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

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