Comparison of three approaches to providing contraceptive counseling

It is without question that preventive programs for unwanted fertility are sorely needed. One has only to pick up a newspaper these days to note the astounding illegitimacy rate, especially among teenagers, in this country The problem is not limited to adolescents Pregnancy rates on our college campuses are between 1% and 5% (Amdur & Oreschnick, 1972; Coe & Blum, 1972) Of those college students who become pregnant, most opt for abortion. Programs to promote adaptive contraceptive use do not presently exist, nor do adequate models from which to develop these programs In an extension of present models a two- factor explanation of high illegitimate conception rates and failure to use contraception by many sexually active college students was proposed. The two components were (a) the individual lacks adequate knowledge of contraception and the biology of reproduction, and (b) sex guilt and inadequate awareness and acceptance of one's own values interfere with both the acquisition of such information and the willingness to put it to effective use. In accord with this model an intervention was designed, the purpose of which was two-fold (a) to impart information about human reproductive processes and personal responsibility, and (b) to generate adaptive contraceptive behavior. As Schwartz (1973) and Abramson (Note 3) found that specific formats may have differential efficacy for people varying in degree of sex guilt, three formats were included for study (a) written, (b) lecture, and (c) experiential. A repeated measures design involving pretreatment, postintervention, and followup assessment was used with college females. Subjects attended a two session workshop in which they were provided information regarding (a) the biology of the female reproductive system and facts about various forms of contraception, and (b) values and affects associated with sexuality. It was found that experimental subjects were more knowledgeable than control subjects on factual and value-oriented birth control information at posttreatment and at 6-weeks followup. Thus, knowledge was increased. However, the other major goal of the study, namely, increasing and maintaining consistent use of contraception was not realized. Birth control use was not changed as a function of treatment and adaptive attitude change was not promoted. Additionally, no overall differences among the three training formats were found. In contrast to the Schwartz (1973) and Abramson (Note 3) studies no significant interactions were found by level of sex guilt and treatment format. Lack of change in birth control use was hypothesized to be a function of one of two factors (a) the present model and other existing models of contraceptive use are not adequate to specify essential variables to be included in actual treatment interventions, and (b) accurate and valid instrumentation to measure contraceptive behavior does not presently exist. The validity of these two hypotheses could not be ascertained from the present study However, it was suggested that future research focus more specifically on development of better instruments to measure outcome as well as continuing to develop adequate models upon which to base interventions.