title: Measuring oral contraceptive knowledge: a review of research findings and limitations.
abstract: OBJECTIVE
  Poor oral contraceptive (OC) knowledge may contribute to premature OC discontinuation and unintended pregnancy. Yet, to understand relationships between OC knowledge and contraceptive behavior, knowledge must be adequately measured. This review evaluates the findings and methodological limitations of research in which OC knowledge has been measured.
  
  
  METHODS
  We performed a systematic review of primary research from January 1965 to January 2009. Studies were audited for study characteristics, purpose for measuring OC knowledge, key findings and measurement properties including administration method, knowledge domains, reliability, validity, health literacy and cultural sensitivity.
  
  
  RESULTS
  We reviewed 21 studies: 18 cohort studies, including one psychometric evaluation, and three randomized trials. Results on OC knowledge outcomes were variable. Measures were largely self-administered survey (n=15) and lacked assessment of all OC knowledge domains. Information on measures' characteristics, reliability, validity, health literacy and cultural sensitivity was limited.
  
  
  CONCLUSIONS
  Existing OC knowledge measures lack critical psychometric elements, leading to inconsistent and unreliable findings.
  
  
  CONCLUSIONS
  Poor OC knowledge measurement precludes identifying counseling needs and developing interventions for contraceptive behavior change. Future research considerations include: measurement information in publications, psychometric evaluations, formal reliability/validity techniques, and attention to all OC knowledge domains, health literacy and cultural sensitivity.
authors.affiliation: Office of Population Research, Princeton University, Princeton, NJ 08544, USA. kshall@princeton.edu
authors.forename: Kelli Stidham
authors.initials: KS
authors.lastname: Hall
authors.forename: Paula M
authors.initials: PM
authors.lastname: Castaño
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Stone
authors.forename: Carolyn
authors.initials: C
authors.lastname: Westhoff
mesh_terms: D003268:Contraception Behavior; D003276:Contraceptives, Oral / Q000008:administration & dosage*; D003376:Counseling; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D010349:Patient Compliance
chemical_list: D003276:Contraceptives, Oral