Role of acculturation on oral contraceptive use among Korean immigrant women
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The current dissertation study was formatted as a manuscript style and consisted of three unified, journal-ready manuscripts. Manuscript I and II correspond to a systematic review of the literature on attitudes toward oral contraceptive (OC) use among women of reproductive age and the relationship of acculturation with contraceptive use patterns among immigrants, respectively. Manuscript III corresponds to the main dissertation study that was conducted to explore the role of acculturation on OC use among Korean immigrant women. It was specifically aimed to explore the effect of acculturation on attitudes, subjective norms, and intention, with regard to OC use in this population. For the most part, manuscript III presents the methodology of this empirical dissertation study, including the design and methods, statistical analysis, and findings. The Theory of Reasoned Action (TRA; Ajzen & Fishbein, 1980), incorporated with the concept of acculturation, provided the theoretical framework for this study. A random sample of 146 Korean immigrant women was selected from the five boroughs (Queens, Manhattan, Brooklyn, the Bronx, and Staten Island) of the City of New York, based on Korean surname-based telephone lists. Data were collected using a telephone survey interview from September 2006 to February 2007. Participants were asked to respond to demographic and OC use history questionnaires, Suinn-Lew Asian Self-Identify Acculturation Scale (SL-ASIA: Suinn, Rickard-Figueroa, Lew, & Vigil, 1987), and Lee's Oral Contraceptive Use Scale (LOCUS) with five subscales. Pearson correlations, multiple regressions, and hierarchical regression analyses were conducted to evaluate the hypotheses formulated by a modified version of the TRA model. In general, participants reported low to moderate levels of acculturation. Their attitudes toward OC use were slightly positive, whereas normative pressure and intention to use OCs tended to be negative. The results of analysis revealed that acculturation explained some of the variance in attitudes, subjective norms, and intention to use OCs. Women who were moderately acculturated, as opposed to those who were low acculturated, tended to believe that OC use would lead to positive outcomes and evaluated positively the act of using OCs. In turn, these women held a more favorable attitude toward OC use. In addition, the more acculturated women were, the more likely they were to perceive social pressure to and intend to use OCs. Nevertheless, the findings should be carefully interpreted in that only small portions (i.e., 3 - 6%) of the variances in attitudes, subjective norms, and intention were accounted for by acculturation. This might be due to the low variability in acculturation scores (1.7 to 3.5) obtained in this study. To capture the full scope of acculturation on OC use, future studies must include participants with a broader range of acculturation, including Korean American whose acculturation levels differ substantially from immigrants'.