Paving the way for male hormonal contraception: A consumer behavior approach

Abstract

Background: Male contraceptive options are limited to condoms or vasectomy and have lacked significant developments for about a century, suggesting the value of exploring male hormonal contraceptives (MHC). In October 2018, a transdermal gel method entered Phase 2 clinical trials, indicating MHC may soon be available. However, eventual uptake of potentially contentious innovations, like MHC, requires informed marketing and promotional strategy. Consumer behavior research methodologies can aid in determining consumer perspectives, providing a framework for effective marketing to encourage MHC adoption upon market introduction. Methods: Phases 1 & 2. Focus groups (n=29) and individual, in-depth interviews (n=20) among college-aged men and women aged 18-26 years were conducted using a semi-structured approach. Techniques from expanded grounded theory were used, allowing for a constant comparative approach to data contextualization and theme identification. Ads were created based on focus group results and tested in the interviews. Content analysis served as the data analysis strategy, allowing for a constant comparative approach to data contextualization and theme identification. Phase 3. College-aged men and women (n=1,997) aged 18-26 years participated in a web-based survey. Multiple linear regression was used to examine significant predictors of attitudes toward, interest in, and intention to use or encourage use of MHC. A conjoint analysis procedure was also used to assess the relative importance of attributes on ad effectiveness and preference. Results: Phase 1. Three primary themes emerged from focus group discussions: 1) openness to MHC; 2) resistance to MHC; and 3) MHC gel innovation characteristics. Men and women were generally interested in the idea of an MHC method. Hesitance about MHC surrounded the social acceptance of a novel contraceptive product, resistance to changing current contraceptive routines, and fear of health consequences. Participants shared insights about promotional strategies which fell within the diffusion of innovations (DOI) characteristics of relative advantage, complexity, compatibility, and observability. Phase 2. In-depth interviews offered insight into perceptions of message development for MHC. Four themes emerged: 1) humor, 2) information, 3) relatability, and 4) credibility. Message testing in interviews yielded an understanding of elements participants responded most strongly to, including: 1) ad sentiment, 2) trustworthiness, and 3) visual appeal. Phase 3. Regression analyses revealed being sexually active (p=0.001) and having prior knowledge of potential MHC methods (p=0.031) aligned with positive MHC attitudes, interest, and intention. Conservative political views (p=0.002) and being satisfied with current male birth control offerings (p=0.000) were associated with negative MHC attitudes. Conjoint analysis identified informational messages as most important (56.62%). Informational (p=0.000) and aspirational messages (p=0.003) paired with relatable characters were the most highly preferred ads. Conclusions: Findings revealed college-aged men and women express a general interest in the idea of MHC, with hesitance stemming from social acceptance of a novel contraceptive product, resistance to changing current contraceptive routines, and fear of potential side effects and long-term health consequences. Promotional strategy for MHC, or similar novel health products, must focus on stratifying consumers based on their readiness to accept a potential innovation and use tactics like aspirational marketing, social norms marketing, and informational marketing to confirm benefits and address concerns. Qualitative formative research also illuminated salient concepts for MHC advertising. Message testing revealed informational ads with elements of credibility may be most useful for promoting MHC, along with ad concepts audiences feel they can relate to or trust, and practical messaging or imagery meant to increase agency in use. The quantitative survey further supported these findings among a broader, university audience, indicating informational messages or aspirational messages paired with trustworthy, relatable characters are the most effective ad attributes to incorporate into marketing strategy when promoting a novel contraceptive product, like MHC.