Oral contraceptive use: The application of the transtheoretical model

Sara Suzanne Johnson, University of Rhode Island


The major purpose of the proposed research was to refine and validate a continuous staging algorithm for compliance in order to identify different profiles of compliance among approximately 300 oral contraceptive (OC) users. The four secondary goals of this research were: (1) to replicate the previous profiles found among OC users (Johnson, et al., 1995); (2) to develop and/or refine measures against which the profiles can be validated (i.e., decisional balance and temptations); (3) to compare the efficacy of three different staging algorithms for OC compliance; and (4) to test the predictive ability of the constructs of the Transtheoretical Model of Change (TTM) in the area of compliance with OC. Three hundred and six pill users from two community samples responded to an anonymous questionnaire regarding pill use and the TTM constructs. Reliable and valid measures with sound psychometric properties were developed for stage of change, decisional balance, and temptations. Cluster analysis was employed to identify, replicate, and validate six profiles of compliance using the continuous staging measure. Staging distributions provided by the continuous staging measure were compared to a discrete, single item staging question and to a four item algorithm. The four item algorithm was based on the number of and level of concern regarding missed or off-schedule pills. Based on stage distribution, relationship of stage to other TTM constructs, and effect size estimates, it was concluded that the continuous staging algorithm was the most valid. Finally, hierarchical multiple regressions indicated that demographics and sex history variables did not add significantly to the prediction of compliance based on the TTM constructs. Moreover, stage emerged as a strong and significant predictor and the model constructs accounted for a large proportion of the variance in noncompliance. The ability of the TTM's constructs to predict noncompliance is of particular importance given that this research addressed a difficult question by restricting the range of prediction to current pill users and not including individuals who had discontinued pill use. Discontinuation is presumably easier to predict because it is the most extreme form of noncompliance. Implications for individualizing interventions to improve compliance are discussed. ^

Subject Area

Health Sciences, Medicine and Surgery|Psychology, Clinical|Education, Health

Recommended Citation

Sara Suzanne Johnson, "Oral contraceptive use: The application of the transtheoretical model" (1997). Dissertations and Master's Theses (Campus Access). Paper AAI9908233.