ArticleBMJ open2026
Assessing the believability of contraceptive misinformation among young Latinas (CREO): protocol for a discrete choice experiment.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
introductionContraceptive misinformation circulates widely on social media, and young Latinas are disproportionately exposed and more likely to internalise it, shaped by language barriers, limited institutional access and historical mistrust of the medical system. Prior work documents its prevalence and links influencer credibility to contraceptive behaviour, but which specific message features drive believability remains unknown. This protocol describes a discrete choice experiment (DCE), the first phase of the Choice and Reaction to Evaluate Online Opinions on Family Planning study, designed to identify which characteristics of contraceptive misinformation posts most influence perceived believability among young Latinas. METHODS AND ANALYSIS: This is a cross-sectional online study using a visual DCE grounded in the Online Misinformation Engagement Framework. Six attributes across 19 levels (influencer type, contraceptive method, narrative type, side effect type, misinformation construct and tone) were retained from 13 candidates based on theoretical grounding, visual operationalisability and non-collinearity. A D-efficient fractional factorial design reduced 864 possible combinations to 32 profiles across 16 forced-choice pairs. Eligible participants (self-identified Latinas or Indigenous women from Latin America, aged 18-29, residing in the USA) will be recruited via targeted social media ads and will complete all 16 tasks, selecting the more believable of two simulated Instagram posts per pair. A target sample of 500 exceeds Johnson-Orme requirements for main and interaction effects. Conditional logit will serve as the primary analysis; mixed logit will be estimated as a secondary specification to assess preference heterogeneity. ETHICS AND DISSEMINATION: This study was deemed exempt by the University of California, San Francisco Institutional Review Board (IRB #25-45383). Participants will provide informed consent and complete a structured debriefing correcting the misinformation presented in the DCE stimuli. Findings will be disseminated through peer-reviewed publication, conference presentations and community forums serving Latinas, in English and Spanish.
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