Influence of Social and Behavioral Factors on Intention to Use Emergency Contraceptive Pills

With the US Food and Drug Administration's approval of behind the counter status for the emergency contraceptive Plan B on August 26, 2006, one of the last major external hurdles for women accessing emergency contraceptive pills (ECPs) appears to have been removed. It is unknown however, whether prescription-free availability will be the final factor in women's predisposition to use ECPs or if other intrinsic factors may override use. The purpose of this study was to examine social and behavioral factors that have been suggested in the literature as possible influences on intention to use ECPs among college women. The author performed logistic regression to test how well the constructs: knowledge, self-efficacy, attitude, perceived social norms, perceived threat of pregnancy, and past behaviors explain intention to use ECPs. This study was conducted among a population at risk for unintended pregnancy – American college students. Of the 4,219 randomly selected female students who received an invitation email to participate in the study, 1,718 completed surveys were analyzed. The full theoretical model including: sociodemographic factors, knowledge, self-efficacy, attitude, perceived social norms, pregnancy severity, and past behaviors significantly predicted intention to use ECPs. The strongest predictors of intention to use ECPs were: knowledge that ECPs are not a form of abortion and knowledge that ECPs have the ability to prohibit or delay ovulation, high self-efficacy, a positive attitude, a strong desire to avoid becoming pregnant, and past ECP use. Strategies to address social and behavioral factors as barriers to ECP use should target these factors.