The Influence of Family and Friends' Basic Conditioning Factors and Self-Care Agency on Unmarried Teenage Primipara' Engagement in Contraceptive Practice

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Abstract
One in 10 teenagers age 15 to 19 becomes pregnant each year in the United States and 5 in every 6 of those pregnancies are unintended (Scott, 1983; Trussell, 1988); only 6% are due to failure of the contraceptive used (Cobliner, 1981). The birth rate among teenagers is increasing (National Center for Health Statistics, 1990), as are repeated pregnancies in unmarried teenage primiparas (National Academy of Sciences Symposium, 1987). A previously pregnant teenager has a greater likelihood of becoming pregnant again than a never-pregnant counterpart (Miller, 1983; Polit & Kahn, 1986), and the likelihood of repeated pregnancy is further increased if the first pregnancy is carried to term (Koenig & Zelnik, 1982). Repeated pregnancies in unmarried teenage primiparas are associated with higher infant mortality rates, decreased likelihood of completing high school, and increased unemployment rates and welfare dependency (Ford, 1983). Thus, failure to engage in contraceptive practice to prevent repeated pregnancies among unmarried teenage primiparas is a major problem. Researchers have attempted to use contraceptive practice models involving attitudes and plans, but these have not been successful in predicting contraceptive use. A study of 260 high school teenagers, of whom 90% were eligible for a free or subsidized lunch (Galavotti & Lovick, 1989), found that older age at first intercourse, higher number of welfare benefits received by household (including Medicaid, food stamps, and free or reduced-price lunch), and use of the school-based clinic were significant predictors of contraceptive use. These findings suggest that economic support and knowledge enhance contraceptive use among school children who have never been pregnant. However, in other studies, neither availability (Harris, 1986) nor knowledge (Burbach, 1980; Nadelson, Notman, & Gillon, 1980) of contraceptives predicted contraceptive use among unmarried teenage primiparas. A study of 43 unmarried teenage...