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 = I ntermittent 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 womens 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

• IUDs , 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