Elsevier

Journal of Adolescent Health

Volume 40, Issue 3, March 2007, Pages 275.e15-275.e22
Journal of Adolescent Health

Original article
Adolescent Dual Method Use: Relevant Attitudes, Normative Beliefs and Self-Efficacy

https://doi.org/10.1016/j.jadohealth.2006.10.003Get rights and content

Abstract

Purpose

To encourage dual contraceptive method use—protection from both STD and pregnancy—health behavior change efforts must target powerful risk and protective factors that are amenable to change. This study examines longitudinal relationships between adolescents’ contraceptive-related cognitions and dual method use.

Methods

Data are from 1123 sexually active 7–11th-grade participants in the National Longitudinal Study of Adolescent Health, Waves 1 and 2 (W1, W2). A series of nested path models examined relationships between participants’ contraceptive use level at most recent intercourse (zero, one, two methods) and contraceptive-related cognitions. Parallel analyses were completed with four grade/gender groups.

Results

Dual method use at most recent intercourse ranged from 14.3% to 25.0%. Path models suggested that contraceptive use levels and contraceptive-related cognitions were moderately stable over time. Cross-sectionally, contraceptive use level was associated with parent approval of birth control (older youth, younger girls), birth control attitudes (older youth, younger boys), perceived pregnancy consequences (older youth), perceived sexually transmitted disease risk (older girls), perceived benefits of sex (younger girls), and contraceptive self-efficacy (older youth). W1 father approval of birth control (younger girls), mother disapproval of sex (older girls), and birth control attitudes (older boys) predicted W2 contraceptive use levels. W1 contraceptive use levels predicted several W2 cognitions among older youth.

Conclusions

Sexually active adolescents’ perceptions of parent expectations about sex and contraception have important links to dual method use. Adolescents’ attitudes about practical, social, and moral implications of using birth control are also linked to their use of dual contraceptive methods.

Section snippets

Data source

Data are from the first two waves of the National Longitudinal Study of Adolescent Health (Add Health) [23]. Approximately 90,000 7–12th graders at 134 junior and senior high schools completed Add Health in-school surveys, and a random subsample of 12,105 completed additional in-home surveys during the 1994–95 school year (Wave 1); 9–18 months later, participants in 7–11th grades at Wave 1 provided in-home data for Wave 2.

In-home surveys included questions about sexual and contraceptive

Participant characteristics

As noted in Table 1, the study sample consisted of 1123 adolescents (59% female). Close to two thirds (65.4%) were white, 20.6% were black, 10.6% Hispanic, and 3.3% of other races or ethnicities. Eleven percent reported that a parent or parent’s partner received public assistance in the past year. Slightly under half (42.5%) lived with two biologic parents. At W1, participants’ average length of time since first intercourse was 20 months. More than two thirds (69.3%) reported using

Discussion

The current study, utilizing two waves of data from a nationwide sample of 7–11th-grade students, extends empirical understanding of adolescents’ dual method contraceptive use in several ways. Our findings suggest that sexually experienced adolescents’ contraceptive use levels and their contraceptive-related cognitions are moderately stable over 12–18 months’ time. Level of contraceptive use at most recent intercourse appears to be more stable over time among older teens than among younger

Acknowledgments

Funding for this research was provided by grants from NICHD (1R01 HD36868-01; Bearinger, PI), and from the CDC to the Healthy Youth Development - Prevention Research Center (#1-U48-DP-000063; Resnick, PI). This research uses data from Add Health, a program project designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris, and funded by grant P01-HD31921 from NICHD, with cooperative funding from 17 other agencies. Special acknowledgment is due Ronald R. Rindfuss and Barbara

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