WED-073 - Theory-based Predictors of College Females’ Intentions to Use Oral Contraceptive Pills

Brief Abstract Summary: Learn how the theory of planned behavior (TPB) constructs inform college females’ intentions to take oral contraceptive pills (OCPs) and how to apply these findings to design and evaluate TPB-based programs that support eligible college females’ decision-making to use OCPs. More than one third of pregnancies are unintended, and most unintended pregnancies occur in females ages 18-24 yrs (CDC, 2023), which includes traditional college-age women. Results of a non-experimental, cross-sectional study examining TPB based constructs to predict OCP intentions of 226 college females found attitudes (β=.40; p<.001) and perceived behavioral control (β=.33; p<.001) accounted for 42% of the variance in OCP intentions. Health promotion strategies to increase attitude, subjective norm, and perceived behavioral control to support OCP use among eligible college females will be emphasized.

Detailed abstract description: Learn how the theory of planned behavior (TPB) constructs inform college females’ intentions to take oral contraceptive pills (OCPs) and how to apply these findings to design and evaluate TPB-based programs that support eligible college females’ decision-making to use OCPs. Background Over one third of pregnancies in the U.S. are unintended, predominantly among females aged 18-24, including traditional college-aged females (CDC, 2023). Data from 2017-2019 found that OCPs are the most common type of contraceptive used by college females to prevent unintentional pregnancies (Daniels & Abma, 2020). Research is needed to identify factors that influence college females' OCP use intentions and behavior. The theory of planned behavior (TPB) asserts that a person’s attitude toward the behavior, subjective norm, and perceived behavioral control together predict their behavioral intention to engage in the behavior. The TPB has been widely applied to various reproductive health behaviors and intentions for college women (e.g., HPV vaccination, switching from short- to long-acting birth control, condom use). This study aimed to (a) assess college females' attitudes, subjective norms, perceived behavioral control, and intentions to take OCPs daily in the next 6 months, and (b) test the TPB constructs as predictors of these intentions.

Methods: We conducted a non-experimental, cross-sectional study design with 226 college females at a large public university in the southeastern U.S. via an online survey in Fall 2023. Bivariate correlation coefficients were used to assess relationships among the TPB constructs. Confirmatory factor analysis (CFA) and structural equation modeling using maximum likelihood (ML) estimation were used to test construct and predictive validity.

Results: All TPB constructs were significantly positively related to one another, ps < .001. After slight modifications, the CFA indicated reasonable model fit (CFI=.94; RMSEA=.07 (90% CI [.06, .08]), SRMR=.07). Attitude toward the behavior (β=.40, p<.001) and perceived behavioral control (β=.33, p<.001) were significant predictors of OCP intentions, accounting for 42% of its variance. Practical Implications: Our findings may serve as a basis for planning university programs to address unintended pregnancy prevention methods. Our instrument may be used to assess college females’ attitudes, subjective norms, perceived behavioral control, and behavioral intentions to use OCPs both before and after program implementation. Given that attitudes and perceived behavioral control were the best predictors of behavioral intention to use OCPs, practitioners may consider developing programming that emphasizes positive attitudes toward OCP use and strong perceived behavioral control to use OCPs to see whether behavioral intentions increases before and after the intervention. Future studies may utilize a similar approach to determine whether this applies to other commonly used forms of birth control.