Abstract
BackgroundPreconception care, including family planning, is a vital component of healthcare for women of reproductive age. An average female spends the majority of her reproductive life trying to prevent a pregnancy. In order to prevent unintended pregnancy, women often rely on the use of hormonal contraceptives. In the United States, the majority of hormonal contraceptive users are prescribed oral contraceptive pills (OCPs). Reduced adherence to OCPs decreases their ability to prevent pregnancy. The study aimed to measure OCP adherence among female college students, and explore the relationship between OCP adherence, knowledge, and self-efficacy.MethodsThis cross-sectional study recruited a random sample of female college students to participate in an online survey. OCP adherence was based on the 8-item Morisky Medication Adherence Scale (MMAS-8). Secondary reporting of medication adherence included participant reports of the number of missed OCP doses in the previous month and typical month of use.ResultsOf the 5000 invited, 1559 (31.3%) completed the survey. Of those responding, 670 (41.3%) reported use of OCPs. A total of 293 (44.3%) OCP users met criteria for low adherence, 241 (36.4%) met criteria for medium adherence, and 128 (19.3%) met criteria for high adherence. Those with high adherence had higher self-efficacy (P < 0.001) and perceived knowledge (p < 0.001). After controlling for other factors, self-efficacy (b = .37) and perceived knowledge (b = .09) remained associated with OCP adherence.ConclusionLess than 20% of respondents met the criteria for high adherence to OCPs. Self-efficacy and knowledge were associated with higher OCP adherence. Targeted interventions from healthcare providers, health educators, and other adherence related media to increase the knowledge and self-efficacy of patients using OCPs may improve adherence rates. Additional research is needed to evaluate the impact of innovative interventions focused on social and behavioral patient factors, like knowledge and self-efficacy, on adherence to OCPs.
Highlights
Preconception care, including family planning, is a vital component of healthcare for women of reproductive age
Plain English summary A large portion of women rely upon oral contraceptive pills (OCPs) as a part of their family planning strategy
In this study women attending college at one university were recruited to answer questions in an online survey to detect any problems with OCP adherence, and determine if self-efficacy or knowledge influence OCP adherence
Summary
Preconception care, including family planning, is a vital component of healthcare for women of reproductive age. An average female spends the majority of her reproductive life trying to prevent a pregnancy. In order to prevent unintended pregnancy, women often rely on the use of hormonal contraceptives. In the United States, the majority of hormonal contraceptive users are prescribed oral contraceptive pills (OCPs). Reduced adherence to OCPs decreases their ability to prevent pregnancy. The consequences of an unintended pregnancy, which include those that were mistimed and unwanted, include impacts to the fetus, the mother, and society. Fetal impacts include a delay in receiving necessary prenatal supplements, potential for exposure to environmental risks (including alcohol, nicotine, or other drugs), and increased potential for birth defects and low birth weight [1]. Mothers of unintended pregnancies have been shown to be at increased risks of adverse effects from delays in prenatal care, maternal depression, and reduction in income potential [3]. Estimates suggest that unintended pregnancies cost the United States $21 billion in 2010, which includes the cost of births, abortions, and miscarriages from unintended pregnancies [4]
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