Measuring a Critical Component of Contraceptive Decision Making: The Contraceptive Concerns and Beliefs Scale.
Matern Child Health J
; 28(5): 847-857, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38194129
ABSTRACT
INTRODUCTION:
Concerns about safety and side effects from contraceptives are widespread and related to reluctance to use them. Measuring these concerns is an essential component of understanding contraceptive decision-making and guiding contraceptive and interpregnancy clinical care.METHODS:
We used qualitative research and item response theory to develop and test a psychometric instrument to measure contraceptive concerns and beliefs. We developed 55 candidate scale items and tested them among 572 adolescents and adults across nine California healthcare facilities in 2019-2020. We derived a 6-item scale and assessed differences by age and social determinants of health with multivariable regression.RESULTS:
In qualitative data, participants voiced both concerns and positive beliefs about contraception. Quantitative survey respondents were aged 21 years on average, and 24% were parous. Over half (54%) worried contraception has dangerous side effects, and 39% worried it is unnatural. The mean Contraceptive Concerns score, increasing with higher concerns, was 1.85 (SD 1.00, range 0-4, α = 0.81). Items fit a partial credit item response model and met prespecified criteria for internal structure validity. Contraceptive use declined with increasing Concerns score (adjusted prevalence ratio [aPR] = 0.81 [0.72-0.92]). Scores were elevated among Black (mean 2.06; aß = 0.34 [0.09, 0.59]) and Multiracial or other race (2.11; aß = 0.34 [0.02, 0.66]) respondents vs. White (1.66), but not Latinx respondents (1.81; aß = 0.11 [- 0.11, 0.33]). Scores were also elevated among participants with lower maternal education (high school/Associate's 1.89 versus college 1.60; aß = 0.28 [0.04, 0.53]).DISCUSSION:
The psychometrically robust Concerns instrument can be used in research to measure autonomous contraceptive decision-making and to design person-centered care.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Anticoncepção
/
Anticoncepcionais
Tipo de estudo:
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Humans
Idioma:
En
Revista:
Matern Child Health J
Assunto da revista:
PERINATOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos