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Comparing three theories in predicting reproductive health behavior in adolescent women with diabetes

Background: Understanding factors that affect decision-making in using preconception planning is important in order to reduce the rate of unplanned pregnancies and pregnancy-related complications in all women with type 1 diabetes (T1D). Previously, there were no studies of reproductive health-related beliefs, attitudes, or behaviors of adolescent women with diabetes. Constructs from social cognitive models, such as, the Health Belief Model (HBM), Theory of Reasoned Action (TRA), and Social Cognitive Theory (SCT), are factors that can influence these behavioral outcomes.
Objective: Three theories were each tested in terms of goodness of fit with respect to decision-making with reproductive health behaviors in female teens with diabetes; and to identify a composite model of the most significant predictors across all three theories.
Method: Secondary analysis was conducted from a data set from a cross-sectional study. Data were collected from a telephone interview by same-gender research assistants on a sample of 87 female adolescents with T1D from four medical centers using the ¡§Reproductive Health Attitudes and Behavior¡¨ (RHAB) Questionnaire. Measures represent demographic, psychosocial, constructs of the three theories, and behavioral outcomes. Logistic regression analyses were used to examine the prediction of the three theories in the outcome variable (birth control use in the future).
Results: Good model-fit were found for both the HBM (Nagelkerke R2= .66) and TRA (Nagelkerke R2= .47). The composite model consisted of perceived barriers, cues to action, personal attitude, intention, and age, which were statistically reliable in predicting the future use of birth control in the female teens with diabetes. Perceived barriers (OR= .56, 95% CI= 0.32-0.97), cues to action (OR= .25, 95% CI= 0.10-0.61), personal attitude (OR= .72, 95% CI= 0.59-0.87) and intention (OR= .70, 95% CI= 0.50-0.97) were the strongest predictors among all constructs.
Conclusion: Perceived barriers, cues to action, personal attitude, and intention appear to predict birth control use in the future in this sample of adolescent females with T1D. Intervention studies to prevent future unplanned pregnancies in this high-risk population could focus on strategies to target these factors that are amenable to change.

Identiferoai:union.ndltd.org:PITT/oai:PITTETD:etd-04252005-152820
Date28 April 2005
CreatorsWang, Shiaw-Ling
ContributorsSusan M. Sereika, PhD, School of Nursing and Graduate School of Public Healt, Denise Charron-Prochownik, RN, PhD, School of Nursing and Graduate School of Public Health, Yookyung Kim, PhD, School of Nursing and Graduate School of Public Health, Linda Siminerio, RN, PhD, Schools of Medicine and Nursing
PublisherUniversity of Pittsburgh
Source SetsUniversity of Pittsburgh
LanguageEnglish
Detected LanguageEnglish
Typetext
Formatapplication/pdf
Sourcehttp://etd.library.pitt.edu/ETD/available/etd-04252005-152820/
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