Transcript Differences in Contraceptive Attitudes among College Students

Contraceptive Attitudes among
Female College Students
Kellie D. Bryant RN, DNP
Associate Professor
SUNY Downstate
Problem: Unintended Pregnancy &
Contraception
• 60% of pregnancies are unintended
• Leading causes are lack of contraceptive use
and contraceptive failure
• 53% of unintended pregnancies could have
been avoided if women used contraception
Highest Teenage Pregnancy Rate
1. US (52.1 births/1000 women 15-19 years)
2. United Kingdom (30.8 births/1000) second
Highest teenage births among 28 rich nations.
Reasons for Lack of
Contraceptive Use
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Misconceptions about contraceptives
Negative attitude about contraception
Failure to recognize the risk of pregnancy
Inability to communicate with their partner
about contraceptives
• Partners disapprove of contraception
• Worried about side effects
Barriers to Contraception
• Cost, substandard health care facilities,
childcare issues, and lack of transportation
• Among Blacks and Hispanics -decreased
income, higher rate of unemployment,
decreased level of education, and lack of
insurance
Purpose of Study
• To examine contraceptive attitudes and
demographic characteristics of
contraceptive users among female college
students from three different groups of
contraceptive use
Three Contraceptive Groups
1. “All the time” = Uninterrupted user
2. “Sometimes” = Intermittent contraceptive
user
3. “Never” = Contraceptive nonusers
Importance of Proposed Study
• Contraceptive use among college students
has not been well examined
• Lack of research on contraceptive use since
the development of newer forms of
contraceptives
Importance of Proposed Study
• Identification of women’s attitudes about
contraceptives may help health care
providers eliminate some of the barriers and
misconceptions regarding contraceptives.
• Women ages 18-24 have a high rate of
unintended pregnancy rate
Research Questions and
Hypothesizes
Research Questions
1. What are the most commonly used
contraceptive methods among female
college students?
2. What percentage of female college
students are in the 3 groups of
contraceptive users: uninterrupted,
intermittent, and nonusers?
Research Questions
3. What are the most common demographic
characteristics among the 3 groups
(uninterrupted contraceptive users,
intermittent contraceptive users, &
contraceptive nonusers?
4. What are the contraceptive attitude scores
of female college students?
Research Question
5. Do contraceptive attitude scores of female
college students vary by race, age, marital
status, and socioeconomic status?
6. Do contraceptive attitude scores vary
among uninterrupted contraceptive users,
intermittent contraceptive users, and
contraceptive nonusers?
Hypothesis
1. Demographic factors associated with
uninterrupted contraceptive use are being
married, 24 years of age or older, from a
higher socioeconomic status, and White.
Hypothesis
2. Contraceptive attitude scores will be lowest
among females who are Black or Hispanic,
less than 24 years of age, unmarried, and
from lower socioeconomic levels.
Hypothesis
3. Contraceptive attitude scores among
uninterrupted contraceptive users will be
higher than among intermittent
contraceptive users and nonusers.
Methods
Design
• Quantitative, comparative descriptive
design
• Participants categorized by the frequency
they use their preferred contraceptive
method: 1) Uninterrupted, 2) Intermittent,
and 3) non use of contraceptives.
Setting
• University located in a highly diverse area
of a large metropolitan city on the east
coast.
• 47% black, 15% Hispanic, 25% white, and
13% Asian
• 72% female
• Average age of an undergraduate student is
24 years
Sample Criteria
• Inclusion criteria - female college student,
between the ages of 18 to 44, who can read
and speak English and has been sexually
active in the past three months
• Exclusion criteria - females older than 44,
younger than 18 years of age, and students
who do not speak or read English.
Sample
• Convenience, purposive sample N = 120
• Mean age = 24.2
Range = 18 to 44 years
• Racial background : Black (45%),
White (19.2%), Hispanic (14.2%),
Asian/Pacific Islander (13.3%).
Sample
• Student income: 65.3 % earned <$19,999
• Marital Status: 12.5% married
• Religion: 63.4% Christian, 11.7% No
Religion
Classified into 3 groups of contraceptive
users: 1) Uninterrupted, 2) Intermittent, 3)
Non- user
Years of College of Participants
Questionnaire
The survey consisted of three questionnaires
• Contraceptive Attitude Scale
• Contraceptive Use Tool
• Demographic Tool
• Survey took approximately 11 minutes to
complete
Results
RQ 1 Results: Most commonly used
contraceptive methods
• The 5 most preferred methods: male
condom (48.2%), pill (22.4%), withdrawal
(10.6%), patch (4.7%), and Depo Provera
(4.1%).
RQ 2: What % are uninterrupted,
intermittent and nonusers
Research Question #3
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What are the most common demographic
characteristics among uninterrupted
contraceptive users, intermittent
contraceptive users, and contraceptive
nonusers?
RQ# 3 Results
• The findings from this study failed to find a
relationship between contraceptive use and
race, age, socioeconomic level, years of
education, or religion
• May be due to the homogenous sample of
students at the University.
Research Question #4
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What are the contraceptive attitude scores
of female college students?
RQ#4: Results
• The contraceptive attitude scores for the
participants in the study were homogenous.
• Most participants had a positive attitude.
• The mean score for the group was 4.1008
out of 5 with a SD of 0.498.
Research Question #5
• Do contraceptive attitude scores of female
college students vary by race, age, marital
status, and socioeconomic status?
RQ # 5 Results
• Contraceptive attitude scores did not vary
by age, race, marital status, and
socioeconomic status
Research Question #6
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Do contraceptive attitude scores vary
among uninterrupted contraceptive users,
intermittent contraceptive users, and
contraceptive nonusers?
Results among 3 Contraceptive
Groups
• Uninterrupted users scored 0.27 points
higher on the contraceptive attitude scale
than intermittent users.
• Uninterrupted users scored 0.45 points
higher than nonusers.
Contraceptive Attitude Scale
• Students with higher contraceptive attitude
scores were more likely to be consistent
contraceptive users.
Additional Findings
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Blacks were more likely to use condoms.
Older women less likely to use birth control.
Whites more likely to use withdrawal method.
Younger students more likely to use condoms.
Students with more years of college were more
likely to use birth control.
Top 5 Reasons for Not using
Birth Control
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Worried about side effects
Health concerns
Opposed to birth control
Partner opposed
Want children
Woman 35 and Older
• Women 35 & older were less likely to use
birth control
• May be due to older woman believing they
have a small chance of becoming pregnant
• May be due to increased fear of side effects
due to advanced age and the misconception
that hormonal methods may negatively
affect their health.
Younger Woman and Condoms
• Increased condom use was among younger
woman.
• May be contributed to younger woman
being less likely to be married or in a long
term monogamous relationship.
• Younger woman to be more likely to use
condoms due to concerns about protection
against sexually transmitted infections.
Evidence Based Practice
What Works???
• Better contraceptive services;
• New methods that are more effective and
easier to use;
• Methods with noncontraceptive benefits
• Making methods available without the need
to see a doctor
• Improved education -
Evidence Practice to Decrease
Unintended Pregnancies
• Women considering birth control should
receive detailed information - both verbal
and written
Information to Discuss with
Clients
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Contraceptive efficacy
Duration of use
Risks and possible side effects
Non-contraceptive benefits
The procedure for initiation and
removal/discontinuation
• When to seek help while using the method
Evidence Based Practice
• Adequate time during consultations to
address contraceptive and broader health
issues .
• Contraceptive and sexual health services in
schools to promote and provide the
planning, delivery, and evaluation of sex
and relationship education.
Evidence Based Practice
• IUD’s , IUS, and implants are more cost
effective than the injectable contraceptives
• Increasing the use of these methods will
reduce the number of unintended
pregnancies
In Reality…
• No single intervention will make a
measurable difference.
• Providers should concentrate on
encouraging correct and consistent use.
• Frequent follow-up appointments are
required .
The End
Questions and Answer