title: Comparing three theories in predicting reproductive health behavioral intention in adolescent women with diabetes.
abstract: BACKGROUND
  Understanding factors that affect decision-making in using preconception planning is important to reduce the rate of unplanned pregnancies and pregnancy-related complications in all women with diabetes. Previously, there were no studies of reproductive health-related beliefs, attitudes, or behaviors of adolescent women with diabetes. Constructs from social cognitive models, such as, the health belief model (HBM), theory of reasoned action, and social cognitive theory, are factors that can influence these behavioral outcomes.
  
  
  OBJECTIVE
  To compare the predictive powers of these three theories in regard to decision-making with reproductive health behaviors in teens with diabetes and to identify a composite model of the strongest predictors across all three theories.
  
  
  METHODS
  Data were collected from a telephone interview by same-gender research assistants on a sample of 87 female adolescents with type 1 diabetes (T1D) from four medical centers using the reproductive health attitudes and behavior (RHAB) questionnaire. Measures represent demographic variables, constructs of the three theories, and behavioral outcomes. Standard multiple regression analyses were used to examine the prediction of the three theories in the outcome variable [intention for using birth control (BC)].
  
  
  RESULTS
  Among the three theories considered, the HBM explained the highest percent of variance (24.4%) in intention to using BC. The best composite model consisted of perceived barriers, cues to action, and self-efficacy (explaining 26.1% of the variance). These three variables were also the strongest predictors among all constructs considered.
  
  
  CONCLUSIONS
  In this sample of adolescent females with T1D, the strongest predictors from the three theories for intention to using BC appeared to be perceived barriers, cues to action, and self-efficacy. Intervention studies to decrease future unplanned pregnancies in this high-risk population could focus on strategies to target these factors that are amenable to change.
authors.affiliation: Health Promotion & Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261, USA.
authors.forename: Shiaw-Ling
authors.initials: SL
authors.lastname: Wang
authors.forename: Denise
authors.initials: D
authors.lastname: Charron-Prochownik
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sereika
authors.forename: Linda
authors.initials: L
authors.lastname: Siminerio
authors.forename: Yookyung
authors.initials: Y
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003463:Cues; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D010551:Personality; D011237:Predictive Value of Tests; D012098:Reproduction / Q000502:physiology*; D020377:Self Efficacy; D011795:Surveys and Questionnaires