Journal Article

Measurement of social norms affecting modern contraceptive use: A literature review

As a critical building block to developing social norms interventions to support healthy family planning and other reproductive health behaviors, we conducted a literature review to identify and evaluate social norm measures related to modern contraceptive use. Of 174 articles reviewed in full, only 17 studies met our criteria for inclusion. Across these articles, no single measure of norms was used in more than one study; failure to specify the boundaries of who was engaging in and influencing the behaviors of interest contributed to the variation. Most of the studies relied on cross-sectional data, only included condom use as their contraceptive use outcome, used individual- or interpersonal-level behavior change theories rather than social-level theories, and assumed a reference group, all of which limit the quality of the norm measures. We make several recommendations to bring greater consistency and comparability to social norm measures. 

Published in a peer-reviewed journal of the Population Council. Elizabeth Costenbader is Social Scientist and Rachel Lenzi is Research Associate, FHI 360, Global Health, Population and Nutrition, Durham, NC. Rebecca B. Hershow was a FHI 360–UNC Gillings School of Global Public Health Fellow, FHI 360, Durham, NC and is Doctoral student, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Kim Ashburn was Senior Program Officer for Research, Institute for Reproductive Health, Georgetown University, Washington, DC and is currently Senior Research Officer, Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC. Donna R. McCarraher is Director, FHI 360, Reproductive, Maternal, Newborn, and Child Health, Durham, NC.