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PubMedDate not supplied

The role of sexual self-concept in the use of contraceptives.

Sexual self-concept--defined as an individual's evaluation of his or her own sexual feelings and actions--is proposed as an important predictor of contraceptive behavior among teenagers, and a scale measuring the concept is described. In exploratory analyses among university students, sexual self-concept is found to be associated with frequency of contraceptive use and use at most recent intercourse. It is also associated with their choice of contraceptive--students who had used prescription methods at last coitus had significantly higher scores on the sexual self-concept scale than did those who had used nonprescription methods or no method. These findings, together with the finding from analysis among high school students that sexual self-concept appears to improve with age, suggest that younger teenagers may be poorer users of contraceptives because of a lower sexual self-concept. Counseling and sex education that address social and psychological issues may help improve adolescent contraceptive practice by addressing teenagers' views of their own sexuality.

Adolescent↗
PubMed1980

Twenty-seven strategies for teaching contraception to adolescents.

This article summarizes research on the effects of education on adolescents' contraceptive behaviors and suggests strategies to enhance teaching for contraception. Learning about birth control methods in sex education classes does not necessarily enable teenagers to use them effectively. In addition to needing accurate, unbiased information about contraceptive technology, teenagers need help in clarifying their values so that their social behaviors are congruent with their moral codes. Adolescents also benefit from understanding how contraception relates to sexual behavior and how family planning may enable them to become parents at the time of their choice. Twenty-seven strategies for teachers are listed, each one related to a particular contraceptive problem adolescents encounter.

Adolescent↗
PubMedDate not supplied

Parent-child communication and adolescent sexual behavior.

Data collected over a two-year period from more than 500 teenagers and their mothers indicate that neither parental attitudes toward premarital sex nor parent-child communication about sex and contraception appear to affect teenagers' subsequent sexual and contraceptive behavior. Teenagers are often ignorant of their parents' attitudes toward sex-related issues, and they and their parents often contradict one another in describing the kinds of sex-related conversations they have had. In only two cases was a significant relationship found between communication and adolescent behavior: Girls whose mothers reported that they had discussed sex with their daughters were less likely to subsequently initiate coitus; and girls who reported that their mothers had discussed birth control with them were more likely to use effective contraceptives. However, the former association disappeared when it was the daughters who reported the communication, and the latter disappeared when it was the mothers who reported it.

Adolescent↗
PubMedDate not supplied

Stage of behavior change for condom use: the influence of partner type, relationship and pregnancy factors.

A theoretical model was used to examine the influence of relationship factors, pregnancy intentions, contraceptive behavior and other psychosocial characteristics on stages of behavior change in condom use among heterosexual black women of reproductive age. Data from an inner-city street survey compared women who were not contemplating condom use, women who were attempting to use condoms or had used them consistently for short periods of time, and those who had achieved long-term consistent use. Women's relationship with their main partner appears to be an important factor in understanding their use of condoms both with main partners and with other partners. For condom use with the main partner, factors such as emotional closeness and partner support were significant predictors of the likelihood that women would be attempting to use condoms rather than not contemplating use. Cohabitation and the belief that condom use builds trust were significant predictors of long-term consistent condom use. Having a regular or main partner was strongly associated with intentions to use condoms with other partners. Women who wanted to become pregnant were much less likely to intend to use condoms with their main partner, and women using oral contraceptives were less likely to be long-term consistent condom users.

Adolescent↗
PubMed1988

Racial differences in contraceptive choice: complexity and implications.

Previous research has failed to generate consensus about why black fertility has persistently exceeded that of whites in the United States. In an effort to shed light on this question, this article examines black/white differences in sociodemographic factors affecting contraceptive choice. Using data from the 1976 and 1982 National Surveys of Family Growth, we find a complex pattern of black/white differences. Not only does contraceptive choice vary by race, but the effects of such variables as age, marital status, and education also differ between blacks and whites. For example, compared with whites, black married women avoid coital methods, and compared with blacks, white women shift contraceptive behavior more as they change marital status. The complex nature of the racial differences in contraceptive choice are interpreted as reflecting differences in marriage patterns and trends.

Adult↗
PubMed2005

Differences in health behaviors and parenting knowledge between pregnant adolescents and parenting adolescents.

To better understand the differences between pregnant adolescents and parenting adolescents, we examined substance use, contraceptive behavior, and parenting knowledge among 91 first-time pregnant and parenting adolescents enrolled in an adolescent parenting case management program. After one year of program participation, pre- and post-test comparisons indicated improvements in contraception use and parenting knowledge, and increases in reported use of cigarettes, alcohol and other drugs among both groups. Adolescents who entered the program while pregnant experienced greater benefit than adolescents who entered the program already parenting. We discuss several implications for practitioners at both the programmatic and direct practice level who work with young women during pregnancy and as they transition to early parenthood.

Adolescent↗
PubMed1991

The sexual and contraceptive socialization of black adolescent males (black adolescent sexuality).

The major source, quantity, and quality of sex and contraceptive information African-American males received as teenagers, and the impact of that information on sexual and contraceptive behavior, were examined among 250 males ranging in age from 12 to 70 years. Mothers were the major sources of sex and birth control information for the adolescent, young adult, and middle adult groups. Fathers and male friends were the second sources most indicated. All of the sample received sex information, and only a small proportion received no birth control information. The amount of sex information received was found to be a significant predictor (P = 0.0018) of the age at first intercourse and the regularity of use of birth control after that. The amount of birth control information received was also a significant predictor (P = 0.0093) of the regularity of use of birth control after the first coitus. Because parents influence their children's behavior through a socialization process, their support of their teenage sons in matters of sexuality and contraception may be of potential value in mitigating the effects of early, unprotected sex.

Adolescent↗
PubMed2004

Effects of a community-based sex education and reproductive health service program on contraceptive use of unmarried youths in Shanghai.

PURPOSE: To evaluate the effectiveness of a youth-friendly intervention in promoting one safe sex behavior-contraception and condom use among unmarried young people aged 15-24 years in Shanghai, China. METHODS: The study was conducted in two towns of a suburban area of Shanghai (one as the intervention and the other as the control), with comparable socio-cultural-economic and demographic characteristics. The intervention intended to build awareness and offer counseling and services related to sexuality and reproduction among unmarried youths, in addition to the routine program activities, which were exclusively provided in the control site. Baseline surveys were conducted in both sites before the implementation of the intervention, and similar surveys were conducted in both sites 20 months after the intervention had been initiated to test the feasibility and effectiveness of the intervention. In total, 1220 unmarried young people from the intervention site and 1007 from the control site, including 1304 out-of-school youths and 923 high school students, were recruited, and about 92% of them were successfully followed up. Four main measures were examined (i.e., ever contraceptive use, current regular contraceptive use, ever condom use, and contraceptive use at onset of sexual intercourse-if it occurred during the course of the intervention). The reasons for nonuse of contraceptives, the status of joint decision on contraception and the first method used were also assessed. Data were analyzed using Logistic regression models with dichotomous measures of contraceptive use and Generalized Estimating Equations (GEEs) with repeated measures. RESULTS: At baseline, there was no statistical difference in contraceptive use between the intervention and control groups. After intervention, the proportions reporting regular contraceptive use and condom use in the intervention group were much higher than that in the control group (p <.001). A group x time interaction effect (p <.0001) was found for regular contraceptive use and ever condom use. Logistic regression analysis with dichotomous measures of contraceptive use and GEEs with repeated measures showed similar results. The regular contraceptive use and ever condom use were correlated with subject's occupation and family economic status, respectively. After adjusting for demographic factors, the subjects from the intervention group were 14.58 (OR) times as likely to use contraceptives at onset of intercourse as those from the control group (95%CI: 8.55-24.87, p <.0001). Similar results were found for both females and males. CONCLUSIONS: A multifaceted intervention program that provided information and skills, as well as counseling and services, appears to have positive influences on contraceptive practice and condom use among unmarried young females and males in suburban Shanghai.

Adolescent↗
PubMed1999

The impact of the family planning supply environment on contraceptive intentions and use in Morocco.

Although the extent to which organized family planning programs influence reproductive preferences remains a subject of debate, most observers would grant that such programs play a key role in helping individuals to realize their contraceptive and reproductive intentions. However, few prior studies have quantified the magnitude of this facilitating or enabling effect of family planning services, given existing demand for contraception. This study takes advantage of panel survey data and linked information on the supply environment for family planning services in Morocco in order to bridge this research gap. In the analysis, contraceptive use during the 1992-95 period is related to contraceptive intentions in 1992; individual-, household-, and community-level determinants of contraceptive behavior; and family planning supply factors. Estimation procedures are used that control for unobserved joint determinants of contraceptive intentions and use. Evidence of a significant enabling or facilitating role of family planning services is found, and the results also suggest that family planning program factors influence contraceptive intentions in important ways.

Adolescent↗
PubMed1991

Adolescent women's contraceptive decision making.

A modified rational decision model incorporating salient events and social influences (particularly from sexual partners) is used to analyze adolescent women's consistent use of oral contraceptives (OCs) over a six-month period. Data are taken from a panel study of 308 clients of an inner-city family planning clinic. Expected OC use was computed for each subject on the basis of subjective expected utility (SEU) theory, and is found in multivariate analyses to be a significant predictor of actual OC use. In addition, variables representing baseline and follow-up partner influences, the salience of pregnancy for the subject, and positive side effects of OCs during the first months of use are found to predict OC use. Partner's support of OC use during follow-up and positive side effects of OCs are found to predict OC use among subjects for whom OC use was not the expected decision according to baseline SEU. Implications of the findings for models of adolescents' contraceptive behavior and for clinicians are discussed.

Adolescent↗
PubMed1998

Attitudes of men towards family planning in Mbeya region, Tanzania: a rural-urban comparison of qualitative data.

Family planning programmes in Tanzania date back to the 1950s. By the early 1990s, however, only 5-10% of women of childbearing age used contraceptives in the country. Low contraceptive prevalence in Tanzania is reportedly attributable to men's opposition to family planning. This paper employs focus groups to explore the role of Tanzanian men in family planning. More specifically, it presents a rural-urban comparison of the attitudes of men in Mbeya region, Tanzania, to family size preference, sex composition, partners' communication on family planning matters and contraceptive behavior. Findings indicate that men express positive attitudes towards fertility-regulating methods. There is, moreover, little rural-urban variation in male attitudes towards family planning in the study area. Possible reasons for this normative convergence (including structural similarities and rural-urban migration between the two communities) are discussed.

Adolescent↗
PubMed1997

The influence of quality of care upon contraceptive use in rural Bangladesh.

Efforts to develop quantitative indicators of quality of care for family planning services, and to evaluate its role in contraceptive behavior, remain at an early stage. The present study, based upon an analysis of prospective data from a sample of 7,800 reproductive-aged rural Bangladeshi women, provides empirical evidence on the importance of quality of care for contraceptive practice. The results demonstrate that the perceptions of women regarding the quality of field-worker care were significantly related to the probability of subsequent adoption of a family planning method. Women who were not using a method and who scored high on an index of perceived quality of care were 27 percent more likely to adopt a method subsequently, compared with women with a low score. Effects were even more pronounced for contraceptive continuation; high quality of care was associated with a 72 percent greater likelihood of continued use of any method of contraception.

Adult↗
PubMedDate not supplied

Prebirth psychosocial factors as predictors of consistency in contraceptive use among Taiwanese adolescent mothers at 6 months postpartum.

OBJECTIVE: To assess contraceptive behavior and whether pre-birth psychosocial factors could predict consistency in contraceptive use among adolescent mothers at six-month postpartum. DESIGN: Prospective study. SAMPLE: 104 Taiwanese adolescent mothers. MEASUREMENTS: Participants completed a contraception questionnaire in their third trimester and a postpartum contraception questionnaire at six-month postpartum. RESULTS: Prior to giving birth, the adolescent mothers most commonly answered that condom use (39.8%) was the contraceptive method they planned to use after delivery. It was also more commonly reported in the postpartum to be the method they actually were using (54.3%). Stepwise logistic regression analysis further showed that a more positive contraceptive attitude (odds ratio=1.104) and a higher self-efficacy (odds ratio=1.068) in contraceptive use in the pre-birth period increased the probability that a participant would report that she always used contraceptives in the postpartum period. Nevertheless, a higher score in the pre-birth period in the area of subjective contraceptive norms (odds ratio=0.978) decreased this probability. The final regression model could correctly classify 81.7% of the participants. CONCLUSIONS: Health care professionals should provide adolescent mothers with the information they need to improve their attitude and self-efficacy toward contraception before they enter the postpartum period.

Adolescent↗
PubMed1991

Pregnancy avoidance and coital behavior.

This study proposes a behavioral model that identifies determinants of coital activity in the context of pregnancy avoidance and assesses the relationships using weekly panel data collected on 300 rural married women in Sri Lanka in 1988. We discuss the utility of the design, which is similar to that of an epidemiological surveillance system, for the measurement of coital behavior and pregnancy risk perceptions. Perceptions of pregnancy risk, spousal agreement on sexual relations, menstrual and lactational status, and cycle timing, all measured daily, are found to influence significantly the probability of coitus on that day. The findings suggest that substantial gains in studying fertility regulation are likely from closer investigation of the behavioral connections between motivation for pregnancy avoidance and coital incidence. Comparison of such panel data with those of cross-sectional sample surveys also provides insights into the validity of measures of coital and contraceptive behavior.

Adolescent↗
PubMed1990

Characteristics of women having abortion in China.

A pre-coded, closed response questionnaire was administered to women at abortion clinic sites in August 1985. The convenience sample was comprised of 1200 women, 200 samples in both Chengdu and the Lianshan Yi Autonomous Region in Sichuan Province, 400 in Nanjing and Jiangsu Province, and 400 in the municipality of Shanghai. The women were interviewed by physicians as part of the women's intake medical history. The sample yielded 574 respondents who were urban and 624 who were rural. The number of previous abortions reported ranged from 0 to 5. Nearly half of the abortion recipients had had at least one prior abortion and 18% had had two or more prior abortions. Education, age, marriage duration and residence have apparent effect on abortion order. The urban respondents reported an average of 1.08 children vs 1.60 children for the rural respondents. Approximately 72% of the respondents claimed to have been using a contraceptive method at the time they became pregnant. The most commonly used method was the IUD (41.6%), followed by the pill (21.3%) and the condom only (16.5%). Residence appeared to be the greatest factor determining the type of contraceptive methods. The data presented here are limited and cannot be generalized to the larger population. However, they do shed some light on the contraception characteristics of a group of women who undergo abortion procedures in China. Their response to questions to contracepting behavior prior to abortion suggests that the problem, in part, is behavioral. For example after the expulsion of the IUD, no other method was substituted to avert pregnancy. In order to alleviate the problem of contraceptive failure, and subsequent abortion, there are policy as well as training and education implications for the state.

Abortion Applicants↗
PubMed2005

Emergency contraception.

Emergency contraception is increasing in use and has become a universal standard of care in the United States. This article reviews available forms of emergency contraception, their indications, contraindications, adverse effects and efficacy at preventing pregnancy. This article describes the mechanism of action of different forms of emergency contraception and provides recommendations on when to start or restart an ongoing method of contraceptive after emergency contraception use. Literature on the impact of the advance provision of emergency contraception on contracepting behaviors is reviewed, and behavior change counseling related to emergency contraception is described.

Adolescent↗
PubMed2005

Understanding pregnancy in a population of inner-city women in New Orleans--results of qualitative research.

Unintended pregnancy has conventionally been defined as a pregnancy that is mistimed or unwanted, and this classification has been widely used in survey research. This study explores the utility of these constructs for women who visited a family planning clinic and a prenatal clinic in inner-city New Orleans, LA, and, by extension, for women of similar background and experience. We used semi-structured, open-ended research to explore sexual debut and history, contraceptive knowledge and use, pregnancy history, partner relations, and service use among 77 women (73 of whom were African-American). This study addresses the apparent paradox of high-risk sexual and contraceptive behavior in the presence of expressed preferences to postpone childbearing. It provides some insight into the cultural and social context in which these events and decisions take place and explores the multiple dimensions that shape women's sexual behaviors and their desires for pregnancy. The dimensions explored include perceptions of and experiences with sex/sexuality, values concerning childbearing/motherhood, relationships with partners, experiences with contraception, and attitudes toward abortion. The apparent ambivalence seen in reports of women asked whether a pregnancy was intended, such as statements that they did not want to get pregnant but were either not using contraception or using it irregularly, calls into question the idea that intendedness can be routinely and easily inferred from survey research. Correspondingly, it is not possible to simply assume that either intentionality or future intentions directly affect decisions to use contraception. The problem is that the many factors-structural and individual-affect women's preferences and ability to postpone a pregnancy or to use contraception.

Abortion, Induced↗