Unintended Pregnancy Prevention and Active Duty Women

Purpose: The purposes of this study were to implement and evaluate the effects of an educational program in reproductive health in terms of knowledge, attitudes, decisional balance (relative weight given to pros and cons), self-efficacy, stages of change, and contraceptive use, and to identify the independent variables most likely to predict behavioral change in the use of contraceptives among single, active-duty women during the 4-month study period.

Design: The theoretical framework for this quasi-experimental longitudinal study was based on the proposed Contraceptive Behavior Change Model.

Instrumentation: Instruments consisted of pretest/posttest for knowledge of reproductive health and questionnaires on contraceptive behavior covering reproductive history, attitudes, stages of change, decisional balance, and self-efficacy.

Method: Data were collected on three separate occasions at over a 4-month period. The intervention for the experimental group consisted of two class sessions, 2 months apart, whereas the control group received no intervention.

Sample and Analysis: Descriptive statistics, t tests, ANOVA, correlation, and regression were used to analyze data from the sample of 198 Navy enlisted women recruited from the U.S. Navy ships in San Diego, California.

Findings: The program was effective in increasing knowledge, and repetitive intervention allowed for a better long-term effect in retaining knowledge. A positive change in attitude, decisional balance, and self-efficacy over time were seen in the experimental group, making participants more accepting about contraception. The study variables of attitude, cons, and stages of change correlated positively with contraceptive use (p .05), whereas decisional balance and self-efficacy correlated with attitude and stages of change with knowledge, attitude, and self-efficacy. Stages of change explained 93% (experimental group) and 73% (control group) of the variance in contraceptive use at the end of the program. There was a decrease in sexual activity and greater use of contraceptive methods over time among sexually active women in the experimental group, leading to decreased unintended pregnancies (1 vs. 16 in the control group). The reduced rate has the potential benefit of a significant cost savings to the society, as well as improved readiness for mobilization and quality of life for sailors and their families.

Nursing Implications: Implementing effective interventions to reduce unintended pregnancy is essential, and research is needed to examine issues surrounding the nonuse of contraceptives and/or to investigate the motivational components of adolescent pregnancy.

Final report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2008108729.xhtml