Psychosocial Determinants of Intention to Use Dual Contraception Among Thai Female Students: Integrating the Health Belief Model and Theory of Planned Behavior.
Outcomes: Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Social influences are relevant to female adolescents’ intentions to use dual contraception. Subjective norms—perceived social expectations around contraceptive use—were positively associated with intention, although they did not remain an independent predictor in the multivariable model. The discussion emphasizes that contraceptive decision-making can vary with social and cultural context and recommends communication and awareness activities through adolescents’ social circles, particularly friends, family, and partners, to create a supportive environment for dual contraception decisions.
Objectives To identify factors associated with and predictive of intention to use dual contraception—concurrent condom use and another effective contraceptive method—among female upper secondary school students in Nonthaburi Province, Thailand, using an integrated Health Belief Model and Theory of Planned Behavior framework.
Methods This cross-sectional study included 407 female students in grades 10–12 selected through multistage sampling. Data were collected from November 2025 to January 2026 using a researcher-developed 56-item questionnaire. Measures included personal factors and constructs from the Theory of Planned Behavior and Health Belief Model. The social norms measure was subjective norms regarding contraceptive use, assessed alongside perceived behavioral control and attitudes using five-point agreement response options. Analyses included descriptive statistics, chi-square tests, Pearson correlations, and multiple regression.
Results Intention to use dual contraception was high (mean 4.17/5); 70.3% of participants had high intention. Subjective norms were also high (mean 4.19/5), with 80.6% reporting high agreement, and were moderately positively correlated with intention (r=0.459, p<0.001). Five independent predictors emerged: greater self-efficacy (β=0.395), fewer perceived barriers (β=−0.183), greater perceived severity of unintended pregnancy and sexually transmitted infections (β=0.180), greater perceived susceptibility to consequences of non-use (β=0.121), and greater perceived behavioral control (β=0.100). Together, these explained 61.6% of variance in intention. Conclusions: Female students generally reported high intentions to use dual contraception, shaped by interconnected personal, cognitive, and psychosocial factors. The authors recommend targeted interventions and adolescent-friendly services that strengthen self-efficacy and behavioral control, reduce access barriers, increase understanding of pregnancy and sexually transmitted infection risks, and engage adolescents’ social networks to support informed contraceptive decision-making.
Norms Addressed
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