Adolescent compliance with oral contraceptives : relation to self-assessment, lifestyle regularity and multidimensional health locus of control

This study addressed the issue of adolescent compliance with oral contraception by investigating the use of self-report and behavioral measures to differentiate compliant and noncompliant subjects. Subjects (n=22) were predominantly black, low-income adolescent girls, ages 15.2-19.9 (mean 17.7), attending an urban family planning clinic. Inclusion and exclusion criteria were designed to select 2 groups at each extreme of the dimension of contraceptive compliance. Questionnaires were administered to all subjects. Items included (1) self-report of past medication compliance, (2) self-assessment of ability to comply with oral contraception and 6 targetted behaviors (toothbrushing, diet, exercise, sleep, homework and chores), and (3) Multidimensional Health Locus of Control. Self-reported behavioral data were also collected from 10 subjects using a method from behavioral ecology. A trend in the data indicated adolescents can assess their own ability to comply with contraception, and the implications of this for interventions are discussed. Results did not support a relationship of contraceptive compliance with any of the following: past compliance with noncontraceptive medications, self-assessment of compliance with targetted behaviors, regularity with which pills were taken or with which the targetted behaviors were performed. In addition, measures derived from self-reported behavioral data indicated that compliant and noncompliant individuals were similar to each other in many respects, although several interesting differences were found. Noncompliant subjects spent more time at home and had less diversity of activities and companions than compliant subjects. Implications for current understanding of adolescent contraceptive compliance and future research are discussed.