Using the theory of planned behavior and self-identity to explore women’s decision-making and intention to switch from combined oral contraceptive pill (COC) to long-acting reversible contraceptive (LARC)

Background \Most college women use the combined oral contraceptive pill (COC) despite more effective long-acting reversible contraceptive (LARC) methods (e.g., IUDs and implant) being available. Resistance to change methods may be impacted by how a woman identifies with being a COC-user. Methods Data were collected via 186 web-based surveys distributed to female students attending a university in the southeastern United States (Mean age = 20.0 ± 1.; range = 18–22). Structural equation modeling (SEM) determined TPB fit in understanding LARC intention. Results SEM results received acceptable fit (χ2 (670, N = 186) p < 0.01, Comparative Fit Index (CFI) of 0.84, and Normative Fit Index (NFI) of 0.75). A Root Mean Square Error of Approximation (RMSEA) of 0.09 was produced, with a 90% confidence interval of 0.08 to 0.09. Including self-identity in the model yielded similar fit, with χ2 (866, N = 186) p < 0.01, CFI of 0.83, and NFI of 0.73. Self-identity and attitude pathways were significant (p < 0.01) toward intention, extending the TPB model. Conclusions The TPB proved to be acceptable in understanding COC users’ intention to obtain LARC. Results provide direction for LARC messaging tailored toward COC users and self-identity. Electronic supplementary material The online version of this article (10.1186/s12905-019-0772-8) contains supplementary material, which is available to authorized users.

Participation in this study will require about 15-20 minutes of your time. As a participant in this research, you will be asked to complete a web-based survey.
Your responses will be anonymous. We will keep all information strictly confidential and destroy it when the research is complete. At no time will you be able to be identified in any reports or publications resulting from this research.
Although it is not anticipated that you will benefit directly through your involvement in this study, this research is expected to benefit women through better understanding of contraception, which may allow health care providers to better serve individual women.
There is minimal risk associated with this study. Should you experience any psychological or social distress from your participation, please contact College of Charleston Health Services at healthservices@cofc.edu, or your preferred medical provider.
Your participation is completely voluntary, and you may discontinue participation at any time.
Upon completion of the survey, you will be able to choose to be entered into a drawing to win a gift basket from Lush valued at around $30. Your contact information will be collected in a separate survey and will remain unidentified with your responses to this survey. How long has the pill been your primary contraceptive method?
Have you ever heard of the contraceptive method called the Implant (e.g.,

Nexplanon, Implanon)?
To me, obtaining an IUD or Implant seems Choosing an IUD or Implant as my primary birth control method would be Using an IUD or Implant would be more convenient for my lifestyle than other contraceptive methods, such as the pill.
IUDs and Implants are more effective at preventing pregnancy than other contraceptive methods, such as the pill.
An IUD or Implant would be able to control my acne as well as other contraceptive methods, such as the pill.
An IUD or Implant would be as effective at reducing menstrual cramps as other contraceptive methods, such as the pill.  I generally consider changes to be a negative thing.
I'll take a routine day over a day full of unexpected events any time.
I like to do the same old things rather than try new and different ones.
I'd rather be bored than surprised.

Whenever my life forms a stable routine, I look for ways to change it.
If I were to be informed that there's going to be a significant change regarding the way things are done at work or school, I would probably feel stressed.

When I am informed of a change of plans, I tense up a bit.
When things don't go according to plans, it stresses me out. Changing plans seems like a real hassle to me.
Often, I feel a bit uncomfortable even about changes that may potentially improve my life.
When someone pressures me to change something, I tend to resist it even if I think the change may ultimately benefit me.
I sometimes find myself avoiding changes that I know will be good for me.

I often change my mind.
Once I've come to a conclusion, I'm not likely to change my mind.

Thank you for completing the Women's Health Research Team survey!
You can find out more about our research team by visiting hss.cofc.edu/whrt.
Would you like to provide your name, phone number, and email for the chance to win a gift basket from Lush valued at around $30? If you select yes, you will be taken to a second survey so that you can enter your contact information. Your contact information will remain unidentified with your responses to this survey.