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Among adult women of reproductive age, research has focused on depression symptoms after unintended pregnancy, or associated with hormonal contraceptive method use, with little focus on depression as a predictor of unintended pregnancy. This study was conducted to identify mental and behavioral health characteristics associated with use of less effective contraceptive methods. Choosing a less effective method of contraception places sexually active women who are not seeking pregnancy at increased risk of unintended pregnancy. Analysis was conducted using administrative data from family planning visits of 2,476 predominantly Latina and black women who received standardized behavioral and mental health screening as part of clinical care at eight reproductive health centers in New York City serving low-income women. Sociodemographic characteristics, method choice, and behavioral and mental health characteristics were compared between patients who screened positive for depression (using the PHQ-9) and those who did not. The primary outcome measure, contraceptive method choice, was dichotomized into two groups: more effective method or less effective method. In a multivariate logistic regression model adjusting for all behavioral health characteristics (binge drinking, illicit drug use, smoking, anxiety, and childhood or adult physical or sexual abuse) and birthplace, women screening positive for depression had significantly lower odds of choosing a more effective method of contraception (adjusted OR = 0.56, 95% CI: 0.36-0.87). These findings suggest that screening positive for depression may have an effect on contraceptive choice. Contraceptive counseling strategies should be individually tailored to promote decision-making and appropriate contraceptive choice, particularly among women with depression.

PURPOSE To examine the relationship between risk perceptions, health behaviors, and a measure for actual risk of coronary heart disease (CHD). DESIGN Cross-sectional survey. SETTING/SUBJECTS Adults from three outpatient medical clinics with at least one CHD risk factor. MEASURES Perceived risk using the new Coronary Risk, Individual Perception (CRIP) scale, an index of CHD risk, and summary scores for self-reported diet and exercise. ANALYSIS Bivariate associations using Spearman Rank and Kruskil-Wallis; multiple regression models for outcomes (health behaviors). RESULTS The 16-item CRIP scale had acceptable internal consistency (α =0.76; inter-item total correlation=0.34 ± 0.17). The response rate was 80.3% and the mean age of 256 respondents was 56.6 (±9.9) years; 70% were women, 63% Hispanic, and 27% black. CRIP scores were inversely associated with low-fat/high fiber intake (r=− 0.17; p=0.007) and exercise (r=−0.19; p=0.003). Among respondents with 3 or more CHD risk factors (n=132), 44% perceived themselves to be at low risk for CHD. In multivariable models, men with high CRIP scores had higher fat intake than women (p=0.02), but men exercised more (p=0.04). CONCLUSIONS In this study, gender moderated the relationship between risk perception and health behaviors and many respondents underestimated their risk of CHD. Behavioral research aimed at reducing cardiometabolic risk in minority populations should resolve differences between perceived and actual risk of CHD to foster lifestyle changes, and examine temporal relationships between risk perception and health behaviors.