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Statement of the problem/topic of the research or creative work
This proposed project will examine the knowledge, awareness, perceptions and behaviors associated with contraceptive use in college students in both Vietnam and in the US (United States). A contraceptive is defined in the Merriam-Webster dictionary as ‘deliberate prevention of conception or impregnation’. Contraceptives are part of a broader topic of family planning which is defined as, ‘allowing people to attain their desired number of children and determine the spacing of pregnancies’ (WHO, 2018). Family planning is achieved through the consistent and correct usage of contraceptives (Tran, 2018). This is increasingly important in a time where the autonomy of a woman is vital to her economic, occupational, educational and physical well-being, along with the success of the family and community she lives in as well (Singh, 2010).
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This project is important because assessing the knowledge, perceptions, awareness, and behaviors of college students can allow both Universities in their perspective countries to determine how to better educate their students about contraceptives and family planning. The data collected from these surveys will allow us to determine the amount of high awareness and low awareness students. This can give insight into what aspects of education, access, and on campus resources need to be added or improved to further serve their students. This can allow the University to create an environment where students are well-informed, and able to take action in their individual family planning methods.
Another potential contribution of this research is to add to the growing literature surrounding contraceptive awareness, perceptions, and behaviors in college student populations in both the US, and in Vietnam. This is an area of research that has increasing significance as is continues to be a controversial subject in political and social spheres (Guttmacher, 2018).
Relevant background/literature review
Family planning is an extremely important aspect of public health, and has long-lasting and far-reaching effects on all demographics of a population (Guttmacher, 2018). Access to contraception has allowed women to avoid 187 million unintended pregnancies each year (Ahmad, 2015). Women in the US spend on average of 30 years of their life avoiding pregnancy for various reasons, and doing this without any contraceptives has an 85% failure rate (Guttmacher, 2018). Contraceptives have been widely accepted as the best way to allow women, families, and societies flourish as children are spaced out when desired, and not when unplanned. Unplanned or unintended pregnancies can be further broken down into mistimed but still wanted pregnancies, and unwanted pregnancies. Both carry consequences, but unwanted brings forth more challenges and obstacles.
Unintended pregnancies are linked to issues like higher rates of maternal mortality, child mortality, abortion, poverty, and violence in the home (Guttmacher, 2018). It also has broad communal consequences, like a 21 billion dollar hit on the US economy in 2010 (Guttmacher, 2018). Unplanned pregnancies also take away a woman’s opportunity to get an education and enter the workforce (Singh, 2010). These outcomes can be prevented by effective family planning services including increased education, access, and costs of contraceptive methods.
College students in particular are a group that fit the mold for a definition of people who want to avoid pregnancy. Most importantly they are in the age group from 14-44 which is the reproductive age for a woman. The age group that is most at risk for an unintended pregnancy is the 15-19 age group at 18%, which includes many college students (Guttmacher, 2018). Trends are showing that young women are getting married later, pursuing more long-term education at higher rates, and having sex before marriage more frequently (Pachauri, 2003). This all means more time where a woman does not want an unplanned pregnancy to occur. This group can benefit greatly from contraceptive knowledge, and access, and a place like a University is a great place to offer this.
Potential barriers for this study include embarrassment and stigma related to sensitive subjects such as sex and family planning. Barriers in the US and Vietnam will likely be different relating to the different cultures and education provided by the respective country. Most current studies on contraceptives in Vietnam still use data from a 1997 survey, so new data on the subject will be quite valuable to see how far the country has progressed in it’s family planning services (Pachauri, 2003).
Survey Instrument Development
The survey instrument that will be used for this study has been previously used by studies in Vietnam (Tran, 2018) and in Malaysia (Ahmad, 2015). The questionnaire is separated into 4 different sections that include demographic information about participants, an evaluation of the participants knowledge on contraceptives, the perception of contraceptives, and the behaviors exhibited by these students. The answers to the survey will be assessed using a five-point Likert scale. The scale ranges from 1 = strongly disagree, 2 = disagree, 3 = not sure, 4 = agree, to 5 = strongly agree. Reverse coding will be performed for negatively worded questions. Participants with a score of ≥ 25 will be considered to exhibit a high level of awareness, those with a score of < 25 will be considered to have low awareness (Tran, 2018). Surveys will be translated to Vietnamese for the Vietnamese students, and sociodemographic questions like religion and ethnicity will be changed to more relevant options depending on the country.
Section (1): The sociodemographic characteristics of the participants.
Gender, Ethnic group, Religion, marital status, major, age.
Section (2): Evaluation of knowledge regarding contraceptive methods.
- Have you ever heard of contraceptive methods?
- The risk of breast cancer is increased in women taking estrogen‑containing oral contraceptives.
- Male condoms can protect against STDs.
- It is safe to have sex during the period of infertility.
- The common unwanted effects of birth control pills are weight gain and mood swings.
- A woman will not get pregnant within at least 2 months after having stopped taking birth control pills.
- The risk of some types of cancer in women can be reduced using oral contraceptives.
- To get birth control pills, a woman must undergo a pelvic examination.
Section (3): Statements about the participants’ awareness regarding contraception
- Only women take responsibility for using contraceptive methods.
- Contraceptive methods are more harmful than beneficial to health.
- Contraceptive methods can protect the health of family and society.
- The use of contraceptive methods in young people will increase the risk of infertility in the future.
- Contraceptive pills do not 100% guarantee avoidance of pregnancy.
- Women’s experiences of unwanted effects are related to change to a safer form of contraceptive.
- Discussion about contraception with a spouse is embarrassing.
Section (4): Perceptions and behavior in relation to contraceptives.
- It is unnecessary to purchase contraceptives.
- It is embarrassing to ask for condoms from pharmacies, conventional shops, or dispensaries.
- Using condoms will generate less sexual pleasure during intercourse.
- Changes in male attitudes mean that increased participation in contraception may increase the usage rate of contraception in some areas
- Contraceptives can reduce the fear of unwanted pregnancy and afford woman the freedom to enjoy a sexual relationship.
- Contraceptives allow women to pursue higher education by delaying pregnancy and therefore help them to achieve some measure of economic security.
- It is complicated to apply contraceptive methods.
- Sex education, including contraception, should be introduced at an early age.
- Health‑care providers must provide counseling about contraceptive methods, the mechanism of action, the best time to use them, and possible side effects to all women.
Specific activities to be undertaken and a timetable allotted for each activity
The cross-sectional data will be collected using a self-administered survey during the Spring semester of 2019 at a national university in Vietnam and a state university in the US. The Vietnamese university is located in a large city and has approximately 22,000 students. The US university is located in a metropolitan area, and it has about 32,000 students. Before data collection can begin, the Institutional Review Board (IRB) of the US university will need to approve this study. Proper protocol will be done to ensure ethics are well respected in Vietnam, where there is no IRB for the university. Coordination with the collaborators in Vietnam will also need to approve the final study design.
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Participants will be undergraduate students enrolled and attending a social science-related class. Consent will be obtained from each participant before the survey is self-administered. Undergraduate students will be given a consent cover letter and paper survey in class, and turn in the survey during or after class. No identifiable information will be collected. The survey instrument will be translated into Vietnamese from English for participants in Vietnam. The survey will be forward-translated from English to Vietnamese by a translator, and will be back-translated by another translator into English. No compensation will be offered to any participants.
Fall 2018: Survey instrument developed, IRB application.
Spring 2019: IRB approved, Data collection and analysis. Manuscript preparation, and conference presentation.
Spring/ Summer 2019: Ideally apply for publishing of the final study.
Relationship of the proposed work to the student’s future goals
This proposed research opportunity would provide me the incredible opportunity of planning, facilitating, and writing my own research project. I have now been a part of several studies, but none were on a topic that I came up with myself. To be able to study a topic that I chose and see the actual study take place will be an incredible learning experience for an undergraduate student such as myself. Women’s health, and reproductive rights more specifically are what I am most passionate about, so being able to have a hand in contributing to the literature on this subject would be an honor.
At this point in my educational career I am looking to apply to sociology PhD programs next year, so gaining more research experience would not only be internally fulfilling, but also academically valuable. Health research is something that I have really enjoyed as an undergraduate, and something that I will continuing doing into my future career. Having a clear example of the research I am interested in being a part of and proof of my dedication to topics and projects I am passionate about will prove invaluable through my application processes. To be able to provide data on my own University’s students would also be very fulfilling, as contraceptive access and choice are things that I feel are essential to the future success of academic women like myself.
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