RESUMO
The sociomedical characteristics of 96 sexually active adolescent females have been studied in order to understand noncompliance with the contraceptive prescription, an important antecendent of adolescent pregnancy. Compliance was found to correlate positively with postmenarchal age, frequency of intercourse, autonomy in making and paying for a clinic appointment specifically for the purpose of obtaining contraception, and acceptance of a method at the time of the initial clinic visit. These findings serve to alert the pediatrician to the adolescent at risk for noncompliance before the experience of failure, and in so doing to identify those in need of special assistance to ensure the success of contraceptive measures.
PIP: 96 sexually active adolescent females attending the Stanford University Adolescent Clinic of the Dept. of Pediatrics between 9/76 and 11/78 were studied to determine factors which contribute to noncompliance with contraceptive prescription, an important antecedent of adolescent pregnancy. 15 variables were selected for the study and included information on demographic characteristics; medical history; patterns of sexual activity; physical development; and motivation for clinic attendance. Chi-square and stepwise discriminant analyses were the analytical methods used. Mean age of study group was 15.9 years; slightly more than half were blacks. One-third of the group had parental knowledge of their sexual activity. Almost 2/3 had a single sex partner, and mean duration of sexual relationship was nearly 1 year. More than 1/3 had intercourse less often than once a week. Half of the patients had initiated their own clinic appointment, while the remaining were influenced by parents, physicians and others. 44% of the subjects complied with the contraceptive regimen during the study period. Adolescents who paid for their own medical care; who had a single sex partner; who were sexually active more often than weekly; who made their own clinic appointments; and who came to the clinic themselves desiring birth control were more likely to be compliant than the others. Using standardized discriminant function coefficient for 6 variables (computed compliance values; method of payment; method of birth control; frequency of intercourse; appointment source; agenda source), patients were correctly assigned to the compliant or noncompliant group in 72% of the cases. Implications of these findings, and the role of the primary care physician in the prevention of adolescent pregnancy, are discussed.