Approval Sheet The Association Between Contraceptive Choices, Parental Factors, and Hispanic Adolescents' Use of Emergency Contraception Público

Dignam, Toshiko Alana (2011)

Permanent URL: https://etd.library.emory.edu/concern/etds/2514nm03w?locale=es
Published

Abstract

Background: Hispanic adolescents have some of the highest teen pregnancy rates of any race/ethnic group in the U.S. and are the least likely to use birth control. Because adolescents are difficult to study and emergency contraception is a rare event, little is known about emergency contraceptive use among Hispanic adolescents and even less is known about what factors are associated with its use.
Objective: This study examines the relationship between Hispanic adolescents' use of
emergency contraception and the associated contraceptive choices and parental factors
that influence use.
Methods: We conducted a secondary analysis on data from an 8-year intervention study
designed to improve sexual health among adolescents. This matched case-control of 518
Hispanic high school students from 12 urban public schools in California analyzed the
association between emergency contraceptive use, contraceptive choices, and parental
factors using conditional logistic regression.
Results: Results indicate the likelihood of using emergency contraception (EC) increases
as the number of contraceptive methods used increases. The odds of using EC is 4.0
(95% CI: 1.619, 10.106) times greater when using withdrawal exclusively compared to
using nothing at last intercourse. The odds of using EC after practicing withdrawal in
conjunction with using another type of birth control method increases 3.6 times (95% CI:
1.751, 7.330) compared to using no method of birth control during last intercourse.
Additionally, using the pill in conjunction with any birth control method increases the
likelihood of using EC by 4.2 times (95% CI: 1.843, 9.618) compared to using no birth
control. No parental factors, including maternal communication about the consequences
of sex, communication style and adolescent's perceived level of expertise,
trustworthiness, or directness was associated with emergency contraceptive use.
Additionally, the level of relationship satisfaction and perceived parental attitudes about
birth control were not associated with adolescent's EC use.
Discussion: Our study suggests that Hispanic Adolescents who use emergency
contraception are more motivated to prevent pregnancy than their non-EC using peers.
Interventions aimed at increasing EC use among Hispanic teens should target students
currently using no method and those using the withdrawal method. Additionally,
Hispanic parents should be encouraged to include EC in their conversations about birth
control.

Table of Contents

Table of Contents

CHAPTER 1: INTRODUCTION ........................................................................................................................... 8
TEEN SEXUAL ACTIVITY IN THE U.S. .................................................................................................................... 9
Pregnancy, Birth, and Abortion Rates ................................................................................................................... 9
Contraceptive Practices ..................................................................................................................................... 13
CHAPTER 2: COMPREHENSIVE REVIEW OF THE LITERATURE............................................................................... 15
HISTORY OF EMERGENCY CONTRACEPTION IN THE UNITED STATES ........................................................................... 15
Timeline ......................................................................................................................................................... 16
EMERGENCY CONTRACEPTION'S PUBLIC HEALTH IMPACT ......................................................................................... 18
CALIFORNIA'S POLICIES AND PROGRAMS .............................................................................................................. 23
CALIFORNIA'S YOUTH ........................................................................................................................................ 24
Los Angeles Youth Compared Nationally ............................................................................................................... 25
BARRIERS TO USE............................................................................................................................................. 27
COMMUNICATION ABOUT SEX AMONG HISPANICS .................................................................................................. 30
STUDY AIMS AND HYPOTHESIS ........................................................................................................................... 31
CHAPTER 3: PROJECT CONTENT ....................................................................................................................... 33
METHODOLOGY ................................................................................................................................................ 33
Study Design ................................................................................................................................................... 33
Measures ........................................................................................................................................................ 36
Missing Data ................................................................................................................................................... 40
Analysis ......................................................................................................................................................... 40
RESULTS ........................................................................................................................................................ 41
Participant Characteristics .............................................................................. .................................................. 41
Parental Factors............................................................................................................................................... 42
Contraceptive Choices ...................................................................................................................................... 44
CHAPTER 4: DISCUSSION, CONCLUSION, AND RECOMMENDATIONS ................................................................... 47
PARENTAL DISCUSSIONS ABOUT SEX .................................................................................................................. 47
CONTRACEPTIVE CHOICES ................................................................................................................................. 50
STRENGTHS AND LIMITATIONS ........................................................................................................................... 53
REFERENCES .................................................................................................................................................. 70

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