Contraceptive Attitudes among Female College Students

1. Contraceptive Attitudes among Female College Students Kellie D. Bryant RN, DNP Associate Professor SUNY Downstate

2. 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

3. Highest Teenage Pregnancy Rate • US (52.1 births/1000 women 15-19 years) 2. United Kingdom (30.8 births/1000) second Highest teenage births among 28 rich nations.

4. Reasons for Lack of Contraceptive Use • 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

5. 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

6. Purpose of Study • To examine contraceptive attitudes and demographic characteristics of contraceptive users among female college students from three different groups of contraceptive use

7. Three Contraceptive Groups • “All the time” = Uninterrupted user • “Sometimes” = Intermittent contraceptive user • “Never” = Contraceptive nonusers

8. 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

9. 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

10. Research Questions and Hypothesizes

11. Research Questions • What are the most commonly used contraceptive methods among female college students? • What percentage of female college students are in the 3 groups of contraceptive users: uninterrupted, intermittent, and nonusers?

12. Research Questions • What are the most common demographic characteristics among the 3 groups (uninterrupted contraceptive users, intermittent contraceptive users, & contraceptive nonusers? • What are the contraceptive attitude scores of female college students?

13. Research Question • Do contraceptive attitude scores of female college students vary by race, age, marital status, and socioeconomic status? • Do contraceptive attitude scores vary among uninterrupted contraceptive users, intermittent contraceptive users, and contraceptive nonusers?

14. 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.

15. 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.

16. Hypothesis 3. Contraceptive attitude scores among uninterrupted contraceptive users will be higher than among intermittent contraceptive users and nonusers.

17. Methods

18. 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.

19. 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

20. 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.

21. 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%).

22. 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

23. Years of College of Participants

24. Questionnaire The survey consisted of three questionnaires • Contraceptive Attitude Scale • Contraceptive Use Tool • Demographic Tool • Survey took approximately 11 minutes to complete

25. Results

26. 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%).

27. RQ 2: What % are uninterrupted, intermittent and nonusers

28. Research Question #3 • What are the most common demographic characteristics among uninterrupted contraceptive users, intermittent contraceptive users, and contraceptive nonusers?

29. 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.

30. Research Question #4 • What are the contraceptive attitude scores of female college students?

31. 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.

32. Research Question #5 • Do contraceptive attitude scores of female college students vary by race, age, marital status, and socioeconomic status?

33. RQ # 5 Results • Contraceptive attitude scores did not vary by age, race, marital status, and socioeconomic status

34. Research Question #6 • Do contraceptive attitude scores vary among uninterrupted contraceptive users, intermittent contraceptive users, and contraceptive nonusers?

35. 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.

36. Contraceptive Attitude Scale • Students with higher contraceptive attitude scores were more likely to be consistent contraceptive users.

37. Additional Findings • 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.

38. Top 5 Reasons for Not using Birth Control • Worried about side effects • Health concerns • Opposed to birth control • Partner opposed • Want children

39. 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.

40. 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.

41. Evidence Based Practice

42. 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 -

43. Evidence Practice to Decrease Unintended Pregnancies • Women considering birth control should receive detailed information - both verbal and written

44. Information to Discuss with Clients • 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

45. 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.

46. 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

47. 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 .

48. The End Questions and Answer