The health belief model and the contraceptive behavior of college women: implications for health education

This study applied the "health belief model" in a comparison of the subjective perceptions, attitudes and beliefs between college women who were adequate or inadequate contraceptors. The 171 sexually active subjects were ascertained from clients of the Family Planning Clinic at the University of Illinois. A questionnaire was designed and tested to measure variables of perceived susceptibility to pregnancy, seriousness of unplanned pregnancy, benefits and barriers of contraceptive use. Inadequate contraceptors or risk-takers were defined as women who used no contraception, less effective methods such as rhythm, spermicides only or withdrawal, or effective methods sporadically. 49.5% of the subjects were risk-takers. Among the inadequate contraceptors, 17% were nonusers, 29% relied on ineffective methods, and 52% used effective methods sporadically. There was no difference between the 2 groups in their belief in seriousness of an unplanned pregnancy. The groups differed significantly in their perceived susceptibility to pregnancy (p.001). They also differed significantly in perception of overall costs and benefits of contraception (p.001), a score created by combining 12 questions on topics such as difficulty and embarrassment in obtaining contraceptives and inconvenience and awkwardness in dealing with them. There was a smaller significant difference (p.05) in a score termed "general use cost benefits," but no difference in a score called "method specific perceptions." These results were corroborated by a discriminate analysis which singled out the perceived costs and benefits and the perceived susceptibility variables as accurate predictors of the adequate contraceptor group. The health belief model showed considerable utility in explaining contraceptive behavior.     

Evaluating the Effectiveness of Workshop Interventions on Contraceptive Use Among First-Year College Students

Summary

This study investigated the impact of interventions designed to affect contraceptive knowledge and attitudes on the intent to use and reported use of contraceptives among 362 first year college students. After completing a pretest questionnaire, students were randomly assigned to a nonintervention control group or one of four workshops utilizing different approaches to education about sexuality and contraceptive use. The posttest results indicated that all four treatment groups increased in contraceptive knowledge relative to the control group. In addition, groups receiving an experientially oriented intervention showed significantly more positive changes in their     

Sexual Activity and Weekly Contraceptive Discontinuation and Selection Among Young Adult Women in Michigan

Understanding young women’s contraceptive and pregnancy prevention behaviors is important for helping women and their partners control if and when they have children. Prior research on associations between patterns of sexual activity and contraceptive behaviors is limited. We assessed the influence of recent sexual activity on discontinuation and selection of specific contraceptive methods. We used weekly data from the Relationship Dynamics and Social Life (RDSL) study, a longitudinal 2.5-year population-based project that sampled woman ages 18 and 19 (N = 1,003) in one Michigan county. We estimated logistic and multinomial regression models that accounted for clustering of weekly observations within partnerships and women. Weekly discontinuation of longer-acting methods declined with increasing sexual activity in the past month, as did discontinuation of shorter-acting hormonal methods. Sexual activity was associated with decreased selection of condoms relative to other methods. Future research into life events that lead to changes in the frequency of sexual activity may provide insight into times when women are at risk of contraceptive discontinuation. These findings underscore the importance of anticipatory guidance in contraceptive counseling so that when women change their contraceptive behavior they are equipped in advance with resources to make safe transitions between methods.     

Using student subjects in experimental research: a challenge to the practice of using students as a proxy for taxpayers

The tax discipline has accepted the practice adopted in the economics and psychology disciplines of using student subjects for experimental research purposes. However, in other social science disciplines (e.g. accounting, management or consumer research), experimental research that uses students as a substitute for another group has been widely criticised as having little external validity. In this research, data are compiled from journal articles over a 20?year period to investigate the extent to which tax experiments use student subjects and the potential implications from this practice. Three research questions are addressed. First, do tax studies using student subjects justify or explain the use of student subjects? Second, are policy recommendations or other extrapolations to the tax-paying population made from the student subject results? Third, is any acknowledgement made of the potential limitations of using student subjects? The findings indicate that approximately half of the tax experiments investigated used student subjects. Of these, approximately 80% provided no justification for their chosen subject sample. A similar proportion did not acknowledge any limitations from the use of a student sample. Around half of the papers using student subjects extrapolated their findings to the general tax-paying population or provided tax policy recommendations. In addition, the research indicates that the tax discipline has not had the same level of robust debate on the use of student subjects in experimental research as that seen in other disciplines. This potentially limits the external validity and utility of many of the tax research experiments undertaken to date.     

Barrier versus oral contraceptive use: a study of female college students

Although they provide birth control and are easier to use, oral contraceptives (OCPs) are not the preferred approach to preventing sexually transmitted disease (STD). Do the knowledge, attitudes, and experiences of oral contraceptive users place them at greater risk for STDs than those who employ barrier methods? This study examined differences between sexually active female college students (ie, those who reported ever having had vaginal intercourse) who used OCPs and those who employed barrier methods of contraception at the time of their most recent intercourse. The authors analyzed HIV- and other STD-related knowledge, attitudes, and behaviors from three consecutive annual health surveys of young women about to begin their first year of college. Findings showed barrier and OCP users to be comparable in knowledge about the effectiveness of various contraceptive methods in protecting them against STDs, perceived personal susceptibility to HIV, and experiences with alcohol before sexual intercourse. Oral contraceptive users, compared with those in the group who used barrier methods, reported a greater number of recent partners (p less than .03) and greater perceived vulnerability to STDs (p less than .03). Student healthcare providers must develop creative educational strategies to encourage simultaneous use of both oral contraceptives and barrier methods to protect students against STDs and pregnancy.     

The Reported Influence of Research Participation on Premarital Relationships

We examined the reported influence of participation in research on individuals in premarital relationships. Data were from a larger longitudinal study of 60 dating couples. We designed a questionnaire to evaluate the effects of participation. Responses to open‐ended questions revealed 3 major sources of influence: attention to relationship evaluation, effects on relationship activities, and indirect or no influence. Closed‐ended items yielded 2 dimensions: relationship‐defining influence and relationship‐evaluating influence. Relationship‐evaluating influence was greater the more respondents participated in the study. The higher were respondents' scores on relationship‐evaluating influence, the more their relationship satisfaction increased over the year long study. We conclude that the effects of participating in the research are primarily educational and enriching in nature, rather than therapeutic as suggested in previous research ( Rubin & Mitchell, 1976 ).     

Sexual Education,Gender Ideology,and Youth Sexual Empowerment

Sexual education plays an essential role in preventing unplanned pregnancy and the transmission of sexually transmitted infections (STIs). School-based sexual education programs, in particular, may be well positioned to address social factors that are empirically linked to negative sexual health outcomes, such as traditional social norms surrounding gender and sexuality. However, youth are seldom granted access to sexual education programs that explicitly address these issues. This study presents findings from a pretest–posttest survey of a sexual education program that did. It was designed for eighth graders (N=95) in the context of a school–community collaboration. The study assessed the links between several components of sexual empowerment, including gender ideology, sexual knowledge, and contraceptive beliefs. Findings link participation in the sexual education program to more progressive attitudes toward girls and women, less agreement with hegemonic masculinity ideology, and increases in sexual health and resource knowledge. Structural equation models suggest that traditional attitudes toward women were significantly related to hegemonic masculinity ideology among both boys and girls, which was in turn negatively related to safer contraceptive beliefs.     

Contraceptive Method Choice Among Young Adults: Influence of Individual and Relationship Factors

Because decisions related to contraceptive behavior are often made by young adults in the context of specific relationships, the relational context likely influences use of contraceptives. Data presented here are from in-person structured interviews with 536 Black, Hispanic, and White young adults from East Los Angeles, California. We collected partner-specific relational and contraceptive data on all sexual partnerships for each individual, on four occasions, over one year. Using three-level multinomial logistic regression models, we examined individual and relationship factors predictive of contraceptive use. Results indicated that both individual and relationship factors predicted contraceptive use, but factors varied by method. Participants reporting greater perceived partner exclusivity and relationship commitment were more likely to use hormonal/long-acting methods only or a less effective method/no method versus condoms only. Those with greater participation in sexual decision making were more likely to use any method over a less effective method/no method and were more likely to use condoms only or dual methods versus a hormonal/long-acting method only. In addition, for women only, those who reported greater relationship commitment were more likely to use hormonal/long-acting methods or a less effective method/no method versus a dual method. In summary, interactive relationship qualities and dynamics (commitment and sexual decision making) significantly predicted contraceptive use.     

The effect of interviewer evaluation of respondents’ attitudes and understanding on future survey participation in a panel study

This study explored whether the interviewers’ judgments of respondents’ performances in an initial survey can predict survey participation for a second survey among the same group of respondents in a panel study. Specifically, this study examined two interviewer variables: the interviewers’ judgments of (1) the respondents’ understanding of survey questions and (2) the respondents’ attitudes toward the survey. The analyses revealed that respondents who were rated to have an excellent understanding of the survey questions and friendly attitudes were more likely to respond to the second interview request than those with a poor understanding and unfriendly attitudes, after controlling for the characteristics of the respondents. Of these two, the judgment of the respondents’ attitudes was a stronger predictor. However, interviewer’s judgments are not correlated with the primary survey outcome or the data quality. This suggests limited value of the interviewer observation.     

The Influence of Perceived Parenting Style and Contraceptive Self-Efficacy on College Student Contraceptive Use

ABSTRACT

Few studies have examined the influence that parenting style has on the contraceptive use of college students. The current study explored the relationships between perceived parenting style, contraceptive attitudes, contraceptive self-efficacy, and contraceptive use in 270 college students. Analyses revealed that perceived parenting style had a relationship with contraceptive attitudes and when combined with contraceptive self-efficacy predicted contraceptive use. Findings suggest that for college students, both internal and external influences on beliefs contribute to contraceptive use and the parent–child relationship remains influential. Further research should explore specific aspects of parent–child communication that increase self-efficacy and subsequent contraceptive use. The implications of current results could inform the delivery of parent education and student sexual health programs.     

Web-based survey 'Contraception and attitudes to sexual behaviour' completed by women accessing a UK menopause website

Background and methodology Sociodemographic trends mean increasing numbers of new relationships in later life. These trends may not only have health consequences for women and health services but also impact on the targeting of sexual health messages. This study aimed to examine attitudes and knowledge surrounding contraception, sexual health and unwanted pregnancy among those accessing the website www.menopausematters.co.uk. A voluntary online survey was completed. RESULTS: Survey was completed by 550 respondents. Three hundred and sixty-six women, 94% of whom self-classified as pre- or perimenopausal, had been sexually active with a male partner in the previous four weeks. Commonest contraceptive methods used by perimenopausal and postmenopausal women were condoms, combined oral contraceptive pill (COCP) and male sterilization. Up to 42% of women surveyed were unhappy with their contraception. A total of 27% premenopausal, 32% perimenopausal women and 40% postmenopausal used no contraception. One-third of women were unhappy about this and 19 unplanned pregnancies had occurred. The majority of women were informed regarding COCP use over 35 years, hormone replacement therapy, emergency contraception and ceasing contraception. The majority of women were unaware that more terminations of pregnancy are performed in women over 40 than any other age group per total pregnancies.Almost a third of women were unaware that chlamydia incidence is increasing in older women. Most would use condoms in new relationship. Discussion and conclusions Women accessing www.menopausematters.co.uk are well informed about contraception and sexual health. The majority of those accessing the site are sexually active, but many use no contraception, or are unhappy with their chosen method, leaving them vulnerable to unwanted pregnancy or sexually transmitted infection.     

Reproductive Attitudes and Behavior Among Latina Adolescents

SUMMARY

This study examines the relationship between acculturation and sexual activity, contraceptive use and attitudes toward self. The sample consisted of 290 Latinas participating in a statewide adolescent pregnancy prevention program funded by the California Department of Health Services. Respondents were divided into three groups for purposes of analysis: those born outside the United States, those born in the United States who spoke primarily Spanish in the home, and those born in the United States who spoke primarily English in the home. Results indicated that less acculturated adolescents were less likely to engage in sexual activity. Place of birth was the most important predictor of differences in reproductive attitudes and behavior; language spoken in the home was not a predictor of sexual activity. There were no significant differences in contraceptive use among the sexually active respondents in the three groups. Respondents born outside of the United States had more negatives attitudes toward self on one measure; respondents born in the United States who spoke primarily Spanish in the home were more likely to plan to attend college, and to delay sexual activity because their parents would be upset, than the other groups. The authors suggest factors that may explain these differences in attitudes and behavior among the three groups.     

Correlates of the contraceptive behavior of adolescents/young adults

Pregnancy among adolescents/young adults continues at epidemic levels despite widespread concern regarding its social and psychological consequences. Cognitive psychologists point out that active decisions and behaviors such as those involved in effective contraception are facilitated or inhibited by any of a number of relevant attitudes and beliefs. The present investigation examined several such cognitive variables. Specifically, the following hypotheses were tested: Among adolescents/young adults, the use of effective contraception would be positively related to (a) the number of known cases of unwanted pregnancy of which subjects were directly aware, and (b) sexual guilt. A sample of 147 sexually active single college students aged 18–19 provided information relevant to these hypotheses. Analyses indicated that contraceptive behavior was unrelated to the number of unwanted pregnancies of which subjects were aware, but was substantially and significantly associated with sexual guilt, even when the possibility of pregnancy was precluded. The nature and implications of these findings are explored.     

A toolkit for accessible and respectful engagement in research

Social, scientific, and ethical factors underscore the value of respectfully including people with intellectual/developmental disabilities in research despite significant barriers to their research participation. In pursuit of this goal, we worked with two research advisors with intellectual/developmental disabilities to develop a qualitative study toolkit emphasizing accessibility, flexibility, variety, and responsiveness. The toolkit includes procedures and materials for recruitment, consent, interview locations and questions, breaks, and incentives. We recommend that future research utilizes insights of individuals with intellectual/developmental disabilities in research that impacts their lives, and that researchers systematically improve the use of procedures and toolkits.     

Incongruent Teen Pregnancy Attitudes,Coparenting Conflict,and Support Among Mexican‐Origin Adolescent Mothers

The current longitudinal study examined whether differences between Mexican‐origin adolescent mothers and their mother figures (N = 204 dyads) in attitudes on the status attained through teen pregnancy were associated with conflict in their coparenting relationship and whether coparenting conflict was associated with adolescent mothers' perceptions of social support. Findings revealed that when adolescents held more positive attitudes than their mother figures about the status gained through teen pregnancy, they tended to report greater coparenting conflict with their mother figures. Furthermore, greater coparenting conflict was significantly associated with decreases in adolescents' perceptions of social support (i.e., emotional, instrumental, companion support) 1 year later. Findings underscore the importance of incongruent attitudes and the quality of coparenting relationships between adolescent mothers and their mother figures in relation to support processes. Findings are discussed with respect to understanding Mexican‐origin adolescent mothers' social support in the context of family subsystem attitudes and interactions.     

A research note on male‐female differentials in the experience of heterosexual love

Debate regarding the morality of abortion has ranged from expressions of concern for the fetus by anti‐abortionists to assertions by those favoring legalized abortion that women should control their own bodies. The present research explored the possibility that the social acceptability of the sexual relationship and the extent of contraceptive conscientiousness of an abortion applicant influences favorability of response toward abortion. After responding to a measure of attitudes toward premarital contraceptive use, 40 college students read 10 brief case histories of young unmarried women who were purportedly requesting abortion. As hypothesized, participants' support for abortion was influenced by the source of contraceptive failure (method vs. personal), kind of contraceptive (artificial vs. natural), and kind of sexual relationship (steady vs. casual). Results were discussed in terms of the possibility that observers may wish to restore justice by giving greater support for abortion for conscientious contraceptive users involved in socially approved sexual relationships than for careless contraceptive users whose involvements are more casual. It was suggested that societal attitudes toward contraception for unmarried persons may interact with the reality of the prevalence of premarital sexual activity to increase the premarital pregnancy rate.     

Gender,Contraceptive Attitudes,and Condom Use in Adolescent Romantic Relationships: A Dyadic Approach

Although sexual risk behavior occurs in a dyadic context, most studies of adolescent sexual behavior focus on individuals. This study uses couple data (N = 488 couples) from the National Longitudinal Study of Adolescent Health to examine how partners' contraceptive attitudes correlate over time and whether male or female partners' attitudes are better predictors of condom use. Net of their own prior attitudes, partners' prior attitudes predicted both male and female adolescents' Wave 2 attitudes. This association was stronger for female than for male adolescents, suggesting that female attitudes were influenced more by males' prior attitudes than vice versa. When entered together, only male adolescents' attitudes predicted dyadic condom use. Findings suggest that male partners may have greater influence on adolescent contraceptive decisions and that prevention programs should emphasize the relational context of sexual behavior.     

Masochism and the female sexual role

The present study compared the contraceptive risk‐taking behavior (CRT) of 35 white and 28 black, unwed, sexually active, young (ages 14 to 18) female outpatients in mental health clinics with a record of chronic contraceptive rejection, with that of a matched group of clinically unlabelled (normal) subjects. The subjects' offered CRT explanations were categorized by independent judges and subjected to multifactor contingency analyses and post‐hoc contrast procedures. The results indicated no differences between the clinical and normal subjects, but within groups, clinically‐oriented explanations tended to be more frequent than political‐economic explanations among white subjects, while the reverse held true for black subjects. In addition, 90 college students were asked to state what they considered a rational CRT response, as well as what CRT response they would expect from a hypothetical unwed, sexually active, 16‐year‐old female contraceptive rejector described as either white, or black, or not mentioned by race. The results indicated that clinically‐oriented CRT explanations were expected for the white contraceptive rejector, political‐economic CRT explanations were expected and seen as rational for the black contraceptive rejector, and situa‐tional CRT explanations were attributed most often when the race of the contraceptive rejector was not mentioned. The results are discussed in terms of clinical, rational, and social‐psychological models in current CRT research.     

Factors influencing college women's contraceptive behavior: An application of the integrative model of behavioral prediction

Objective: This study investigated variables within the Integrative Model of Behavioral Prediction (IMBP) as well as differences across socioeconomic status (SES) levels within the context of inconsistent contraceptive use among college women. Participants: A nonprobability sample of 515 female college students completed an Internet-based survey between November 2014 and February 2015. Methods: Respondents were asked about their contraception use, knowledge and information sources, demographic information, and IMBP factors, including attitudes, norms, and perceived behavioral control (PBC). Results: While overall attitudes, norms, PBC, and intentions for contraceptive use were high, only 46.8% of women used contraception consistently. Data also revealed only moderate levels of knowledge about contraception. While there were no differences across SES levels for attitudes, PBC, norms or knowledge, SES levels did differ in sources used to acquire contraceptive information. Conclusions: This study highlights the need to consider where college women acquire contraceptive information which is associated with SES.