Habit Strength and Adherence to Oral Contraceptives: the Role of Time- and Place-Based Cues

Abstract

Purpose: Non-adherence to the oral contraceptive pill (OCP) has been reported by almost half of OCP users. As the efficacy of the OCP requires daily adherence, poor adherence often leads to unplanned pregnancies in women who depend on this method of contraception. This study aims to investigate the association between habit strength and time- and place-based cues in the context of adherence to the OCP.

Methods: A cross-sectional questionnaire of 245 current OCP users with a mean age of 22.41 years (SD = 4.78) and a range of 18-52 years was conducted. The Self-Report Behavioural Automaticity Index was employed to measure habit strength. The Medication Adherence Report Scale was used and modified to refer to OCP non-adherence specifically. Additional measures were employed to assess the use of time- and place-based cues. Data were analysed using correlational analyses.

Results: Stronger habit strength was associated with better adherence to the OCP (r = - 0.25, p < .001). Having a fixed time of day to take the OCP was associated with habit strength and OCP adherence. Having a fixed place to store the OCP was associated with habit strength but not with OCP adherence.

Conclusions: Time- and place-based cues are likely to be an important part of any intervention design to support adherence and strengthen the habit of taking the OCP. It is recommended that future replications include longitudinal study designs and analyses.

Keywords: Habit strength; Medication adherence; Oral contraceptive pill; Place-based cues; Time-based cues.