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

Wang, Shiaw-Ling (2005) Comparing three theories in predicting reproductive health behavior in adolescent women with diabetes. Doctoral Dissertation, University of Pittsburgh.

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    Abstract

    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.


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    Item Type: University of Pittsburgh ETD
    ETD Committee:
    ETD Committee TypeCommittee MemberEmail
    Committee CoChairCharron-Prochownik, Denise
    Committee CoChairSereika, Susan M
    Committee MemberSiminerio, Linda
    Committee MemberKim, Yookyung
    Title: Comparing three theories in predicting reproductive health behavior in adolescent women with diabetes
    Status: Unpublished
    Abstract: 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.
    Date: 28 April 2005
    Date Type: Completion
    Defense Date: 05 April 2005
    Approval Date: 28 April 2005
    Submission Date: 25 April 2005
    Access Restriction: No restriction; Release the ETD for access worldwide immediately.
    Patent pending: No
    Institution: University of Pittsburgh
    Thesis Type: Doctoral Dissertation
    Refereed: Yes
    Degree: PhD - Doctor of Philosophy
    URN: etd-04252005-152820
    Uncontrolled Keywords: adolescent; birth control; diabetes; Health Belief Model; Social Congitive Theory; Theory of Reasoned Action
    Schools and Programs: School of Nursing > Nursing
    Date Deposited: 10 Nov 2011 14:42
    Last Modified: 05 Jun 2012 10:01
    Other ID: http://etd.library.pitt.edu/ETD/available/etd-04252005-152820/, etd-04252005-152820

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