title: The relationship between female adolescent self-esteem, decision making, and contraceptive behavior.
abstract: OBJECTIVE
  To examine the relationship between female adolescent self-esteem, decision making, and contraceptive behavior in multiethnic, 14- to 17-year-olds, residing on the Big Island of Hawaii.
  
  
  METHODS
  This was a descriptive cross-sectional survey design using a convenience sample of 98 female adolescents aged 14-17 who came to five different clinics on the Big Island of Hawaii for health care. Along with a brief demographic questionnaire, global self-esteem was measured by Rosenberg's Self-Esteem Scale, decision making was measured by the Flinders Adolescent Decision Making Questionnaire, and sexual activity and contraception use was measured by a nonnormed Sexual History and Contraceptive Use Questionnaire developed for this study. Descriptive statistics, logistic regression, and correlations were used to analyze associations and correlations between age, global self-esteem, decision self-esteem, decision coping (vigilant and maladaptive), and contraceptive use for sexually active female adolescents.
  
  
  CONCLUSIONS
  No significant associations or correlations were found between age, global self-esteem, decision self-esteem, decision coping (vigilance), and the decision to use contraception in sexually active adolescent females. There was, however, significant negative correlation (p < .05) between overall maladaptive decision making and contraceptive use in sexually active female adolescents. This suggests that sexually active adolescent females with higher maladaptive scores are less likely to use contraception. There was also significant association (p < .05) between maladaptive decision making in contraceptive use and sexually active female adolescents. For every one unit increase on the maladaptive scale, the odds of using contraception were estimated to decrease by 7%.
  
  
  CONCLUSIONS
  Adolescence is a period of transition that involves biological, cognitive, psychological, and social changes. During the vulnerable transition period of adolescence, decisions relating to contraception may occur. Interventions focused on improving decision-making skills and stimulating thinking around not only sexual issues but also on relationship and communication in adolescent issues may facilitate more competent decision making. Understanding the relationship between female adolescent self-esteem, decision making, and contraceptive behavior has contributed to the knowledge base about female contraceptive behavior. Gaining further insight into these relationships will help healthcare professionals provide counseling and health care to female adolescents.
authors.affiliation: University of Hawaii at Hilo. 200 W. Kawili Street, Hilo, HI 96720. coma002@hawaii.rr.com
authors.forename: Kathleen
authors.initials: K
authors.lastname: Commendador
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology*; D001294:Attitude to Health / Q000208:ethnology*; D003268:Contraception Behavior / Q000208:ethnology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D018864:Cultural Diversity; D003657:Decision Making; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D008960:Models, Psychological; D009722:Nurse Practitioners; D015404:Nursing Methodology Research; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology / Q000517:prevention & control; D000297:Psychology, Adolescent; D012649:Self Concept; D012736:Sex Education; D012725:Sexual Behavior; D011795:Surveys and Questionnaires