Date of Award

May 2016

Degree Type


Degree Name

Master of Science



First Advisor

Diane M. Reddy

Committee Members

Raymond Fleming, Susan Lima


Contraception, Contraceptive Knowledge, Medical Mistrust, Pregnancy, Social Influence


Despite evidence that social referents could be influencing hormonal contraceptive decisions in adult women, the current research has done little to investigate this area. The purpose of the current work was to begin to identify whether women’s hormonal contraceptive decisions may be influenced by their social referents’ support for hormonal contraceptive use and social referents’ contraceptive behaviors. Sexually active women (n=194), aged 18-34, completed an online survey examining their sources of contraceptive information, feelings towards pregnancy, contraceptive use/preferences, contraceptive knowledge, and medical mistrust. In addition to this, as part of the survey they identified three important women in their lives and provided information on their perception of each social referent’s contraceptive use and support for contraceptives. Participants also listened to one of four audio vignettes where a doctor character and a friend character each provided either positive or negative support for a fictitious hormonal contraceptive. Participants rated their attitudes towards the fictitious contraceptive after listening to the vignette. It was hypothesized that participants’ perception of the social referents’ support of their personal hormonal contraceptive use and participants’ perceptions of referents’ hormonal contraceptive behaviors would impact the odds that participants used hormonal contraceptives at last intercourse, but that this relationship would be moderated by contraceptive knowledge. It was also hypothesized that individuals who received conflicting information about a fictitious hormonal contraceptive from the physician and friend characters in the audio vignettes (with one for the contraceptive use, the other against) would hold different contraceptive attitudes when compared to those who heard both characters agree about the contraceptive. It was expected that the relationship between vignette condition and attitudes towards the fictitious contraceptive would be moderated by medical mistrust.

A number of participants identified social referents as sources of contraceptive information with 35.1% listing mothers and/or female guardians as a source, 23.2% listing their best friend, 22.7% listing friends, and 12.9% listing their sisters. In a logistic regression, social referents’ perceived support of hormonal contraceptive use was found to increase the odds that the women reported using hormonal contraceptives at last sexual intercourse. Social referents’ perceived contraceptive behaviors and participants’ contraceptive knowledge scores were not found to be related to participants’ contraceptive use at last sexual intercourse. Hierarchical regressions investigating the outcomes of the audio vignettes suggested that the friend and physician characters’ contraceptive support is statistically related to attitudes towards the fictitious contraceptive; however, the relationship between the vignette conditions and contraceptive attitudes was moderated by participants’ levels of medical mistrust. These findings point towards social referents as a potential influence on hormonal contraceptive decision-making in adult women. Future research is warranted to better determine and understand the role of social referents in hormonal contraceptive decision-making.