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  • Title: Contraceptive and condom use adoption and maintenance: a stage paradigm approach.
    Author: Grimley DM, Prochaska JO, Velicer WF, Prochaska GE.
    Journal: Health Educ Q; 1995 Feb; 22(1):20-35. PubMed ID: 7721599.
    Abstract:
    The Transtheoretical Model of Behavior Change was examined for its applicability to contraceptive and condom use adoption and maintenance using N = 248 heterosexually active college-age men and women. The model posits that individuals do not go directly from old behaviors to new behaviors to new behaviors, but progress through a sequence of stages: precontemplation, contemplation, preparation, action, and maintenance. The stages of change offer a temporal dimension that provides information regarding when a particular shift in attitudes, intentions, and behavior may occur. The model also postulates a set of or outcome variables--the pros and cons of change and self-efficacy. The results demonstrated that individuals were furthest along in the stages of change for general contraceptive use, followed closely by condom use with other (e.g., casual) partners, and then condom use with main partners. Although no sex differences were found for the stages for the three separate contraceptive behaviors, males and females differed on the pros and cons and levels of self-efficacy when engaging in intercourse with the two types of partners. MANOVA/ANOVA results indicated that the relationship between stages and other constructs follows predicted patterns suggesting that the transtheoretical model may provide a useful framework or paradigm for understanding contraceptive and condom use behavior. The applicability of the Transtheoretical Model of Behavior Change to contraceptive and condom use adoption and maintenance was assessed in a study of 248 sexually active students (mean age, 18.88 years) at a US university. This model posits that individuals progress through a sequences of five stages in moving from old to new behaviors: precontemplation, contemplation, preparation, action, and maintenance. The pros and cons of change and self-efficacy act as intervening or outcome variables. The present investigation attempted to refine the model further by examining the utility of "intention to change in the next 30 days" combined with the behavioral criterion of currently using contraception and/or condoms "almost every time." Condom use was reported by 39.8% of students with main partners and by 75.3% with casual partners. Study subjects were farthest along in the stages of change for general contraceptive use, followed closely by condom use with casual partners, and then condom use with main partners. Those in the precontemplation stage evaluated the cons of contraceptive use as higher than the pros, but a crossover of the pros and cons occurred sometime before the action stage. Similarly, perceived self-efficacy was lowest in the precontemplation stage, but increased with movement along the continuum of change. These findings suggest that programs that seek to reduce high-risk behaviors should be tailored to individuals' particular stage of change.
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