title: The influence of oral contraceptive knowledge on oral contraceptive continuation among young women.
abstract: BACKGROUND
  Using a multidimensional approach, we assessed young women's knowledge of oral contraceptives (OC) and its influence on OC continuation rates.
  
  
  METHODS
  We used data from 659 women aged 13-25 years participating in a randomized controlled trial of an educational text message OC continuation intervention. Women received 6 months of daily text messages or routine care. At baseline and 6 months, we administered a comprehensive 41-item questionnaire measuring knowledge of OC's mechanism, effectiveness, use, side effects, risks, and benefits. We ascertained OC continuation status and reasons for discontinuation at 6 months. We analyzed relationships between OC knowledge and continuation with multivariable logistic regression.
  
  
  RESULTS
  Young women scored, on average, 22.8 out of 41 points on the OC knowledge assessment at baseline and 24.7 points at 6 months. The 6-month OC continuation rate was 59%. OC continuers had >2-points-higher OC knowledge scores at 6 months than discontinuers (p<0.001). Those who reported discontinuing their OCs for side effects and forgetfulness scored >2 points lower than women who discontinued for other reasons (p-values<0.001). In multivariable regression models, each correct response on the baseline and 6-month knowledge assessments was associated with a 4% and 6% increased odds of OC continuation, respectively. Six-month OC knowledge scores were negatively associated with OC discontinuation due to side effects (odds ratio [OR] 0.94) and forgetfulness (OR 0.88).
  
  
  CONCLUSIONS
  OC knowledge, which was low among young women in our study, was associated with OC continuation and common reasons for discontinuation. Continued efforts to characterize relationships between OC knowledge and behavior and to test the effectiveness of different components of interventions aimed at increasing knowledge, addressing side effects, and improving use of OCs are warranted.
authors.affiliation: 1 Department of Obstetrics and Gynecology, Institute for Social Research, University of Michigan , Ann Arbor, Michigan.
authors.forename: Kelli Stidham
authors.initials: KS
authors.lastname: Hall
authors.forename: Paula M
authors.initials: PM
authors.lastname: Castaño
authors.forename: Carolyn L
authors.initials: CL
authors.lastname: Westhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D003268:Contraception Behavior; D003276:Contraceptives, Oral; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D015999:Multivariate Analysis; D010349:Patient Compliance / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods*; D017010:Reminder Systems; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D060145:Text Messaging; D014481:United States; D014505:Urban Population; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral