142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Factors Associated with Effective Contraception Use To Prevent Pregancy Among Young, Urban Women

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 10:30 AM - 10:45 AM

Deborah Nelson, PhD , Department of Public Health, Temple University, Philadelphia, PA
Stephen Lepore, PhD , Department of Public Health, Temple University, Philadelphia, PA

Unintended Pregnancy (UP), a mistimed or unwanted pregnancy, is a significant public health problem, linked to numerous adverse outcomes with high rates among women experiencing violence and birth control sabotage.  Birth control sabotage involves the intentional sabotage of contraception by a sexual partner. Interventions to reduce UP target changes in individual behaviors without recognizing violence exposure or resiliency resources. Building resiliency among young, urban women may be important to promote consistent contraception use. In 2013, the Young Women’s Health Study enrolled 315 young urban, sexually active women to understand factors contributing to consistent contraception use. Audio computer assisted survey instrument (ACASI) collected information on substance use, interpersonal violence and birth control sabotage, depressive symptoms, self-esteem, sexual self-efficacy, and contraception use.

Less than 45% reported consistent contraception use. Women reporting consistent contraception reported significantly lower depressive symptoms compared to women reporting inconsistent contraception (29.0% vs. 51.2% p-value=0.001). Regression analysis found that older age (aOR=1.16, 95% CI: 1.02-1.32), receiving a contraception prescription (aOR=2.68, 95% CI: 1.21-5.94) and low depressive symptoms (aOR=0.43, 95% CI: 0.19-0.93) were significantly related to consistent contraception use. One-quarter reported birth control sabotage. The combination of depressive symptoms and birth control sabotage was significantly lower among women reporting consistent contraception (aOR=0.40. 95% CI: 0.17-0.95) but low depressive symptoms was the strongest predictor of consistent contraception (aOR=0.28, 95% CI: 0.13-0.59).

Interventions to decrease depressive symptoms and improve conversations with all sexually active women about contraception, within the context of birth control sabotage, may promote consistent contraception use and decrease UP.

Learning Areas:

Implementation of health education strategies, interventions and programs
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Explain the limitations of current public health interventions designed to increase contraception use and reduce unintended pregnancy among young urban women. Demonstrate the importance of recognizing a young woman’s social and resiliency resources when discussing contraception options. Evaluate the findings from an NIH-funded study designed to examine individual resiliency factors, social support network characteristics and birth control sabotage on consistent and effective contraceptive use among young, urban sexually active women seeking care in family planning clinics. Assess the role of resiliency factors in promoting and prioritizing consistent contraception use among women experiencing birth control sabotage. Discuss these findings in the context of developing new interventions to improve contraception use and reduce unintended pregnancy among young, urban women.

Keyword(s): Reproductive Health, Contraception

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: NA

Qualified on the content I am responsible for because: For over 15 years, I have been leading NIH-funded research in reproductive health with a particular focus in examining the role of early pregnancy markers, social/behavioral risk factors, and violence on adverse pregnancy outcomes among urban women. I have successfully implemented and completed three NIH-funded studies in urban clinics. I am currently evaluating the role of resiliency factors on the risk of unintended pregnancy among young, urban women (R21-HD071200-01A1).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.