TY - JOUR
T1 - Is depression associated with contraceptive motivations, intentions, and use among a sample of low-income latinas?
AU - Carvajal, Diana N.
AU - Ghazarian, Sharon
AU - Crowne, Sarah K S
AU - Brown, Pamela Bohrer
AU - Pokras, Olivia Carter
AU - Duggan, Anne K.
AU - Barnet, Beth
N1 - Funding Information:
This research was supported by the American Academy of Family Physicians Foundation, The Thomas Wilson Sanitarium for the Children of Baltimore , and by Grant T32HS017596 from the Agency for Healthcare Research and Quality , which supports the family health services research training program in which Dr. Carvajal was a postdoctoral fellow. The authors gratefully acknowledge Grant APRPA006010 , the Family Health Services Research NRSA training program grant funded by the Agency for Healthcare Research and Quality, and the Highlandtown Healthy Living Center staff members for their time, effort, guidance, and patience with this project. Salary support for Olivia D. Carter-Pokras from the Prevention Research Centers Program, Centers for Disease Control and Prevention (cooperative agreement 1 U48 DP001929). The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The corresponding author, Diana N. Carvajal, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
PY - 2014/1
Y1 - 2014/1
N2 - Background: Latinas in the United States experience high rates of unintended pregnancy and low rates of contraception use, yet reasons are not completely understood. Depression is common among pregnant and nonpregnant Latinas; its influence on contraceptive motivations, intentions, and use is understudied. Objectives: We sought to 1) describe Latinas' contraceptive motivations, intentions, and use; 2) use structural equation modeling to test associations between depression and contraceptive self-efficacy/motivations/intentions/use; and 3)determine whether associations differ by pregnancy status. Methods: This cross-sectional study included Latinas ages 15 to 45 recruited from an urban Federally Qualified Health Center in Baltimore, Maryland. Structured surveys were used to collect data regarding depressive symptoms measured using the PHQ-9. All other constructs were measured with previously validated questions. Constructs included contraceptive self-efficacy, positive and negative contraceptive motivations (perceived advantages and disadvantages of using contraception), contraceptive intentions to begin or continue contraception use, and contraceptive methods currently used. Results: Among pregnant Latinas, depression was associated with negative motivations (β=0.16; p<.05), negative motivations were associated with intentions (β=-0.22; p<.01), and contraceptive self-efficacy was associated with intentions (β=0.43; p<.001). Among nonpregnant Latinas, contraceptive self-efficacy was associated with intentions (β=0.78; p<.001) and intentions were associated with use (β=0.40; p<.05). Conclusions: Among pregnant Latinas, negative motivations intervene in the association between depression and contraceptive intentions. For nonpregnant Latinas, intentions intervene in the association between self-efficacy and contraceptive use. This study underscores the importance of depression screening during pregnancy and encourages practitioners to target contraceptive motivations to improve contraceptive use.
AB - Background: Latinas in the United States experience high rates of unintended pregnancy and low rates of contraception use, yet reasons are not completely understood. Depression is common among pregnant and nonpregnant Latinas; its influence on contraceptive motivations, intentions, and use is understudied. Objectives: We sought to 1) describe Latinas' contraceptive motivations, intentions, and use; 2) use structural equation modeling to test associations between depression and contraceptive self-efficacy/motivations/intentions/use; and 3)determine whether associations differ by pregnancy status. Methods: This cross-sectional study included Latinas ages 15 to 45 recruited from an urban Federally Qualified Health Center in Baltimore, Maryland. Structured surveys were used to collect data regarding depressive symptoms measured using the PHQ-9. All other constructs were measured with previously validated questions. Constructs included contraceptive self-efficacy, positive and negative contraceptive motivations (perceived advantages and disadvantages of using contraception), contraceptive intentions to begin or continue contraception use, and contraceptive methods currently used. Results: Among pregnant Latinas, depression was associated with negative motivations (β=0.16; p<.05), negative motivations were associated with intentions (β=-0.22; p<.01), and contraceptive self-efficacy was associated with intentions (β=0.43; p<.001). Among nonpregnant Latinas, contraceptive self-efficacy was associated with intentions (β=0.78; p<.001) and intentions were associated with use (β=0.40; p<.05). Conclusions: Among pregnant Latinas, negative motivations intervene in the association between depression and contraceptive intentions. For nonpregnant Latinas, intentions intervene in the association between self-efficacy and contraceptive use. This study underscores the importance of depression screening during pregnancy and encourages practitioners to target contraceptive motivations to improve contraceptive use.
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U2 - 10.1016/j.whi.2013.10.003
DO - 10.1016/j.whi.2013.10.003
M3 - Article
C2 - 24439935
AN - SCOPUS:84892458701
SN - 1049-3867
VL - 24
SP - e105-e113
JO - Women's Health Issues
JF - Women's Health Issues
IS - 1
ER -