lack of adequate insurance coverage and transportation.</p><p><strong>Conclusions: </strong>Improving knowledge about side effects of contraceptive methods, addressing misconceptions, and increasing accessibility to contraceptive methods by providing transportation and financial assistance while maintaining reproductive autonomy may be effective strategies to improve equitable access to contraception and reduce unintended pregnancies among this population.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"340-349"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Insurance Coverage and Unplanned Births in Rotterdam, the Netherlands: A Natural Experiment in the Generation R Study.","authors":"Clair A Enthoven, Jeremy A Labrecque, Nicole Lucassen, Marco Varkevisser, Hilmar H Bijma, Hanan El Marroun, Pauline W Jansen","doi":"10.1111/psrh.70020","DOIUrl":"10.1111/psrh.70020","url":null,"abstract":"<p><strong>Objectives: </strong>Starting January 1 2004, contraception was removed from the Dutch social health insurance for people aged 21 years and over. This study investigated the effect of social health insurance coverage for contraception on unplanned births.</p><p><strong>Methods: </strong>Data from the Generation R Study was used, a population-based birth cohort of pregnant people with delivery dates between 2002 and 2006 (N = 2516) in Rotterdam, the Netherlands. Logistic regression models were constructed with a pre-post policy variable, date of the last menstruation relative to January 12,004 and the interaction between them to allow the model to change over time with unplanned births as outcome, adjusted for age, migration background, educational level, household income and financial difficulties.</p><p><strong>Results: </strong>Removing contraception coverage from the social health insurance in 2004 showed a small increase in the odds ratio for unplanned birth, which was not statistically significant (OR = 1.18; 95% CI = 0.79-1.75). When participants with the last menstruation between January 1, 2004 and July 1, 2004 were excluded, a significant increase in the odds ratio for unplanned birth was found (OR = 2.69; 95% CI = 1.09-6.66).</p><p><strong>Conclusions: </strong>In our population of pregnant participants aged 21 years and older, we found tentative evidence that removal of contraception from the social health insurance may have led to a small increase in unplanned births with a time lag of 6 months. As this study only included pregnant people who gave birth, our results should be interpreted with caution and further research is needed for a definite conclusion on the effect of health insurance coverage on unplanned pregnancies.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"293-300"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I'm Pregnant, What Do I Do?\": Exploring How People Having Abortions in Britain Find and Use Online Sources of Information.","authors":"Rosa Mackay, Rachel Scott, Maria Lewandowska, Rebecca Meiksin, Natasha Salaria, Patricia A Lohr, Sharon Cameron, Melissa Palmer, Rebecca S French, Kaye Wellings","doi":"10.1111/psrh.70016","DOIUrl":"10.1111/psrh.70016","url":null,"abstract":"<p><strong>Background: </strong>Accurate, timely, and supportive information is important for high-quality abortion care. Limited research explores how people find and use online sources of information (OSI) during the abortion process, particularly in Britain. Understanding experiences of using OSI is important for the development of person-centered services and resources.</p><p><strong>Methods: </strong>We conducted a thematic analysis of qualitative data from 41 semi-structured interviews carried out in 2021/2022 with people who had recent experience of abortion in Britain.</p><p><strong>Results: </strong>Using OSI was common amongst participants. Our analysis generated four distinct motivations for doing so. People used OSI to find information about accessing abortion services. OSI was also used to demystify abortion, as many participants did not understand what the process involved or know what to expect. Connection and solidarity were sought through OSI, and some participants felt supported by the content they found, particularly through the accounts of others. Finally, people used OSI to explore their relationship with their pregnancy during the abortion process. Using OSI brought benefits-including finding non-judgmental and supportive resources-and challenges, including struggling to find relevant information or encountering negative stories and anti-abortion views. Nonetheless, participants appreciated OSI and expressed a desire for more real-life stories and online spaces where they could connect with others.</p><p><strong>Conclusions: </strong>People having abortions want and need different things from the online resources they consult. However, OSI have the potential to provide valuable information, connection, and a place for exploration around the topic of abortion. Future work should explore how OSI can meet these different needs, guided by the motivations of users.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"281-292"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post Birth Control Syndrome Narratives on TikTok: A Content Analysis.","authors":"Emily J Pfender, Leah R Fowler","doi":"10.1111/psrh.70026","DOIUrl":"10.1111/psrh.70026","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to examine how TikTok videos tagged with #postbirthcontrolsyndrome (PBCS) made by different types of creators communicate health risks and coping strategies, using the Extended Parallel Process Model (EPPM) to assess threat, fear, and efficacy appeals.</p><p><strong>Methods: </strong>We conducted a content analysis of the top 100 TikTok videos using the hashtag #postbirthcontrolsyndrome by coding videos for EPPM variables (threat, fear, efficacy), creator type (healthcare provider, content creator, regular user), and engagement metrics (likes, comments, saves).</p><p><strong>Results: </strong>Content creators frequently portrayed PBCS as severe (40/49) and highlighted side effects (44/49). Healthcare providers emphasized that PBCS is common (13/33) and provided management strategies (14/33; e.g., tips after discontinuing hormonal contraception). Videos describing severe symptoms received higher comments. Preparatory strategy videos garnered more saves.</p><p><strong>Discussion: </strong>PBCS content on TikTok often uses fear-based messaging with limited efficacy information, which may influence contraceptive decisions. Differences in framing between creators and providers suggest a need for more evidence-based communication. Engagement trends indicate that both fear appeals and actionable advice drive more user interaction, reinforcing the importance of balancing emotional salience with credible guidance in social media health messaging.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"423-429"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}