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  • 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
    • 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
      • 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
    • “ All the time” = Uninterrupted user
    • “ Sometimes” = I ntermittent contraceptive user
    • “ 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
    • 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?
  • 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?
  • 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?
  • 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
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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