An extended expectancy-value approach to contraceptive alternatives

Abstract

The expectancy value-normative influence model is based on the premise that the overall value to an individual of using an object (e.g. a specific contraceptive method) is a function of the degree to which its use is perceived to result in favorable consequences and the avoidance of unfavorable ones. Components of the Fishbein Extended Model are identified and discussed. The first the attitudinal component (Aact) made up of overt behavior (B) and behavioral intent (BI) incorporates 1) the individuals strength of belief connecting each salient contraceptive attribute and consequence of use to an individuals evaluation of each of the salient attributes. This component also includes the expectancy (beliefs regarding contraceptive characteristics) and the value (whether these characteristics and their results will be satisfactory or unsatisfactory). Normative beliefs (NBi) and motivation to comply (MCi) round out the model structure. This model was applied in a pilot study of contraceptive alternatives. The 23 attitude items used in the questionnaire were derived from in-depth interviews with 8 discussion groups composed of men and women of different backgrounds and were pretested on 117 respondents. The sample consisted of 58 individuals (21 males 37 females) ages 18 or older. Multiple correlations varied from R = .46 (pill males) to .88 (diaphragm females) with a median R of .57 and tended to be higher for females perhaps reflecting their greater involvement in the contraception decision-making process. The highest multiple Rs were obtained for lesser used methods such as the diaphragm and foam. Female intentions for the couple to use condoms were dominated by the normative (perceptions regarding the actions we think important others believe should be taken) rather than attitudinal (beliefs regarding the characteristics associated with the consequences of a method) component as were male intentions to have the couple use oral contraception. Attitudinal influences predominated for the diaphragm while IUD intentions were largely under normative control and those for foam under joint influence. Highly significant attitudinal correlations were found for questionnaire items that the user groups considered relevant for their evaluations of the method. While these findings should be considered tentative given the small and restrictive sample they illustrate the potential of this theoretical approach for understanding family planning and population behavior.