Evaluative Indices Assigned to Contraceptive Methods by University Undergraduates

Background: Preordinate attitudes and beliefs about contraception may influence acceptance or rejection of a particular method. Purpose: We examined the attitudes about contraception methods held by undergraduate students (N=792) at two large southeastern universities in the United States. Methods: Twelve methods were rated on 40 semantic differential scales. Means of the scale sum scores for men and women were compared using t-tests. Results: Among women the most favorably rated methods were: abstinence, oral contraceptive, male condom, Nuva ring, contraceptive patch, emergency contraception, male sterilization, female sterilization, diaphragm and female condom, each yielding a mean above the scale midpoint. The most negatively rated methods were withdrawal and douche. For men, the ratings in descending order were: oral contraceptive, male condom, abstinence, contraceptive patch, emergency contraception, female sterilization, Nuva ring, female condom, diaphragm, withdrawal, male sterilization and douche. There were four statistically significant (P < 0.05) gender differences, with abstinence, male condom, male sterilization and Nuva ring all rated more favorably by women. Discussion: These evaluative indices suggest that contraceptive methods elicit varied responses among potential users that theoretically could manifest themselves in acceptance or rejection of a particular method. Improved understanding of the traits by which potential users judge contraception may be beneficial in fostering communication between potential users and practitioners who provide relevant advice. Translation to Health Education Practice: Health educators and other practitioners engaged in contraception counseling must consider that persons may already hold strong feelings about some methods before they enter the clinical setting. McDermott RJ, Malo TL, Dodd, VJ, Daley EM, Mayer MB. Evaluative indices assigned to contraceptive methods by university undergraduates. Am J Health Educ. 2011;42(4):228-234. This paper was submitted to the Journal on July 28, 2010, revised and accepted for publication on March 6, 2011. Robert J. McDermott is a professor in the Department of Community and Family Health, University of South Florida, Tampa, FL, 33612; E-mail: [email protected]. Teri L. Malo is a research associate in the Department of Community and Family Health, University of South Florida, Tampa, FL, 33612. Virginia J. Dodd is an associate professor in the Department of Health Education and Behavior, Research Article University of Florida, Gainesville, FL, 33611. Ellen M. Daley is an associate professor in the Department of Community and Family Health, University of South Florida, Tampa, FL, 33612. Alyssa B. Mayer is a graduate research assistant in the Department of Community and Family Health, University of South Florida, Tampa, FL, 33612. Robert J. McDermott, Teri L. Malo, Virginia J. Dodd, Ellen M. Daley, and Alyssa B. Mayer American Journal of Health Education — July/August 2011, Volume 42, No. 4 229 sex, multiple or casual sex partners, coincidental risk behaviors such as alcohol or other drug use) increase their likelihood of experiencing negative consequences such as sexually transmitted infections (STIs) or unintended pregnancy. Women in college 20 to 24 years of age have one of the highest rates of unintended pregnancy due to lack of contraceptive use and unsafe sexual practices. More than 80% of college-aged women are sexually active but are not seeking to become pregnant. Approximately 12% of college students report either experiencing or being involved in an unplanned pregnancy and 52% report having had an unplanned pregnancy “scare” at least once. Preventing unintended pregnancy and reducing rates of STIs are important health objectives that may be met by encouraging the use of acceptable and effective contraceptive methods. However, preordinate attitudes and beliefs about contraception may influence acceptance or rejection of a particular method. Semantic differential scales can be used to study attitudes and reactions to various words or terms, as many words have both a denotative (i.e., dictionary definition) and connotative (i.e., representational) meaning. Previous experience and sets of beliefs may help shape individuals’ representational interpretations of words, and thus, different people may assign contrasting connotations to the same word. Semantic differential scales have been used to measure the connotative meaning an individual assigns to a construct, including contraception and other sexuality-related concepts. Research on connotative meanings assigned to contraceptive options has focused on traditional methods of birth control. McDermott and Gold examined connotative meanings assigned to ten contraceptive options (condom, diaphragm, douche, female sterilization, IUD, male sterilization, oral contraceptive, rhythm, spermicide and withdrawal). Sarvela et al. increased the overall number of methods to 13 by adding abstinence, the contraceptive sponge, and the vaginal suppository for consideration. Other researchers focused exclusively on college students’ semantic evaluation of the male condom. because semantic or connotative examination of attitudes about contraception has not been conducted recently, research is warranted to track the changing attitudes and popularity of traditional methods as well as to assess newer contraceptive technologies. Previous research also has indicated the existence of both sex differences and similarities in contraception method evaluation that further warrants clarification and periodic monitoring through updated research.