Predicting contraceptive behaviour among adolescents : social, cognitive, and contextual influences

Abstract

Reports from Norway and other western countries show that many adolescents do not protect themselves from unintended pregnancies and sexual transmitted infections (STIs). The incidence of STIs such as chlamydia infections has increased in recent years in Norway and other European countries. The general aim of this thesis was to investigate the social, cognitive, and contextual factors that predict adolescents’ decisions about whether or not to use contraception. The study population of this thesis comprised all of the students in ninth grade at three schools in Oslo (n =196). The findings presented in Paper 3 are based on data from a cross-sectional health study (The Norwegian Youth Health Study) among students attending tenth grade in urban and rural regions of Norway, reporting having had at least one coital experience (n =4467).<br><br>

The results of this thesis show that the Theory of Planned Behaviour and the Prototype/Willingness model provide important information about the psychological processes underlying the decision among young adolescents to use contraceptives. Likewise, the results showed that contraceptive use among adolescents was influenced by different contextual levels (individual, family, community and societal) and thus supported the socio-ecological model (Bronfenbrenner, 1979). <br> Furthermore, social influence from friends, parents, and partners were the most important predictors among boys and girls for intentions to use contraceptives. In addition, moral norms were one of the most important predictors of boys’ intentions to use contraceptives, and for girls and boys willingness of to have unsafe sex. Perceived health-risk prototype was an important predictor for the intention to use contraception among girls and for the decision among boys to use condoms. Furthermore, perceived risk and fear of getting STIs together with the opinions of parents and friends about contraceptive use and their approval of it were the most important factors for girls’ decisions to use condoms. <br><br>

The most important individual and contextual predictors of condom use among boys were friend support, visits to youth health services, few episodes of drunkenness and not using doping agents. The most important predictors of condom use among girls were parental monitoring, general self-efficacy, few episodes of drunkenness, and not smoking daily. For girls, visits to youth health clinics, parental monitoring, and not smoking daily were most important for their use of contraceptive pills. The results from this work point to several important practical issues in terms of preventing STIs and unintended pregnancies among adolescents.