High Self-Efficacy Correlates With Use of Long-Acting Reversible Contraceptives [20A

Abstract

INTRODUCTION: The American College of Obstetrics and Gynecology recommends long-acting reversible contraceptives (LARCs) as the safest and most effective reversible contraceptives. In the US, only 7% of women use LARCs, and 45% of pregnancies continue to be unintended. Barriers to LARC use can be intrinsic or extrinsic. While previous studies focus on extrinsic barriers to LARC use, our study evaluates intrinsic barriers. We hypothesize that two psychological traits, locus of control (LOC) and contraceptive self-efficacy (SE), influence use of LARCs. METHODS: Data are from the baseline survey of an IRB-approved randomized control trial. The study population was 874 privately insured Pennsylvania residents aged 18-40, who were not intending pregnancy for 12 months. LOC (internal vs external) and contraceptive SE (high vs low) were measured using composite scores from 5 and 8-item scales respectively. The association of LOC and SE with LARC use was determined using multivariable logistic regression adjusting for future pregnancy intention, education, and history of unintended pregnancy. RESULTS: LARC use was predicted by high SE (Adjusted OR 1.90, 95% CI 1.13, 3.19), but not by internal LOC (Adjusted OR 0.86, 95% CI 0.53-1.42). LARC use was also predicted by ambivalence about future pregnancy and history of previous unintended pregnancy. CONCLUSION: Women with high SE had an increased use of LARCs. Efforts to identify patients with low self-efficacy may provide opportunity for increased counseling and interventions to promote use of LARCs.