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Semin Adolesc Med. 1987 Jun;3(2):135-44.

A social psychologic model of female adolescents' compliance with contraceptives.



A theoretical model is proposed to help the clinician organize the multiple interrelationships between factors that may influence a female adolescent's compliance with her birth control method. 1 variable that has been found to be predictive for compliance in adults that was not included in the model is the quality of the patient-physician relationship. This variable was excluded because the model is a social psychological model that focuses on the attitudes and behavior of the female adolescent. The female adolescent's perception of the quality of her relationship with her health care provider can be accounted for under the component of the model discussing costs of acquiring birth control. A table contains a checklist of information the clinician may want to obtain from a patient to help determine if she may be at risk for noncompliance. Factors that influence contraceptive compliance are reviewed: frequency of sexual intercourse, perceived probability of pregnancy, premarital sexual standards and experiences, intimacy of sexual relationship, physical and emotional development, cognitive assessment of pregnancy, parental and peer support, and personality development. Lindemann and DeLamater argue that frequency of intercourse is the "prime mover" in the process of acquiring and using birth control. As the frequency of coitus increases or decreases, awareness of the possibility will increase or decrease. DeLamater hypothesizes that before assessing that pregnancy may be undesirable and thus initiating contraceptive use to prevent pregnancy, a woman 1st must perceive that she is at significant risk for becoming pregnant. Russ proposes that a major reason that sexually active female adolescents fail to use effective birth control is that they do not fully accept sexual intercourse as morally acceptable for themselves and thus are unable to rationally prepare for it. Rains argues that when a female adolescent initiates sexual activity, she is in a state of moral ambivalence, which is defined as being unable to accept her own sexual activity. Based on available data, it is proposed that female adolescent physical development, postmenarcheal age, and length of time since 1st intercourse will be positively associated with both coital frequency and contraceptive compliance. The model also specifies that several factors will have a direct effect on contraceptive compliance, independent of the influence of frequency of sexual intercourse. These include the female adolescent's cognitive assessment of pregnancy, parental and peer support, and their personality development.

[Indexed for MEDLINE]

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