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Development and Validation of a Multidimensional Intravaginal Ring Acceptability Scale Among US Women and Their Male
Ann Gottert1, Barbara A Friedland2, Marlena Plagianos2
1Population Council, Social and Behavioral Sciences Research, Washington, District of Columbia, USA.
Perspectives on Sexual and Reproductive Health
|April 11, 2025
Summary
A new scale, the Intravaginal Ring Acceptability Scale (IVR-AS), effectively measures user and partner perceptions of intravaginal rings (IVRs). Smaller diameter IVRs were found to be more acceptable to users.
Area of Science:
- Reproductive health
- Medical device development
- Psychometrics
Background:
- Intravaginal rings (IVRs) are utilized for contraception and other applications.
- Assessing user and partner acceptability is crucial for IVR adoption.
- Standardized tools are needed to evaluate IVR acceptability.
Purpose of the Study:
- To develop and validate the Intravaginal Ring Acceptability Scale (IVR-AS).
- To create a multidimensional, standardized tool for assessing IVR acceptability.
- To evaluate IVR-AS among end-users in the United States.
Main Methods:
- Developed a scale with items reflecting specific aspects of IVR acceptability for women and male partners.
- Utilized a randomized, crossover clinical trial involving three nonmedicated silicone IVRs of different diameters.
- Assessed scale reliability and convergent validity using exploratory factor analysis and multivariable regression.
Main Results:
- The final 19-item women's scale and 8-item men's scale demonstrated high reliability (Cronbach's alpha > 0.78).
- Higher scores on the IVR-AS correlated with favorable assessments of IVR use, such as ease of insertion/removal.
- Smaller diameter IVRs (46/56 mm) received higher acceptability scores than the larger (66 mm) IVR.
Conclusions:
- The IVR-AS reliably captures multiple dimensions of IVR acceptability for both women and their partners.
- The scale demonstrated excellent reliability and convergent validity.
- Further validation of the IVR-AS in future studies is recommended.
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