Applied Nursing Research 36 (2017) 95–99

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Applied Nursing Research

journal homepage: www.elsevier.com/locate/apnr

Original article

Adaptation of the contraceptive self-efficacy scale for heterosexual

Mexican men and women of reproductive age
María Luisa Flores Arias, BSN, MCE, EEI, Clinical Instructor a,1,
Jane Dimmitt Champion, PhD, DNP, FNP, AH-PMH-CNS, FAANP, FAAN, Professor, School of Nursing b,⁎,2,
Norma Elva Sáenz Soto, PhD, MCE a,3
a
Nursing School, Universidad Autonoma de Nuevo Leon, Mexico
b
The University of Texas at Austin, United States

a r t i c l e i n f o a b s t r a c t

Article history: Aim: Development of a Spanish Version Contraceptive Self-efficacy Scale for use among heterosexual Mexican
Received 27 November 2016 populations of reproductive age inclusive of 18–35 years.
Revised 22 February 2017 Background: Methods of family planning have decreased in Mexico which may lead to an increase in unintended
Accepted 2 June 2017 pregnancies. Contraceptive self-efficacy is considered a predictor and precursor for use of family planning
methods.
Keywords:
Methods: Cross-sectional, descriptive study design was used to assess contraceptive self-efficacy among a hetero-
Adaptation
Self-efficacy
sexual Mexican population (N = 160) of reproductive age (18–35 years). Adaptation of a Spanish Version Con-
Contraception traceptive Self-efficacy scale was conducted prior to instrument administration.
Mexican heterosexual population Results: Exploratory and confirmatory factorial analyses identified seven factors with a variance of 72.812%. The
adapted scale had a Cronbach alpha of 0.771. A significant correlation between the Spanish Version Contraceptive
Self-efficacy Scale and the use of family planning methods was identified.
Conclusions: The Spanish Version Contraceptive Self-efficacy scale has an acceptable Cronbach alpha. Exploratory
factor analysis identified 7 components. A positive correlation between self-reported contraceptive self-efficacy
and family planning method use was identified. This scale may be used among heterosexual Mexican men and
women of reproductive age. The factor analysis (7 factors versus 4 factors for the original scale) identified a dis-
crepancy for interpretation of the Spanish versus English language versions. Interpretation of findings obtained
via the Spanish versión among heterosexual Mexican men and women of reproductive age require interpretation
based upon these differences identified in these analyses.
© 2017 Elsevier Inc. All rights reserved.

1. Introduction
Mexico has recently implemented multiple strategies to increase the
use of family planning methods (FPM) and thus reduce the incidence of
unwanted pregnancies. Success however has not been achieved as the
use of FPM in Mexico among heterosexual men and women has actually
decreased during this time (ENADID, 2014). Among married women of
childbearing age, the last National Survey on Demographic Dynamics
conducted by the National Institute of Geographical Statistics and
⁎ Corresponding author.
E-mail addresses: luisanayo@hotmail.com (M.L.F. Arias),
jdchampion@mail.nur.utexas.edu (J.D. Champion), normaelva2000@yahoo.com.mx
(N.E.S. Soto).
1
Contribution. Conceptualization of study, literature review, sampling, statistical analy-
sis, presentation of findings, discussion.
2
Contribution. Literature synthesis, instrument translation, interpretation of findings.
3
Contribution. Manuscript revisions.
Informatics in 2009 found that 9.8% (1.7 million) of these women
reported using FPM (WHO, 2015, CONAPO, 2015, ENADID, 2014,
Guttmacher Institute, 2013).
The use of FPM among men such as vasectomy, male condom or tra-
ditional methods (rhythm and interrupted intercourse) actually de-
creased from 2009 to 2014 from 19.2% to 16.8% (Prendes, Aparicio,
Reyes, & Lescay, 2001). Faced with this reality, the need arises for health
professionals to investigate factors such as self-efficacy that influence
heterosexual Mexican men or women of reproductive age to decide to
use FPM.
Self-efficacy is understood as a predictor of human behavior.
Bandura defined self-efficacy as the person's self-confidence to carry
out a specific activity or goal (Pender et al., 2015). As such, self-efficacy
is recognized as a key factor for family planning as well as a precursor to
generate a favorable contraceptive attitude and a predictor of FPM ad-
herence (Muhindo, Nankumbi, Groves, & Chenault, 2015, Peyman et
al., 2009 and Heinrich, 1993). Other findings indicate that women

http://dx.doi.org/10.1016/j.apnr.2017.06.003
0897-1897/© 2017 Elsevier Inc. All rights reserved.
96 M.L.F. Arias et al. / Applied Nursing Research 36 (2017) 95–99

perceive an inability to use any FPM (Ong, Temple-Smith, Wong, Table 1

McNamee, & Fairley, 2012). Sociodemographic characteristics.

There are no instruments to assess contraceptive self-efficacy in het- Variable Mín. Máx. M SD
erosexual Mexican populations. Levinson (1995) developed an English- Age 18 35 27.73 5.354
language contraceptive self-efficacy scale to measure perceptions of Scholarship 1 12 5.73 3.580
ability to take responsibility for sexual and contraceptive behaviors Monthly income 0 $ 26,000 $ 6336.18 $ 6520.388
across a variety of situations among sexually active adolescent Relationship time 0 22 5.05 5.560
No. of children 0 4 1.29 1.102
women. The instrument consists of 18 items, answered with a
No. sexual partners 1 10 2.19 1.730
Likert scale with options ranging from 1 = not completely true for
me, to 5 = completely true for me. In order to obtain the final score, it f %
is required that the value of items 2, 5, 6, 8, 9, 11, 12, 14 and 15 be No. previous use of FPM. 82 51.3%
reversed, so that the high final scores refer to a higher self-efficacy for No. current use of FPM. 60 37.5%
the practice of contraception. No. intention to use FPM. 45 28.1%
This instrument has been translated and used among Chinese,
French, Brazilian and Canadian women, as well as in Latin American,
American and European men (Cronbach Alpha N 0.73). Although this rates as reported by the National Health and Nutrition Survey of 2012
scale was adapted by Gomez et al., (1996) for use among a Spanish pop- (ENSANUT, 2012).
ulation, it is not available in Spanish. The present study aim was to adapt Participants were approached in these areas by the principal investi-
the Spanish Version Contraceptive Self-efficacy Scale for use among het- gator and were given a description of the purpose of the study and then
erosexual Mexican men and woman of reproductive age inclusive of 18 asked for their verbal consent. Once potential participants were identi-
to 35 years. fied, they responded to the selection criteria and were asked to volun-
Adaptation of the Spanish Version Contraceptive Self-efficacy Scale tarily sign a written informed consent. Regarding the selection criteria,
provides the opportunity to assess contraceptive self-efficacy for a Mex- potential participants were asked their age and gender. They were
ican population as a predictor of contraceptive behavior, to guide the
creation of strategies to promote the use of FPM. This process may facil- Table 2
itate a reduction in deaths of women and children as an outcome of un- Principal components analysis.
intended pregnancies (Akintade, Pengpid & Peltzer, 2011).
Inicial Extracción

2. Methods 1. Me siento responsable de lo que pasa sexualmente con mi 1.000 0.670

pareja…I am responsible for what happens sexually with
my partner
This descriptive, cross-sectional study was conducted in Guanajuato, 2. No le puedo decir cómo me siento sexualmente… 1.000 0.558
Mexico. The study was reviewed and approved by the ethics commit- I can't tell how I feel sexually …
tees of the Autonomous University of Nuevo León and the Health Secre- 3. Cuando tengo relaciones sexuales (RS), las puedo 1.000 0.753
disfrutar…
tariat of Guanajuato. Participants provided informed consent,
When I have sexual relations, I can enjoy them …
participation was voluntary and confidentiality of their responses was 4. Puedo decir fácilmente que No… 1.000 0.732
assured. I can easily say No …
5. Yo tampoco puedo hablar de las RS, que están pasando… 1.000 0.670
2.1. Instrument adaptation process I can't talk about sexual relations
6. Cuando pienso en el significado, no puedo tener RS… 1.000 0.685
When I think of the meaning of sex, I cannot have sexual
Adaptation of the Spanish Version Contraceptive Self-efficacy Scale relations
was carried out in four stages following the methodology proposed by 7. Puedo para las RS fácilmente aunque estemos excitados… 1.000 0.758
Ramada-Rodilla, Serra-Pujadas, and Delclós-Clanchet (2013). This I can NOT have sexual relation even though we are very
excited
methodology includes the following stages: 1) initial review of the
8. Puedo tener RS incluso si no estuviéramos protegidos… 1.000 0.668
scale, 2) translation and re-translation of the scale, 3) pilot test and 4) I would have sexual relations even if we were not protected …
validation of the scale. The first stage consisted of a thorough review 9. A veces solo hago lo que quiere sexualmente, porque yo no… 1.000 0.728
of the original instrument with two bilingual experts concerning Sometimes I just do what my partner wants, because I don't …
human sexuality. One of the experts knew the objectives of the present 10. Pudiera decirle que quiero tener RS, con él/ella…I could 1.000 0.630
tell a partner that I want to have sexual relations …
study and the other did not, in order to facilitate the understanding of 11. No podría continuar usando MPF, si mis padres pudieran 1.000 0.705
each item, its purpose and its way of measuring the construct. In the sec- enterarse…I wouldn't continue to use contraception if
ond stage four bilingual experts, two native English-speaking experts my parents might find out …
from the United States and two native Spanish-speaking experts from 12. No podría ir a la farmacia y preguntar por algún MPF…I 1.000 0.764
can't go to the pharmacy and ask about family planning
Mexico, performed the translation and re-translation of the instrument,
methods …
providing recommendations to improve the instrument and its under- 13. Puedo preguntar si tiene protección o decirle que yo 1.000 0.859
standing by potential participants. Modifications were made via com- No…I can ask my partner about protection or say that I
parisons of translations to prevent compromise of the semantics or do not have it …
original conceptualization of the scale. 14. Me puedo dar tiempo para colocarme algún MPF…I can 1.000 0.871
take the time to get a form of contraception
In the third stage, the quality and applicability of the translation was 15. Le puedo decir con facilidad que estoy usando un MPFI 1.000 0.838
assessed through a pilot study in a second level hospital in Mexico in can easily say that I am using contraception
areas such as the emergency waiting room, external consultation and 16. Puedo parar antes de la penetración, sino puedo hablar 1.000 0.773
postpartum rooms. The second level of medical care in Mexico includes de protección…I can stop before penetration and ask
about using protection
the hospital configuration, but also offers FPM through an external con-
17. Hay momentos en los que puedo hablar de MPF. pero no 1.000 0.657
sultation service. This sample consisted of 160 heterosexual men and lo hago…There are times when I should talk about con-
women of reproductive age from 18 to 35 years of age, using systematic traception but I don't
sampling, choosing the first participant in a random manner and from 18. Termino teniendo relaciones porque no se como 1.000 0.790
there every third potential participant that met the selection criteria. detenerlo(a).Sometimes end up having sex because can't
stop it …
The age range was chosen based on reports of Mexico's highest fertility
 M.L.F. Arias et al. / Applied Nursing Research 36 (2017) 95–99 97

Table 3 Table 5
Total variance explained. Correlation between the Contraceptive Self-efficacy Scale and FPM use.

Component Initial eigenvalues Sum of square saturation of Total contraceptive Use of

extraction self-efficacy FPM

Total % of % Total % of % Total contraceptive Pearson's 1 0.158⁎

variance accumulated variance accumulated self-efficacy Correlation
Sig. 0.045
1 4.820 26.779 26.779 4.820 26.779 26.779
Use of FPM Pearson's 0.158⁎ 1
2 2.085 11.586 38.365 2.085 11.586 38.365
Correlation
3 1.516 8.423 46.788 1.516 8.423 46.788
Sig. 0.045
4 1.257 6.985 53.773 1.257 6.985 53.773
5 1.231 6.841 60.614 1.231 6.841 60.614 ⁎ p = 0.05.
6 1.171 6.504 67.119 1.171 6.504 67.119
7 1.025 5.693 72.812 1.025 5.693 72.812
analysis, correlations and Cronbach's Alpha, were calculated and deci-
sions were made regarding retention of questionnaire items.
also asked about the presence of problems with fertility or permanent
sterilization that may have impeded conception. If the potential partic- 3. Results
ipant these questions with positive responses, they were informed that
they would be excluded from the study. Other exclusion criteria were The sample included 160 heterosexual Mexican men and women of
the presence of STIs (human papillomavirus, HIV, chlamydia, gonorrhea, reproductive age (18 to 35 years) who are residents of Guanajuato, Gto,
syphilis) as these infections may potentially impact the use of contra- and were accessing a General Hospital providing the second level of
ceptive methods such as condoms. health care in Mexico (see Table 1). Participants had a mean age of
Participants who met the established study criteria were accompa- 27 years and an average of 5.73 years of education which corresponds
nied to a private area to safeguard confidentiality. If the participant to non-completion of elementary school. Of the 72.5% who reported
could not read or write, the principal investigator assisted the partici- working, these participants received an average monthly income of $
pant by reading the questions and responses on the scale. The research- 6336.18. Participants reported an average of 5.05 years in their current
er took care to show respect at all times to the individual participant's relationship and had an average of 1 child. Approximately half (51.3%)
responses. Following completion of the questionnaire, the researcher reported no previous use of a FPM while 37.5% reported currently
asked participants to express any concerns or provide suggestions to using a FPM; 28.1% indicated they did not intend to use any FPM in
improve overall understanding of the scale. Finally, in stage four, factor the future.

Table 4
Matrix of rotated components.

Varimax with Kaiser Component

1 2 3 4 5 6 7

Me puedo dar tiempo para colocarme algún MPF… 0.909

I can take the time to get a form of contraception
Puedo preguntar si tiene protección o decirle que yo No… 0.900
I can ask my partner about protection or say that I do not have it …
Le puedo decir con facilidad que estoy usando un MPF 0.894
I can easily say that I am using contraception
Puedo parar antes de la penetración, sino puedo hablar de protección… 0.864
I can stop before penetration and ask about using protection
Puedo para las RS fácilmente aunque estemos excitados… 0.701
I can NOT have sexual relation even though we are very excited
Puedo decir fácilmente que No… 0.554
I can easily say No …
Me siento responsable de lo que pasa sexualmente con mi pareja… 0.776
I am responsible for what happens sexually with my partner
Cuando tengo relaciones sexuales (RS), las puedo disfrutar… 0.681
When I have sexual relations, I can enjoy them …
Puedo tener RS incluso si no estuviéramos protegidos… −0.434
I would have sexual relations even if we were not protected …
Yo tampoco puedo hablar de las RS, que están pasando… 0.755
I can't talk about sexual relations
No le puedo decir cómo me siento sexualmente… 0.646
I can't tell how I feel sexually …
No podría ir a la farmacia y preguntar por algún MPF… 0.844
I can't go to the pharmacy and ask about family planning methods
No podría continuar usando MPF, si mis padres pudieran enterarse… 0.744
I wouldn't continue to use contraception if my parents might find out …
Termino teniendo relaciones porque no se como detenerlo(a). 0.837
Sometimes end up having sex because can't stop it …
A veces solo hago lo que quiere sexualmente, porque yo no… 0.813
Sometimes I just do what my partner wants, because I don't …
Cuando pienso en el significado, no puedo tener RS… 0.543
When I think of the meaning of sex, I cannot have sexual relations
Hay momentos en los que puedo hablar de MPF. pero no lo hago… 0.774
There are times when I should talk about contraception but I don't
Pudiera decirle que quiero tener RS, con él/ella… 0.389
I could tell a partner that I want to have sexual relations …
98 M.L.F. Arias et al. / Applied Nursing Research 36 (2017) 95–99

Table 6
Escala de Autoeficacia Anticonceptiva (Español).
Contraceptive Self-efficacy Scale (English).

Enunciado question Opciones de respuesta Likert response scale

1 = No 2 = Casi 3 = Algo 4 = Muy 5=

completamente verdadero verdadero verdadero Completamente
verdadero para mí. para mí para mí para mí. verdadero para mí.
Not at all true of me Slightly true Somewhat Mostly true Completely true
of me true of me of me of me

1. Cuando estoy con mi pareja, me puedo sentir siempre responsable de lo que pase
sexualmente con él/ella. con esta persona
When I am with a boyfriend/girlfriend, I am confident that I can always be responsible
for what happens sexually with him/her.
2. Aun si mi pareja puede hablar del sexo, yo no le puedo decir como me siento
realmente sobre cosas sexuales.
Even if a boyfriend/girlfriend can talk about sex, I can't tell how I really feel about sexual
things.
3. Cuando tengo relaciones sexuales, las puedo disfrutar como algo que realmente quería
hacer.
When I have sex, I can enjoy it as something I really wanted to do.
4. Si mi pareja y yo, nos estamos excitando sexualmente y yo realmente no quiero
tener relaciones sexuales, le puedo decir fácilmente que NO.
If my partner and I are getting really turned on sexually and I really don't want to go
all the way, it is easy for me to say NO
5. Si mi pareja NO habla acerca de las relaciones sexuales que se están dando entre
nosotros, yo tampoco puedo.
If my partner didn't talk about the sex that was happening between us, I couldn't either.
6. Cuando pienso sobre el significado de tener relaciones sexuales, no puedo tenerlas
fácilmente.
When I think about what having sex means, I can't have it so easily.
7. Si mi pareja y yo nos estamos excitando sexualmente y yo realmente no quiero
tener relaciones sexuales (llegar hasta la penetración), puedo parar las cosas
fácilmente para no tenerlas.
If my partner and i are getting turned on sexually, and I really don't want to have sexual
intercourse (go all the way), I can easily stop things so that we don't go all the way.
8. Hay ocasiones que me encuentro tan involucrado(a) sexual y emocionalmente con
mi pareja, que puedo tener relaciones sexuales incluso si no estuviéramos
protegidos (usando algún anticonceptivo)
There are times when I would be so involved sexually or emotionally with my partner
that I could have sexual intercourse even if I weren't protected (using a form of birth
control).
9. A veces solo hago lo que mi pareja quiere hacer sexualmente, porque yo no me
tomo la molestia de tratar de decirle lo que quiero.
Sometimes I just go along with what my date wants to do sexually because I don't
think I can take the hassle of trying to say what I want.
10. Si hubiera una persona del sexo opuesto que me atrajera física y emocionalmente,
me sentiría cómodo(a) de decirle que quiero tener relaciones sexuales con él/ella.
If there was a partner to whom I was attracted physically and emotionally, I would feel
comfortable saying that I wanted to have sex with him/her.
11. No pudiera continuar usando métodos de planificación familiar, nada más de
pensar que mis padres pudieran enterarse.
I couldn't continue to use a birth control method if I thought my parents might find out.
12. Sería difícil para mí ir a la farmacia y preguntar algún método de planificación
familiar (espuma, condones, óvulos, diafragma, pastillas, etc.), sin sentirme
avergonzado(a).
It would be hard for me to go to the pharmacy and ask about a method of family
planning (sponge, condoms, pills, diaphragm) without being embarrassed.
13. Si mi pareja y yo estamos manteniendo relaciones sexuales y estamos a punto de
avanzar a la penetración y no estoy protegido(a), … le puedo preguntar fácilmente
si tiene protección o decirle que yo no tengo.
If my partner and I were getting really heavy into sex and moving to intercourse and I
wasn't protected …
…. I could easily ask if my partner had protection or say that I did not.
14 …me puedo disculpar y darme tiempo para colocarme algún anticonceptivo.
… I could excuse myself to get contraception
15 …le puedo decir con facilidad que estoy usando algún anticonceptivo.
… I could tell my partner that I am using contraception
16 …puedo parar las cosas fácilmente antes de la penetración, si no pudiera hablar
sobre el tema de la protección.
… I could stop things before intercourse if I couldn't bring up contraception.
17. Hay momentos en los que yo pudiera hablar con mi pareja sobre el uso de métodos
anticonceptivos, pero no lo puedo hacer.
There are times when I should talk to my partner about contraception but I can't seem
to do it in the situation.
18. A veces término teniendo relaciones sexuales con mi pareja, porque no encuentro
una manera de detenerlo(a).
Sometimes I end up having sex with a partner because I can't find a way to stop it.
 M.L.F. Arias et al. / Applied Nursing Research 36 (2017) 95–99
Exploratory and confirmatory factorial analysis was conducted (con-
sidered pertinent when obtaining a KMO = 0.755 and a significant Bart-
lett Sphericity Test, Chi square = 1139.392; p = 0.000). The exploratory
factor analyses identified a greater variance explained by seven compo-
nents, contrary to the four components initially proposed by the authors
of the original scale. The results presented below reference the seven
components found identified with this population via factor analysis.
Table 2 indicates that all items are N 0.5 and close to 1, representing
the existence of an acceptable variance explained by each of the items,
thus contributing to the explanation of the resultant factorial model.
Item 2 (“I can't tell how I feel sexually…”) explains the least (55.8%),
while Item 14 (“I can take the time to get a form of contraception”) ex-
plains the most (87.1%).
Table 3 provides a list of Eigenvalues greater than one, which guided
the extraction of the seven main components with an explained vari-
ance of 72.81%. As can be seen, four components explain only 53.77%.
Table 4 shows the factorial load of each item, which allows identifi-
cation of where each factor or component belongs. As can be seen, Com-
ponent 1 is constituted by the Items: 4, 7, 13, 14, 15 and 16; Component
2 by Items 1, 3 and 8; Component 3 includes Items 2 and 5; Component
4 contains Items 11 and 12; Component 5 only comprises Item 18; Com-
ponent 6 comprises Items 6 and 9 and Component 7 includes Items 10
and 17. As noted, Item 10 has a correlation b 0.40. The Cronbach's
alpha ranging from 0.763 to 0.771 is considered acceptable.
Table 5 identifies a significant Pearson correlation (p = 0.45) be-
tween the total values of the Spanish Version Contraceptive Self-efficacy
scale and FPM use reported by the participants. This relationship indi-
cates a positive relationship between these study variables.
4. Discussion
Levinson (1995) developed the first version of the Contraceptive
Self-efficacy Scale, for which four components were deduced through
data analysis including: 1) acceptance of sexual activity and being able
to plan, speak and think about sex and use contraceptive methods; 2) as-
sumption of responsibility for the direction of sexual activity and contra-
ceptive use; 3) assertiveness in preventing intercourse in a given situation
and 4) feelings of sexual excitement. However in our study, the explorato-
ry and confirmatory factorial analyses with four factors presented an ex-
plained variance of low percentage, while with seven factors it rose
significantly (Gomez, Ibaceta, Muñoz, Pardo, & Ubillos, 1996).
A review our study findings indicates Components 1–4 of
the Spanish Version Contraceptive Self-efficacy Scale correspond
to the Components 1–3 identified in the original version by Levison
& Skidmore (1986). These components address 1) acceptance of
sexual activity and ability to plan, speak and think about sex and use
contraceptive methods; 2) assumption of responsibility for the direc-
tion of sexual activity and contraceptive use; and 3) assertiveness in
preventing intercourse in a given situation. Components 5–7 of the
Spanish Version Contraceptive Self-efficacy Scale correspond to Compo-
nent 4, feelings of sexual excitement of the original version. Concerning
the Spanish Version, Component 5 contains one item “Sometimes end
up having sex because can't stop it …” while Component 6 contains
2 items “Sometimes I just do what my partner wants” and “When I
think of the meaning of sex, I cannot have sexual relations.” Component
7 includes 2 items, “There are times when I should talk about contracep-
tion but I don't” and “I could tell a partner that I want to have sexual re-
lations” According to the matrix of rotated components, Item 10 “I could
tell a partner that I want to have sexual relations” included in Factor 7
has a factorial load b 0.40 and a difference smaller than 10 with respect
to the immediately previous value (− 0.386–0.387). According to the
scientific literature reviewed in relation to self-efficacy, this item is not
considered as representative of this variable, for these reasons it was de-
cided to be eliminated for evaluation leaving one item in Component 7.
99
Components 5–7 of the Spanish version contain 1–2 questions each
indicating that these questions stand along in identification of aspects of
sexual relationships effecting contraception self-efficacy. These differ-
ences may be due in part to translation however care was taken in con-
duct of the translations to maintain original context and meaning of
these questions. Alternatively, we suggest that these questions indepen-
dently reflect cultural values and beliefs concerning sex roles among
heterosexual Mexican men and women of reproductive age as related
to self-efficacy and use of FPM. This interpretation is substantiated by
our study finding of a significant and positive relationship between per-
ceived contraception self-efficacy and reported use of FPM.
5. Conclusions
Our findings indicate the Spanish Versión Contraceptive Self-efficacy
Scale is realiable for use among heterosexual Mexican men and women
of reproductive age (Table 6). This scale is recommended for use as a
whole with additional foci on individual components as related to cul-
tural sex roles and relationships. This scale contributes to an under-
standing of contraception self-efficacy as a predictor of sexual and
contraceptive behavior for prevention of unintended pregnancies. It is
important to examine the behavior described in each of the items for
guidance toward relevant health promotion strategies.
Funding
None.
References
Akintade, O. L., Pengpid, S., & Peltzer, K. (2011). Awareness and use of and barriers to
family planning services among female university students in Lesotho. South African
Journal of Gynaecology, 17(3), 72–78.
Consejo Nacional de Población (2015). Participación masculina en la prevalencia
anticonceptiva de mujeres en edad fértil unidas, 2009 y 2014. Retrieved
from http://www.conapo.gob.mx/es/CONAPO/Participacion_masculina_en_
la_prevalencia_anticonceptiva_de_mujeres_en_edad_fertil_unidas_2009_y_
2014.
Gomez, Z. J., Ibaceta, P., Muñoz, F., Pardo, E., & Ubillos, S. (1996). Auteficacia percibida en
relación al comportamiento sexual y contraceptive de los jovenes. Rev. de Psicol. Gral.
y Aplic., 49(1), 173–183.
Guttmacher Institute (2013). Unplanned pregnancy and induced aboration in Mexico.
Causes and consequences. http://www.guttmacher.org/pubs/Embarazo-no-deseado-
Mexico.pdf.
Heinrich, B. L. (1993). Contraceptive self-efficacy in college women. Journal of Adolescent
Health, 14(4), 269–276. http://dx.doi.org/10.1016/1054-139X(93)90173-M.
Instituto Nacional de Estadística y Geografía (2014). Encuesta Nacional de la Dinámica
Demográfica (ENADID). Recuperado de http://www.inegi.org.mx/est/contenidos/
proyectos/encuestas/hogares/especiales/enadid/enadid2014/doc/resultados_enadid14.
pdf.
Levinson, R. A. (1995). Reproductive and contraceptive knowledge, contraceptive self-ef-
ficacy, and contraceptive behavior among teenage women. Adolescence, 30(117),
65–68.
Muhindo, R., Nankumbi, O. J., Groves, S., & Chenault, M. (2015). Predictors of contracep-
tive adherence among women seeking family planning services at reproductive
health Uganda, Mityana Branch. International Journal of Population Research. http://
dx.doi.org/10.1155/2015/574329.
Ong, J., Temple-Smith, M., Wong, W. C., McNamee, K., & Fairley, C. (2012). Materia de
anticoncepción: indicadores de la utilización deficiente de la anticoncepción en
mujeres sexualmente activas que asisten a clínicas de planificación familiar en Victo-
ria, Australia. BMC Public Health, 12(1108). http://dx.doi.org/10.1186/1471-2458-12-
1108.
Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2015). Health promotion in nursing practice
(Seventh edition ). Prentice-Hall.
Peyman, N., Hidarnia, A., Ghofranipour, F., Kazemnezhad, A., Oakley, D., Khodaee, G., &
Aminshokravi, F. (2009). Self-efficacy: Does it predict the effectiveness of contraceptive
use in Iranian women. La Revue de Santé de la Méditerranée orientale, 15(5), 1254–1262.
Prendes, L. M. C., Aparicio, A. Z., Reyes, W. G., & Lescay, M. O. (2001). Participación de los
hombres en la planificación familiar. Revista Cubana de Medicina General Integral,
17(3), 16–21.
Ramada-Rodilla, J. M., Serra-Pujadas, C., & Delclós-Clanchet, G. (2013). Adaptación cultur-
al y validación de cuestionarios de salud: revisión y recomendaciones metodológicas.
Rev. Salud Pública Mex., 55(1), 55–57.
World Organization of the United Nations (2015). Family planning Retrieved from http://
www.who.int/mediacentre/factsheets/fs351/en/.