Improving adolescent contraceptive use: evaluation of a theory-driven classroom-based intervention

Area of Science:

• Adolescent Health
• Behavioral Science
• Public Health Interventions

Background:

• Adolescent contraceptive use is a critical public health issue.
• Interventions targeting psychological antecedents like self-efficacy and anticipated regret may influence contraceptive behavior.
• Understanding factors influencing contraceptive use is vital for preventing unintended pregnancies.

Purpose of the Study:

• To evaluate the impact of intervention materials designed to enhance self-efficacy and anticipated regret on adolescent contraceptive behavior.
• To assess the effect of these interventions on psychological antecedents of contraceptive use, intentions, and actual behavior.
• To compare the effectiveness of self-efficacy (SE) manipulation, anticipated regret (AR) manipulation, and combined AR/SE manipulations against an active control group.

Main Methods:

• A 4 (intervention condition) x 3 (time) mixed design was employed with 414 adolescents from five secondary schools.
• Participants were assigned to an active control, AR manipulation, SE manipulation, or combined AR and SE manipulations.
• Outcome measures included psychological antecedents of behavior change, intentions, and self-reported contraceptive behavior.

Main Results:

• Multivariate analysis of variance (MANOVA) indicated significant increases in outcome measures, including intentions, over time, but no significant differences between intervention conditions.
• Reactivity due to questionnaire administration was noted as a potential confounding factor.
• Among sexually active participants with initially low intentions, significant increases in intention and behavior were observed (F[3,35] = 10.359, P < 0.001, η(p)(2) = 0.47).

Conclusions:

• Behavior change theory-driven interventions show potential for classroom delivery.
• Questionnaires may inadvertently act as interventions, warranting further investigation.
• Post-decisional and behavioral skills interventions may be particularly effective for motivating individuals already intending to use contraception.