Assessing the Stages of Change and Decision-Making for Contraceptive Use for the Prevention of Pregnancy,Sexually Transmitted Diseases,and Acquired Immunodeficiency Syndrome

Abstract

A synergistic approach was taken to examine contraceptive use adoption for two related behaviors: pregnancy prevention and the prevention of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). One hundred twenty-three young adults responded to questionnaire items based on two constructs from the Transtheoretical Model of Change, the Stages of Change and Decisional Balance, as well as other pertinent variables. In Phase 1, two Decisional Balance measures were developed: One for the prevention of pregnancy and one for disease prevention. Final versions of both measures consisted of two 10-item scales: one representing the positive aspects (PROS) and one representing the negative aspects (CONS) of contraceptive and condom use. In Phase 2, the same individuals were staged for both pregnancy and disease prevention according to their readiness to change for contraceptive and condom use. MANOVAs and ANOVAs indicated that the PROS and CONS for both measures were related to stage of change for both contraceptive and condom use. Results from this pilot study were consistent with prior applications of the Transtheoretical Model to the cessation of such problem behaviors as smoking and to the adoption of positive health behaviors such as exercise acquisition.

Get full access to this article

View all access options for this article.

References

Fisher W. : Understanding and preventing teenage pregnancy and sexually transmitted diseases/AIDS , in Edwards J , Tindale RS , Heath L, Posavac EJ (eds.): Social Influence : Processes and Prevention. New York, NY, Plenum Press, 1990.

Zelnik M. , Kantner JF : Sexual and contraceptive experience of young unmarried women in the United States, 1976 and 1981. Fam Plann Perspect 13:215-222, 1977.

Public Health Service : Healthy people 2000: National health promotion and disease prevention objectives-full report with commentary. Washington, DC, US Department of Health and Human Services, DHHS publications no.(PHS)91-50212, 1991.

Hayes CD : Risking the future: Adolescent sexuality, pregnancy, and childbearing . Washington, DC, National Academy Press, 1987.

Alan Guttmacher Institute : Teenage Pregnancy: The Problem That Hasn't Gone Away. New York, NY, Author, 1981.

Jones EG , Forrest JD , Goldman N. , Henshaw SK , Lincoln R. , Rosoff JI , Westoff CF , Wulf D. : Teenage pregnancy in developed countries: Determinants and policy implications . Fam Plann Perspect 17:53-62, 1985.

Westoff CF , Calot G. , Foster AD : Teenage fertility in developed nations: 1971-1980. Fam Plann Perspect 15:105-110, 1983.

Brooks-Gunn J. , Furstenberg FF : Adolescent sexual behavior. Am Psychol 49:249-257, 1989.

Hyde JS : Understanding Human Sexuality (3rd ed). New York, NY, McGraw-Hill, 1986.

10.

Masters WH , Johnson VE , Kolodyny RC : Human Sexuality (2nd ed.). Boston, MA, Little, Brown, 1985.

11.

Centers for Disease Control : Division of STD/HIV Prevention Annual Report. Atlanta, GA, US Department of Health and Human Services, Public Health Service, 1991.

12.

Centers for Disease Control : Voice Informational Systems. Atlanta, GA, CDC, 1992.

13.

Curran JW , Jaffe HW , Hardy AM , Morgan WM , Selik RM , Dondero TJ : Epidemiology of HIV infection and AIDS in the United States. Science 239:610-616, 1988.

14.

Brooks-Gunn J. , Boyer CB , Hein K. : Preventing HIV infection and AIDS in children and adolescents: Behavioral research and intervention strategies. Am Psychol 43:958-964, 1988.

15.

Prochaska JO , DiClemente CC: Stages and processes of self-change of smoking: Toward an integrative model of change. J Consult Clin Psychol 51:390-395, 1983.

16.

Prochaska JO , DiClemente CC: The Transtheoretical Approach: Crossing the Traditional Boundaries of Therapy. Homewood, IL, Dow-Jones/Irwin , 1984.

17.

Prochaska JO , Velicer WF , Rossi JS , Goldstein MG , Marcus BH , Rakowski W. , Fiore C. , Harlow LL , Redding CA , Rosenbloom D. , Rossi SR : Stages of change and decisional balance for twelve problem behaviors. Health Psychol (in press).

18.

DiClemente CC , Prochaska JO : Self-change and therapy change of smoking behavior : A comparison of processes of change of cessation and maintenance . Addict Behav 1:133-142, 1982.

19.

Prochaska JO , DiClemente CC , Velicer WF , Ginpil SE , Norcross JC : Predicting change in smoking status for self-changers . Addict Behav 10:395-406, 1985.

20.

Tsoh JY , Rossi JS , Prochaska JO : Effects of intention and behavior on contemplating smoking cessation . Paper presented at the 100th annual meeting of the American Psychological Association, Washington, DC , August 1992.

21.

DiClemente C.C. Motivational interviewing and the stages of change, in Miller WR , Rollick S (eds.): Motivational Interviewing: Preparing People to Change. New York, NY, Guilford Press, 1991.

22.

Ockene J. , Ockene I. , Kristellar J. : The Coronary Artery Smoking Intervention Study. Worcester, MA, National Heart Lung Institute, 1988.

23.

Prochaska JO : Prescribing to the stages and levels of change . Psychotherapy 28:463-468, 1991.

24.

McConnaughy EA , DiClemente CC , Prochaska JO , Velicer WF : Stages of change in psychotherapy: A follow-up report. Psychother Theory Res Pract 4:494-503, 1989.

25.

McConnaughy EA , Prochaska JO , Velicer WF : Stages of change in psychotherapy: Measurement and sample profiles. Psychother Theory Res Pract 20:368-375, 1983.

26.

DiClemente CC , Prochaska JO , Fairhurst S. , Velicer WF , Velasquez MM , Rossi JS : The processes of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol 59:295-304, 1991.

27.

Janis IL , Mann L. : Decision-Making: A Psychological Analysis of Conflict, Choice, and Commitment . New York, NY, Free Press, 1977.

28.

Mann C. : Use of a decisional balance sheet procedure to improve the quality of personal decision making: A field experiment with college applicants. J Vocational Behav 2:291-300, 1972.

29.

Janis IL , Mann L. : A conflict theory approach to attitude and decision making, in Greenwald A , Brook T , Ostrom T (eds.): Psychological Foundations of Attitudes. New York, NY, Academic Press, 1968.

30.

Velicer WF , DiClemente CC , Prochaska JO , Brandenburg N. : A decisional balance measure for predicting smoking cessation. J Pers Soc Psychol 48:1279-1289, 1985 .

31.

Jackson DN : A sequential system for personality scale development, in Spielberger CD (ed.): Current Topics in Clinical and Community Psychology (Vol. 2). New York, NY, Academic, 1970.

32.

Jackson DN : The dynamics of structured personality tests. Psychol Rev 78:229-248, 1971.

33.

Dixon WJ (ed.): BMDP Statistical Software Manual. Berkeley, CA, University of California Press, 1988.

34.

Cattell RB : The scree test for the number of factors. Multivariate Behav Res 1:245-276, 1966.

35.

Guadagnoli E. , Velicer WF : Relation of sample size to the stability of component patterns. Psychol Bull 103:265-275, 1988.

36.

Rossi JS , Laforge R. , Ruggiero L. , Prochaska JO , Velicer WF , Fava JC : Random digit dialing survey of the 1067 Rhode Islanders for 15 risk factors . Unpublished raw data, 1992.

37.

Prochaska JO , Harlow LL , Redding CA , Snow MG , Rossi JS , Velicer WF : Stages of change, self-efficacy, and decisional balance for condom use and a high-risk sample. Atlanta, GA, Centers for Disease Control, Contract Grant 0-415-003, 1990.

38.

Weisse CS , Nesselhof-Kendall Sea , Fleck-Kandath C. , Baum A. : Psychosocial aspects of AIDS prevention among heterosexuals, in Edwards J. , Tendale RS , Heath L. , Posavac EJ (eds.): Social Influence: Processes and Prevention (Vol. 1). New York, NY, Plenum Press, 1990.

39.

Gordin FM , Gilbert C. , Hawley HP , Willoughby A. : Prevalence of human immunodeficiency virus and hepatitis B virus in unselected hospital admissions: Implications for mandatory testing and universal precautions . J Infect Dis 161:14-17, 1990.

40.

Miller TE , Booraem C. , Flowers JV , Iversen AE : Changes in knowledge, attitudes, and behaviors as a result of a community-based AIDS prevention program. AIDS Educ Prev 2:12-23, 1990.

41.

McDonald NE , Wells GA , Fisher WA , Warren WK , King MA , Doherty JA , Bowie WR : High-risk STD/HIV behavior among college students. J Am Med Assoc 263:3155-3159, 1990.

42.

Prochaska JO : Strong and weak principles for progressing from precontemplation to action based on twelve problem behaviors. Health Psychol (in press).

43.

Prochaska JO , Velicer WF , DiClemente CC , Fava J. : Measuring processes of change: Applications to the cessation of smoking. J Consult Clin Psychol 56:520-528, 1988.

44.

Hatcher RA , Stewart F. , Trussel J. , Kowal D. , Guest F. , Stewart GK , Cates W. : Contraceptive Technology: 1990-1992 (15th ed., revised) New York, NY, Irvington Publishers, Inc., 1990.