birth control
Mexican-American adolescent sexuality and sexual knowledge: an exploratory study.

Padilla AM, Baird TL.

PIP: This article reports the findings of a study designed to examine the sexual knowledge, attitudes, and practices of low-income Mexican- American adolescents. The participants in the study were all about to begin a sex education program in a community health organization in East Los Angeles. The study involved 84 adolescents aged 14-19, 97% of who identified themselves as Mexican-American (the remainder identified themselves as Latino). 51 of the subjects were female and 33 male. The participants completed a 43-item questionnaire concerning demographics, sexual experience and contraceptive use, knowledge of birth control methods, and attitudes towards sexuality and birth control. Only 18 (21%) of the subjects indicated ever having sex. But among this group, 83% reported not using contraception during their last intercourse, and 61% reported never using contraception. Only 22% reported using contraception regularly. Concerning the knowledge of different birth control methods,many of the participants were able to list several methods, but their responses indicated a lack of accurate and specific knowledge about contraceptive methods. In addition to the 43-item questionnaire, 27 of the subjects also completed a sexual and contraceptive knowledge questionnaire. The topics included contraceptive effectiveness, the menstrual cycle, and fertilization. The scores on the questionnaire were low, with an average score of 33% of correct answers. Finally, all 84 participants responded to a sexual attitude questionnaire, which revealed a generally traditional attitude toward the importance of have children, virginity, and the relationship between sex and love.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12284263&dopt=Abstract birth control



birth control
Risk of contraceptive discontinuation among adolescents.

Balassone ML.

School of Social Work JH-30, University of Washington, Seattle 98195.

This prospective study assesses a sample of adolescent oral contraceptive users for correlates of continued use of birth control. Data were collected by interview at both an initial family planning clinic visit and 3 months later. Half of the sample did not return to the clinic for follow-up. Among those contacted by phone, all had discontinued the use of a contraceptive, and 69% were at risk for an unintended pregnancy. Least likely to continue to use the pill were adolescents who perceived substantial health-related problems associated with oral contraceptive use, felt their own risk of pregnancy was less than that of other teenagers, and had poor problem-solving skills. Among the most common problems experienced were the side effects associated with oral contraceptive use and difficulty remembering to take a pill every day. Suggested interventions aimed at supporting continued and effective use of birth control are provided.

PIP: This prospective study assesses a sample of adolescent oral contraceptive users from 3 clinics run by a private family planning agency in Oakland, California for correlates of continued use of birth control. Data were collected by interview at both an initial family planning clinic visit and 3 months later. 1/2 of the sample did not return to the clinic for follow-up. Among those contacted by phone, all had discontinued the use of a contraceptive, and 69% were at risk for an unintended pregnancy. Least likely to continue to use the pill were adolescents who perceived substantial health-related problems associated with oral contraceptive use, felt their own risk of pregnancy was less than that of other teenagers, and had poor problem-solving skills. Among the most common problems experienced were the side effects associated with oral contraceptive use and difficulty remembering to take a pill every day. Suggested interventions aimed at supporting continued and effective use of birth control include reassurance by staff, increased teaching of adolescents by practitioners to associate their pill-taking with another daily activity and to call the clinic should a side-effect occur. The typical medical protocol in family planning clinics requiring referral for additional tests may also interfere with some teenagers' continued use of birth control. Time spent in explaining the need for the tests and better follow-up will also enhance continuation. author's modified

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2606752&dopt=Abstract birth control



birth control
Expanded nursing care for contraceptive use.

Oakley D, Denyes MJ, O'Connor N.

Nursing actions to promote contraceptive self-care are described. Orem's self-care theory was used to develop assessment tools and to plan nursing actions.

PIP: Recent research investigated the expansion of nursing care for contraceptive usage and whether it can improve the quality and continuation of birth control. In public funded family planning programs nurses provide most of the direct care. A questionnaire was given to 1,800 women as a 1st step in ensuring an awareness of their own birth control goals, strengths and limitations. The nurses analyzed the questionnaire and based their ideas on counseling and care on the needs of the individual women. Each nurse would help the client reveal fears of side effects and outline steps for a woman to achieve her goals for avoiding pregnancy using the method she preferred. Often the client needed support and information was shared in a way not to be interpreted as a lecture. When confrontation was used it was in relation to future birth control goals, actions and plans. All of these interactions sought to develop a self-care plan for the client in relation to contraceptive use. The nurse therefore reinforced the goals and actions of the client and made an effort to have a positive communication at all times. Since the nurse is not present when most of the self-care decisions and actions, her efforts must focus on helping the client use her inner resources. Study nurses were catalysts for the client while staff nurses provided the education in family planning. In combination, the study identified the clients' problems and contraceptive self-care.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2764579&dopt=Abstract birth control



birth control
Overview of commonly-practiced birth control methods.

Collins J.

PIP: Noting that health care providers must be knowledgeable about the available contraceptive methods and be able to assist clients in making informed decisions, this article provides a brief overview of commonly practices birth control methods. The article reviews oral contraceptives, the IUD, the condom, the diaphragm, the sponge, the cervical cap, spermicides, and withdrawal (coitus interruptus). Additionally, the article also examines fertility swawareness methods -- abstinence, temperature, rhythm method, mucus examination, and illustration of calendar -- and voluntary sterilization -- including tubal ligation and vasectomy. For each contraceptive method, the author discusses how it works, its effectiveness, its benefits and risks, its drawbacks, and its cost. Excluding abstinence, the most effective method is voluntary sterilization (which is also the most popular method of birth control in the US) with an effectiveness rate of 99.6%. Other highly effective methods include copper-bearing IUDs (99%), oral contraceptives (97.5%), and hormonal-releasing IUDs (97%). The least effective methods include contraceptive foams, creams, jellies, and suppositories (80%); withdrawal (80%); and fertility awareness methods (76%). The article goes on to list contraceptive methods that could soon be available. Finally, the author discusses nurses' role and responsibility in providing effective contraceptive counseling and informed decision making.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2807349&dopt=Abstract birth control



birth control
A direct mailing to teenage males about condom use: its impact on knowledge, attitudes and sexual behavior.

Kirby D, Harvey PD, Claussenius D, Novar M.

ETR Associates, Santa Cruz, Calif.

In August 1987, a letter, informational pamphlet and order coupon for free mail-order condoms were sent to an experimental group of teenage males 16-17 years of age. An experimental design was used to measure the impact of the mailing on teenagers' knowledge, attitudes and behavior. Approximately five weeks after the mailing, 985 members of this group and 1,033 members of the control group (who received no mailing) were interviewed by telephone. About seven months after the mailing, members of the experimental group who claimed they had ordered the free condoms were reinterviewed by phone. The results of the initial interviews revealed that about three-fourths of the teenagers in the experimental group had received the materials, and about two-thirds had read them. Moreover, males in the experimental group, particularly those who reported having received and read the pamphlet, were slightly but statistically significantly more knowledgeable about sexually transmitted diseases (STDs), pregnancy and contraceptives. On the other hand, there were no differences between males in the experimental and control groups in attitudes toward STDs or birth control, nor were there differences in actual sexual activity or in the use of birth control. However, the experimental group was significantly more likely to have ordered condoms by mail, presumably as a result of having received the free mail-order condom offer. Many of those who ordered condoms had previously had sex and had used condoms. However, a sizeable portion of those who ordered condoms did so prior to first intercourse, suggesting a possibly important early intervention.

PIP: In August 1987, a letter, informational pamphlet and order coupon for free mail-order condoms were sent to an experimental group of teenage males ages 16-17. An experimental design was used to measure the impact of the mailing on teens' knowledge, attitudes, and behavior. Approximately 5 weeks after the mailing, 985 members of this group and 1033 members of the control group (who received no mailing) were interviewed by telephone. About 7 months after the mailing, members of the experimental group who claimed they had ordered the free condoms were reinterviewed by phone. The results of the initial interviews revealed that about 3/4 of the teens in the experimental group had received the materials, and about 2/3 had read them. Moreover, males in the experimental group, particularly those who reported having received and read the pamphlet, were slightly but statistically significantly more knowledgeable about sexually transmitted diseases (STDs), pregnancy, and contraceptives. On the other hand, there were no differences between males in the experimental and control groups in attitudes towards STDs or birth control, nor were there differences in actual sexual activity or in the use of birth control. However, the experimental group was significantly more likely to have ordered condoms by mail, presumably as a result of having received the free mail-order condom offer. Many of those who ordered condoms had previously had sex and had used condoms. However, a sizeable portion of those who ordered condoms did so prior to 1st intercourse, suggesting a possibly important early intervention.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2703031&dopt=Abstract birth control



birth control
Analysis of contraceptive behavior of sexually active female adolescents in the United States.

DuRant RH, Sanders JM Jr, Jay S, Levinson R.

Department of Pediatrics, Medical College of Georgia, Augusta 30912-2500.

Drawing on a theoretical model of adolescent contraceptive behavior, we examined the relationships between various social and behavioral variables and contraceptive use by sexually active female adolescents. Hypotheses were tested with the use of a national random sample of sexually active female adolescents (n = 1426), aged 15 to 20 years, from Cycle III of the National Survey of Family Growth. The data were analyzed with Pearson correlation coefficients and multiple regression analysis. Noncompliance with the initial birth control method was the strongest predictor of the adolescents' contraceptive behavior at the time of the interview. Not acquiring birth control at the initial family planning visit and the frequency of family planning visits during the previous 12 months were the second and third best predictors of subjects' contraceptive use. Coital frequency and the length of time between first coitus and the initiation of birth control each explained a small amount of additional variation in the regression model. When combined, these five variables explained 40% of the variation in the contraceptive behavior of this representative sample of sexually active female adolescents. The findings could be useful for clinicians in providing more effective birth control counseling to adolescent patients.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3183855&dopt=Abstract birth control



birth control
Conception and birth control use: Cambodian refugee women's beliefs and practices.

Kulig JC.

PIP: The cultural knowledge held by Cambodian refugee women in western Canada--and the relationship of this knowledge to contraceptive usage--were investigated through participant observation and ethnographic interviews with 30 refugee women and 1 crou khmer (traditional male healer). The reliability of the research was enhanced by the principal investigator's encouragement of input from a recognized leader of the Cambodian refugee community. None of the respondents showed an understanding of the physiological process of ovulation or the timing of conception within the menstrual cycle. Most attributed achievement of pregnancy to a cool body temperature. Herbal medicines were widely used to relieve menstrual cramps and prevent pregnancy. Refugee women who were currently childbearing or had the potential to bear children were most aware of formal birth control methods. Women who had given birth in Southeast Asia but had the potential to have more children placed equal emphasis on formal and informal methods of fertility control, while women past the childbearing years had no knowledge of Western methods of family planning. The crou khmer expressed a belief in the effectiveness of a burning ritual to prevent pregnancy. The young Cambodian refugees expressed a preference for oral contraceptives and tubal ligation as opposed to methods such as the diaphragm, the IUD, and foam that require the woman touch herself. An obstacle is the fact that young Cambodian women are trained to seek information about topics such as fertility control from Cambodian elders, who have very limited knowledge of modern methods of birth control. This suggests a need for methods to deliver this information in a culturally sensitive manner by a nonelder or to develop training for elders. Any informational material that is developed for this population should link traditional and Western beliefs and practices.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3204423&dopt=Abstract birth control