Adolescent dual method use: relevant attitudes, normative beliefs and self-efficacy.

PURPOSE: To encourage dual contraceptive method use--protection from both STD and pregnancy--health behavior change efforts must target powerful risk and protective factors that are amenable to change. This study examines longitudinal relationships between adolescents' contraceptive-related cognitions and dual method use.
METHODS: Data are from 1123 sexually active 7-11th-grade participants in the National Longitudinal Study of Adolescent Health, Waves 1 and 2 (W1, W2). A series of nested path models examined relationships between participants' contraceptive use level at most recent intercourse (zero, one, two methods) and contraceptive-related cognitions. Parallel analyses were completed with four grade/gender groups.
RESULTS: Dual method use at most recent intercourse ranged from 14.3% to 25.0%. Path models suggested that contraceptive use levels and contraceptive-related cognitions were moderately stable over time. Cross-sectionally, contraceptive use level was associated with parent approval of birth control (older youth, younger girls), birth control attitudes (older youth, younger boys), perceived pregnancy consequences (older youth), perceived sexually transmitted disease risk (older girls), perceived benefits of sex (younger girls), and contraceptive self-efficacy (older youth). W1 father approval of birth control (younger girls), mother disapproval of sex (older girls), and birth control attitudes (older boys) predicted W2 contraceptive use levels. W1 contraceptive use levels predicted several W2 cognitions among older youth.
CONCLUSIONS: Sexually active adolescents' perceptions of parent expectations about sex and contraception have important links to dual method use. Adolescents' attitudes about practical, social, and moral implications of using birth control are also linked to their use of dual contraceptive methods.