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Background <p>Previous research has found self-efficacy is associated with reproductive health behaviors and outcomes. However, few studies have quantitatively examined the relationship between barriers accessing contraception and self-efficacy. In addition, existing population-level metrics of contraceptive access tend to focus on method availability, uptake, and use, rather than people’s self-defined needs and preferences. This study uses person-centered metrics to assess the relationship between experiencing a recent challenge or delay obtaining desired contraception and two measures of contraceptive self-efficacy.</p> Methods <p>In 2022, we fielded a nationally representative survey in English and Spanish using NORC’s AmeriSpeak panel, surveying non-sterile 15- to 44-year-olds assigned female sex at birth in the U.S. We describe common challenges and delays obtaining contraception and present the distribution of experiencing a challenge or delay obtaining contraception by key sociodemographic and reproductive health characteristics. We also conduct logistic regression analyses to investigate associations between experiencing a challenge/delay and two measures of contraceptive self-efficacy: confidence in obtaining a desired method when wanted and perceived ease of switching methods when wanted.</p> Results <p>Among the analytic sample of respondents who had ever used or tried to obtain a contraceptive product, device, or procedure (unweighted n = 2,771), about 14% experienced a challenge/delay obtaining desired contraception in the past year. The most common reasons for challenges or delays were related to logistics (transportation, childcare, scheduling; 38.2%) and cost/insurance coverage (35.8%). Among those who experienced a challenge/delay obtaining desired contraception (unweighted n = 301), higher proportions were younger, identified as non-heterosexual, had lower educational attainment, and could afford smaller emergency expenses compared to the subgroup that did not experience a challenge/delay. Experiencing a challenge/delay was associated with decreased odds of feeling very or somewhat confident in obtaining a desired method (aOR 0.14; 95% CI 0.07, 0.25) and decreased odds of feeling it would be very or somewhat easy to switch contraceptive methods (aOR 0.48; 95% CI 0.33, 0.71).</p> Conclusions <p>Eliminating barriers to contraceptive care is crucial to achieving person-centered access. Our research suggests that experiencing a challenge/delay has implications not only for recent contraceptive access but also influences self-efficacy, potentially inhibiting future ability to obtain and use desired contraception.</p>

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Relationship between experiencing a challenge or delay accessing contraception and contraceptive self-efficacy: Data from a 2022 nationally representative online survey

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月15日

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  • Alex Schulte,
  • Ariana H. Bennett,
  • Jennet Arcara,
  • Jamie Bardwell,
  • Aisha Chaudhri,
  • Laura Davis,
  • Brittni Frederiksen,
  • Elizabeth Jones,
  • Catherine Labiran,
  • Raegan McDonald-Mosley,
  • Whitney Rice,
  • Tara Stein,
  • Ena Suseth Valladares,
  • Kari White,
  • Cassondra Marshall,
  • Anu Manchikanti Gomez

摘要

Background

Previous research has found self-efficacy is associated with reproductive health behaviors and outcomes. However, few studies have quantitatively examined the relationship between barriers accessing contraception and self-efficacy. In addition, existing population-level metrics of contraceptive access tend to focus on method availability, uptake, and use, rather than people’s self-defined needs and preferences. This study uses person-centered metrics to assess the relationship between experiencing a recent challenge or delay obtaining desired contraception and two measures of contraceptive self-efficacy.

Methods

In 2022, we fielded a nationally representative survey in English and Spanish using NORC’s AmeriSpeak panel, surveying non-sterile 15- to 44-year-olds assigned female sex at birth in the U.S. We describe common challenges and delays obtaining contraception and present the distribution of experiencing a challenge or delay obtaining contraception by key sociodemographic and reproductive health characteristics. We also conduct logistic regression analyses to investigate associations between experiencing a challenge/delay and two measures of contraceptive self-efficacy: confidence in obtaining a desired method when wanted and perceived ease of switching methods when wanted.

Results

Among the analytic sample of respondents who had ever used or tried to obtain a contraceptive product, device, or procedure (unweighted n = 2,771), about 14% experienced a challenge/delay obtaining desired contraception in the past year. The most common reasons for challenges or delays were related to logistics (transportation, childcare, scheduling; 38.2%) and cost/insurance coverage (35.8%). Among those who experienced a challenge/delay obtaining desired contraception (unweighted n = 301), higher proportions were younger, identified as non-heterosexual, had lower educational attainment, and could afford smaller emergency expenses compared to the subgroup that did not experience a challenge/delay. Experiencing a challenge/delay was associated with decreased odds of feeling very or somewhat confident in obtaining a desired method (aOR 0.14; 95% CI 0.07, 0.25) and decreased odds of feeling it would be very or somewhat easy to switch contraceptive methods (aOR 0.48; 95% CI 0.33, 0.71).

Conclusions

Eliminating barriers to contraceptive care is crucial to achieving person-centered access. Our research suggests that experiencing a challenge/delay has implications not only for recent contraceptive access but also influences self-efficacy, potentially inhibiting future ability to obtain and use desired contraception.