Using Longitudinal Data to Understand Changes In Consistent Contraceptive Use
Using Longitudinal Data to Understand Changes In Consistent Contraceptive Use
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DOI：
10.1363/47e4615
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发表时间：
2015-09-01
影响因子：
5.8
通讯作者：
Frost, Jennifer
中科院分区：
文献类型：
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作者：
Jones, Rachel K.;Tapales, Athena;Frost, Jennifer
背景：大多数避孕行为研究依赖于横截面数据，无法充分衡量避孕药具使用的波动或可能与这一结果相关的环境和态度的变化。方法：2012 年 11 月至 2014 年 5 月期间，从全国 1,842 名 18-39 岁女性样本中收集了四波数据。使用交叉表来检查理论上与持续避孕药具使用相关的随时间变化的特征的变化和稳定性。使用随机效应和固定效应逻辑回归模型来检查与持续使用避孕药具相关的变量。结果：虽然大多数女性在每个调查期间都面临意外怀孕的风险，但在所有四个调查期间，只有 42% 的女性面临意外怀孕的风险。随机效应逻辑回归分析显示，表现出强烈避免怀孕态度的女性持续使用避孕药具的几率是态度较弱的女性的 10 倍。这种强相关性在固定效应模型中得到了证实。然而，强烈的避孕愿望并不是一成不变的。在至少一个调查期间有意外怀孕风险的女性中，53% 的人表示态度发生了变化。 结论：这些发现建立在先前的研究基础上，表明避免怀孕的态度是使用避孕药具的重要动机。重要的是要认识到，许多妇女做出有关怀孕和避孕药具的决定的背景会在相对较短的时间内发生变化。
CONTEXT: Most studies of contraceptive behavior rely on cross-sectional data and are unable to adequately measure fluctuations in contraceptive use or changes in circumstances and attitudes that are likely to be associated with this outcome.METHODS: Between November 2012 and May 2014, four waves of data were gathered from a national sample of 1,842 women aged 18-39 at baseline. Cross-tabulations were used to examine change and stability in time-varying characteristics theorized to be associated with consistent contraceptive use. Random-effects and fixed-effects logistic regression models were used to examine variables associated with consistent contraceptive use.RESULTS: While a majority of women were at risk of unintended pregnancy during each survey period, only 42% were at risk during all four. Random-effects logistic regression analysis revealed that the odds of being a consistent contraceptive user were 10 times as high for a woman who expressed a strong pregnancy avoidance attitude as for a woman who had a weak attitude. This strong association was confirmed in the fixed-effects model. However, having a strong desire to avoid pregnancy was not static; among women at risk of unintended pregnancy during at least one survey period, 53% reported a change in attitude.CONCLUSIONS: These findings build on prior research suggesting that pregnancy avoidance attitudes are an important motivator for contraceptive use. It is critical to recognize that the context in which many women make decisions about pregnancy and contraceptive use changes over relatively short periods of time.