Ecological factors predicting adolescent contraceptive use: implications for intervention

Abstract

Questionnaires addressing areas expected to relate to contraceptive use were completed by 230 female adolescents. Contraceptive use among the 130 sexually active subjects were predicted by a model composed of 12 scales assessing social permissiveness, costs and benefits of contraception, parent communication, boyfriend support, sex education and knowledge, attitudes about pregnancy and contraception, and access to contraception services. Scales from the predictive model which raise ideas for potential intervention strategies assessed parent communication, boyfriend support, and perceived costs and benefits related to contraception. Since there has been public concern that intervention programs for enhancing adolescent contraceptive use might also stimulate sexual activity, correlations were computed between the predictive scales and the measure of sexual experience among all 230 subjects. These data indicated that positive parent communication about sexuality and a perception of high benefits and low costs associated with contraceptive use were not positively correlated with sexual experience. Implications for the prevention of adolescent pregnancy are discussed with an emphasis on designing innovative sex education, improving parent-child communication, resolving conflicts in contraceptive decisionmaking, and supporting the role of boyfriends in contraceptive use.

PIP: Questionaires addressing areas expected to relate to contraceptive use were completed by 230 female adolescents. Contraceptive use among the 130 sexually active subjects was predicted by a model composed of 12 scales assessing social permissiveness, costs and benefits of contraception, parent communication, boyfriend support, sex education and knowledge, attitudes about pregnancy and contraception, and access to contraception services. Scales from the predictive model which raise ideas for potential intervention strategies assessed parent communication, boyfriend support, and perceived costs and benefits related to contraception. Since there has been public concern that intervention programs for enhancing adolescent contraceptive use might also stimulate sexual activity, correlations were computed between the predictive scales and the measure of sexual experience among all 230 subjects. These data indicate that positive parent communication about sexuality and a perception of high benefits and low costs associated with contraceptive use were not positively correlated with sexual experience. Implications for the prevention of adolescent pregnancy are discussed with an emphasis on designing innovative sex education, improving parent-child communication, resolving conflicts in contraceptive decision-making, and supporting the role of boyfriends in contraceptive use. Sex education had relatively weak individual relationships with contraceptive regularity. Objective knowledge about contraception was the strongest predictor of contraception. One of the most striking findings is that positive and open parent communication about sexuality is a strong predictor of regular contraceptive usage. Communication with parents may be important in helping female adolescents accept their sexuality and avoid the denial and conflicts which may deter or delay contraceptive use. Personal conflicts and ambivalence about acquiring and using contraceptives needs more investigation. Typically, there is a 6-month delay between initiation of sexual activity and contraceptive use among adolescents. Several researchers have suggested that a period of sexual activity is necessary before female adolescents accept and take responsibility for their sexuality. Boyfriend support was also a strong predictor of contraceptive use. Males may play an important role in helping and supporting girlfriends in contraceptive decision-making. Just as there is a valuable and growing tendency to place more responsibility on males to use contraception, there should be greater acknowledgment for their role in helping females with contraception.