The Transtheoretical Model and Douching Behaviors in Women Open Access

Payne, Jackelyn B. (2016)

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Introduction: Douching is the act of cleansing the vagina with a mixture of various fluids (such as water, vinegar, iodine, etc.) in an effort to wash out any impurities. Although it has been demonstrated that douching may be detrimental to women's reproductive health and increase the risk of infection, nearly 1 in 4 women between the ages of 15 and 44 practice vaginal douching in the United States. There is little theory-driven research about this topic that can inform the development of interventions and no studies of douching behaviors in women studying healthcare.

Aims: Drawing upon the Transtheoretical Model (TTM), the purpose of this study was to (i) determine the distribution of stages of readiness to quit douching among women at the Rollins School of Public Health and Woodruff School of Nursing, (ii) assess the validity of a created decisional balance measure, and (iii) determine whether the relationship between the stages of readiness and the decisional balance scores were in line with the predictions of the model.

Methods: Data were collected from 205 women aged 20-55 years between January 2016 and February 2016. Participants completed a cross-sectional online survey. Descriptive, bivariate, and post-hoc analyses were conducted.

Results: Overall, 21(10.2%) of participants had a history of douching. Of these, 5 were in the precontemplation stage to quit douching, 1 was in the contemplation stage, 0 were in the preparation stage, 1 was in the action stage, and 14 were in the maintenance stage. The created decisional balance scale was found to be reliable and valid. The differences in decisional balance scores of participants across stages were statistically significant and in line with the predictions of the TTM.

Conclusions: The findings from this study lay the groundwork for further theoretical exploration of this topic not only in the health care and university settings, but for the wider population of women. The created decisional balance scale was found to be reliable and valid. Given the lack of theory-driven research of this topic, this has significant implications for use in future interventions.

Table of Contents

Chapter 1: Introduction 1

Chapter 2: Literature Review 3

Chapter 3: Methods 12

Chapter 4: Results 17

Chapter 5: Discussion 25

References 32

Appendix A: Decisional Balance Instrument 41

Appendix B: Full Survey 42

List of Figures Figure 1: Stages of Change Algorithm 14

Figure 2. Distribution of Participants Among the Stages of Change 19

Figure 3. Distribution of Total Decisional Balance Score by Stage 22

Figure 4. Participants' Pro and Con Scores Distributed Among the Stages of Change 23

List of Tables Table 1. The Rotated Factor Pattern 21

Table 2. Mean Scores for Pros and Cons by Stage of Change 23

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