Approval Sheet The Association Between Contraceptive Choices, Parental Factors, and Hispanic Adolescents' Use of Emergency Contraception Public
Dignam, Toshiko Alana (2011)
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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