Influences on contraceptive use among college women

Abstract

Background: An unintended pregnancy (UIP) occurs before an ideal time or is completely unwanted. In 2011, the rate of UIP in the United States was 49% of all pregnancies. Unintended pregnancies are expensive to society and result in poorer health outcomes for the woman and the infant. Women in the following groups have the highest rates of UIP: aged 20-24; unmarried and co-habitating; income below the poverty level; educational level less than a high school diploma; and, Black or Latina women. Contraceptive use prevents UIP, but many women do not use contraception, especially the highly effective long-acting reversible forms of contraception. Purposes: This descriptive, cross-sectional study examined the relationship between background factors, attitudes, perceived norms, and self-efficacy and the intent to use contraception. Secondly, this study examined the relationship between background factors, intent to use contraception, environmental factors, competency, and reported use of contraception. Finally, this study aimed to establish the validity and reliability of the survey instrument, Influences on Birth Control Use (IBCU). Methods: Participants were a convenience sample of 270 women ages 18-24 attending a large public university or community college in the Midwest. Participants completed a paper survey. The integrated behavioral iv model provided a framework for factors associated with intent to use contraception and reported contraception use. Results: IBCU was found to have reliable sub-scales, especially for attitude and self-efficacy toward contraceptive use. For each one point increase in the attitude scale score, the odds that a participant did not intend to use contraception declined. If a participant reported a rural childhood, they were more likely to report they did not intend to use contraception. If a participant intended to use contraception, they were 15 times more likely to report contraceptive use, and if a participant had health insurance that paid for contraception, they were six times more likely to report contraceptive use. Conclusions: Understanding social differences in rural areas allows providers to offer sensitive reproductive health care to women from those areas. Decreasing the cost of contraception will increase the number of women who use contraception. Men should be included in research on contraception in future