Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, MS, RN, Chair; Kathy Shadle James, DNSc, MSN, RN; Andrea Parodi, CDR, NC, USN, DSN


Active duty, nursing, reproductive health educational program, Risky sexual behavior, Unintended pregnancy prevention, United States Navy, women


Studies have shown that a structured education program for women decreases risky sexual behavior identified as vulnerable for AIDS. However, the outcomes from a structured, repeated, educational intervention in reducing the rates of unintended pregnancies have not been studied in military females who are considered as a high risk. The purpose of this quasi-experimental longitudinal study was to implement and evaluate the effects of a reproductive health educational program regarding knowledge, attitudes, decisional balance, self-efficacy, stages of change, and contraceptive use, and to identify independent variables most likely to predict behavior change in the use of contraceptives among single, active duty women during the 4-month study period. The theoretical framework for this study was based on the proposed Contraceptive Behavior Change Model. Descriptive statistics, t-tests, contingency tables using chi square, two-way repeated measures ANOVA, regression, and correlation were used to analyze data from the sample of 104 Navy enlisted females recruited from the ships in San Diego, CA. In this study, the program was effective in increasing knowledge and repetitive intervention proved a better long-term effect in knowledge retention. A significant difference in a positive attitude change over time was seen in the experimental group, making subjects more accepting about contraception and family planning. Study variables of knowledge and stages of change correlated positively with contraceptive use, while knowledge, decisional balance measure, cons, and self-efficacy correlated with attitude. Regression analyses indicated that knowledge and stages of change over 4 months of the program explained 90% (experimental group) and 64% (control group) of the variance in contraceptive use at the end of the program. There was a decrease in sexual activity and greater use of contraceptive methods over time among sexually active individuals in the experimental group, leading to decreased unintended pregnancies. The reduced rate has the potential benefit of a significant cost-savings to the society, as well as improved mobilization readiness and quality of life for sailors and their families. In addition to implementing effective interventions to reduce unintended pregnancy, future research is needed to examine issues surrounding contraceptive non-use and/or to investigate the motivational components of adolescent pregnancy.

Document Type

Dissertation: Open Access



Included in

Nursing Commons