Contraceptive behavior among unmarried young women: A theoretical framework for research

Abstract

Adoption of the most effective methods of contraception requires individual decision-making and negotiation with c o n t r a c e p t i v e providers. In order to take account of both behavioral elements, a twodimensional framework for understanding contraceptive adoption and continuation by unmarried young is proposed, incorporating a "socialp s y c h o l o g i c a l m o d e l " of i n d i v i d u a l decision-making and an ù interpersonal model" of factors affecting provider-client interaction. The social-psychological model is based on an earlier value-expectancy theory of behavior motivation as applied to health-related behaviors. The interpersonal model is derived from conflict-bargaining perspectives on professional-client interaction; it is suggested that expectations for this interaction are based on a limited number of internalized "models": the ùprofessional"; the " b u r e a u c r a t i c " ; the " c o m m e r c i a l " ; and the Preparation of this paper was supported in part by Grant Number RO1 HD 13623 from the Center for Population Research, National Institute of Child Health and Human Development. Dr. Nathanson is Associate Professor, Department of Population Dynamics, School of Hygiene and Public Health, The Johns Hopkins University. Dr. Becker is Professor, Department of Health Behavior and Health Education, School of Public Health, The University of Michigan. Requests for reprints should be addressed to Dr. Nathanson, Department of Population Dynamics, Johns Hopkins University Schooi of Hygiene and Public Health, 615 North Wolle Street, Baltimore, MD 21205. ~Readers interested in the apendization of specific variables may write to the senior author for copies of research instruments based on the theoretical framework described in this paper. Space limitations do not permit a discussion of aperational issues in the paper itself. ùparental." Insofar as client and professional "models"disagree, communication may break down and client understanding and/or acceptance of provider advice cannot be assured. The components of the social-psychological and interpersonal models are described in detail, and a combined framework is proposed.The majority of pregnancies among unmarried young women are unintended and could be substantially reduced in number by consistent use of contraception; yet close to two-thirds of sexually active young women in the United States are either nonusers or sporadic users of contraceptive methods (Zelnik & Kantner, 1980). The reasons for erratic contraceptive use when pregnancy is not intended are unclear; however, the consequences of such behavior are potentially most serious when the partners are young and unmarried (Card & Wise, 1978;Trussell & Menken, 1978).Although identification and measurement of factors associated with contraceptive continuation have long been issues of concern, development of a substantive framework on which to base explanation and prediction of variation in contraceptive behaviors has lagged behind accumulation of data (Karr, 1971);Kasl, 1973), and...

Effect of application of a Health Belief Model on changing mothers’ beliefs regarding birth spacing in rural areas

“…[17] HBM was one of the first models used to predict and explain variations in contraceptive behavior among women. [18,19] Regarding the distribution of perception of susceptibility of using contraceptives at baseline, first post-test and second post-test, the current study revealed that there was no difference during the study period (see Table 1). These findings are supported by Baa et al [20] who studied "the perceptions of susceptibility to pregnancy among U.S. women obtaining abortions in Texas, one in a large town in a rural area of Washington State.…”

The Health Belief Model Can Guide Modern Contraceptive Behavior Research and Practice

“…The HBM is a cognitive, interpersonal framework that views humans as rational beings who use a multidimensional approach to decision making regarding whether to perform a health behavior 2,7 . The model is appropriate for complex preventive and sick‐role health behaviors such as contraceptive behavior 2,5,7,8 . Its dimensions are derived from an established body of social psychology theory that relies heavily on cognitive factors oriented toward goal attainment (ie, motivation to prevent pregnancy) 8 .…”

“…Overall, the HBM's adaptability and holistic nature facilitate applications in diverse contexts like family planning and with complex behaviors like contraceptive behavior 2,5,7,8 . Family planning is a dynamic and complex set of services, programs, and behaviors toward regulating the number and spacing of children within a family 2,7,11,12 .…”

“…The Health Belief Model (HBM), a well‐tested, comprehensive social cognitive framework by Rosenstock, 7 was one of the first models used to predict and explain variations in contraceptive behavior among women in the 1970s and 1980s 8–14 . Yet, the HBM has seldom since been applied in family planning.…”

An exploration of the health concepts, peer-helping behaviours and attitudes of street-involved youth

“…For example, the HBM has been used in developing the conceptual framework for some adolescent health programs and these programs have measured some success (Eisen, Zellman, & McAlister, 1992;Nathanson & Becker, 1983). The study conducted by Petosa and Jackson (1991), which was previously discussed in this chapter, used the HBM in order to inform reproductive health program development for adolescents.…”