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Five studies examined the possible influence of the sexual double standard on women's contraceptive behavior via sexual attitudes and social norms. In Study 1, longitudinal diary data from a community sample of 62 women showed that women's contraceptive behavior in ongoing sexual relationships was quadratically associated with sexual attitude. Study 2 showed that contraceptive behavior in initial and ongoing sexual encounters differed significantly in a sample of 52 university women. In initial encounters there was a greater reliance on condoms and a greater risk of unprotected intercourse. Studies 3, 4 and 5 used a person perception paradigm to examine women's perceptions of a female contraceptive provider in an initial sexual encounter. In Study 3, 57 women rated a female condom provider in a casual encounter as less nice, less socially acceptable, and her behavior as less appropriate than when her partner provided a condom. However, the target was rated as less wise if she had unprotected intercourse. In Study 4 (N = 249), a pill condition was added and the influence of sexual attitudes was assessed. Relative to when her partner provided a condom, women rated the target as less wise and less nice if she was on the pill, but they rated her as more wise when she provided a condom. Negative sexual attitudes were associated with more negative reactions but generally did not interact with contraceptive condition. In Study 5, 96 women rated the target as a function of who provided a condom (her vs. him) and four properties of the romantic relationship. Providing a condom did not result in negative evaluations in a committed relationship. In a non-committed relationship, when the woman provided a condom she was perceived as less nice but more wise. Furthermore, women used intimacy as a cue for commitment, but did not perceive intimacy alone as adequate justification for intercourse. The results of these five studies suggest that social norms may exist which discourag

The purpose of this cross-sectional and exploratory study was to describe an interaction model of parental and adolescent attributes and sexual communication influences on intentions for contraception and condom use in Mexican high school students between 14 and 17 years of age. This study utilized a secondary analysis of data from an existing experimental study. Concepts from the Theory of Planned Behavior, the Social Cognitive Theory, and the Ecodevelopmental Theory provided the contexts with which to guide this study. The study sample consisted of 756 adolescents and their parents. A SEM model building approach was used to guide the analyses. The model fit indices suggested that the sample data did not have an acceptable fit to the combined measurement model (X²[subscript (30)] = 92.215, p = 0.0000, CFI = 0.97, TLI = 0.95, RMSEA = 0.05, SRMR= 0.04). Based on the correlation coefficients, the observed variables of parents' and adolescents' familialism and religiosity and adolescents' intentions for contraception and condom use were excluded from the structural equation modeling analyses. Two alternative models were constructed form the original and both had an acceptable fit, but based on the theoretical background, one was selected (X²[subscript (15)] = 27.289, p = .0265, CFI = .99, TLI = .99, RMSEA = .03, SRMR = .02). The revised model parents' attributes (self-efficacy for sex communication and beliefs toward sex) showed a strong relationship (r = 0.80) with parents' sexual communication (communication about sex and comfort with sex communication). An additional moderately strong correlation was found between adolescents' sexual communication (communication about sex and comfort with sex communication) and parents' sexual communication (r = .31). Although the final model in this study did not explain the direct and mediator effects on adolescents' intentions for contraception and condom use, findings add new information in relation to the phenomenon of parent-adolescent communication about sex in Mexico. Several conclusions were also drawn from the relationships among parents' attributes, adolescents' attributes, parents' sexual communication, adolescents' sexual communication, and adolescents' intentions for contraception and condom use. Findings from this study are congruent with similar research and can be useful in developing intervention programs to prevent HIV/AIDS in Mexican adolescents.

Jordan has a higher fertility rate (3.8) than the averages of countries similar in income to Jordan (2.2) and compared to the Middle East and North Africa region as a whole (2.8) (WHO, WB, UNICEF, & DHS, 2011). The findings of the 2009 Jordanian Population and Family Health Survey demonstrated that the total fertility rate (TFR) has stopped declining in the country since 2002 (DOS, 2010b; USAID, 2010). The prevalence of contraceptive use has also shown little change in Jordan over the last decade (DOS, 2010b; USAID, 2010). Given that contraception is one of the proximate determinants of fertility (Rahayu et al., 2009), the main purpose of this study was to investigate which factors are contributing to women's current contraceptive behavior and intention for future contraceptive use. Research questions were developed in a comprehensive framework that considers women's intention and actual behavior as outcomes of various interactive factors within a socio-cultural context. In particular, the study's framework was directed by a theoretical basis adapted from Ajzen and Fishbein's Theory of Reasoned Action (TRA) and an extensive review of the available literature in the research area. Obviously, the social set-up and cultural norms in the study setting, together with attitudes toward children and family, represent a traditional scenario that could help explain the consistency of fertility and contraceptive use in the country. Further, the influences of background characteristics on women's contraceptive behaviors and intentions provide another scenario that could help assess the current situation of family planning (FP) in Jordan. In this study, demographic factors, spousal communication variables and healthcare system-related factors are all defined as background characteristics. Attitudes and social norms reflect the women's behavioral determinants and represent the main constructs of the TRA. In fact, involving a set of factors related to women's beliefs and social norms in the study's framework provided an opportunity to explore how these factors might promote or inhibit a woman's intentions and behaviors in respect to contraceptive use. In a three-manuscript format, this research was designed to achieve a number of objectives. The first manuscript aimed at identifying the major factors associated with the current use of contraception among women of childbearing age in northern Jordan. The second manuscript focused on investigating the main factors that are associated with women's contraceptive method preference (e.g. the choice of modern contraceptives as effective methods in preventing pregnancy versus the choice of traditional contraceptives as methods with high failure rates). The third manuscript attempted to explore the key factors associated with women's intention for future contraceptive use since the existence of such an intention would consequently translate into an actual behavior later. In 2010, original cross-section data were collected by means of a face-to-face interview using a structured pre-tested survey. The study sample included women who were currently married and were between 18 and 49 years old. Applying a systematic random sampling procedure, all respondents were recruited from the waiting rooms of five randomly selected Maternal and Child Health (MCH) centers in the Governorate of Irbid, northern Jordan. Using a list provided by the Ministry of Health, all centers in the Governorate were stratified according to the region (urban vs. rural) and randomly selected in proportion to their number in each region. The final sample size for this research consisted of 536 women surveyed, giving a response rate of 92.4 percent. Utilizing logistic regression analyses, the results of the dissertation manuscripts indicate that women's behaviors and intentions toward the use of contraception are affected by a number of factors at the individual, familial and institutional levels. The findings that emerged from the three manuscripts provide health professionals and policy makers with important information to assist in the design of FP programs and campaigns aimed at increasing current contraceptive use, enhancing the adoption of modern contraception and motivating the intention for future contraceptive use. This research strongly suggests that health professionals develop health policies that both expand the availability of MCH centers and strengthen the role of healthcare providers to dispel the numerous rumors and misconceptions surrounding the use of contraceptives, particularly modern ones. Health workers at the MCH centers need to ensure that women have sufficient information about the benefits and side effects of different types of contraception by offering proper FP counseling. The messages that religious leaders can use in advocating for FP would also help make contraceptive use socially acceptable since their opinions are often followed by the majority. This would be a key step toward removing the barriers to contraceptive use. Moreover, to design effective FP interventions, planners should take into account women's attitudes toward the use of contraceptive methods and the components of those attitudes (e.g. women's approval of contraceptive use for birth spacing and perceptions regarding the value of large family sizes and the importance of having male children in Jordanian families). / Graduation date: 2012 / Access restricted to the OSU Community at author's request from May 9, 2012 - May 9, 2013