Mediation Analysis of Barriers and Attitudes in the Nexus Between Adolescent Contraceptive Knowledge and Use: A Cross-Sectional Study in Ho, Volta Region

IF 1.8 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Social Care in the Community Pub Date : 2026-10-13 DOI:10.1155/hsc/4658108

David Adedia, Faith Klinogo, Felix Kwesi Nyande, Vincent Uwumboriyhie Gmayinaam, Sandra Amoateng Marfo, Stephen Agyemaneg, Isaac Baabon, Emmanuel Nkrumah, Victoria Efua Quansah, Joseph Opoku Cobbinah, Nimatu Yahaya, Isaac Menokuu Kelle, Rosemary Komeh Tetteh, Franklina Magblemdio Logodzo, Hubert Amu

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引用次数: 0

Abstract

Background

Despite the high prevalence of pregnancies and births among adolescents, contraceptive uptake remains low, particularly in low- and middle-income countries like Ghana. To understand how knowledge of contraceptives translates into actual contraceptive use among adolescents, the mediation effects of barriers and attitudes were examined.

Methods

We conducted a cross-sectional survey of 841 adolescents aged 10–19 years residing in Ho Municipality, using a structured, validated questionnaire. A path model was fitted to estimate the direct and indirect effects of knowledge on contraceptive use via barriers and attitudes, using a two-tailed significance level of 5%.

Results

The sample comprised 516 female participants (61.4%) and 325 male participants (38.6%); median age was 16 years (IQR 14–18). Knowledge correlated positively with contraceptive use (r = 0.693, p < 0.001) and negatively with barriers (r = −0.246, p < 0.001). In the path model (CFI = 1.00, TLI = 1.00, RMSEA = 0.00, SRMR = 0.00), knowledge had a significant direct effect on contraceptive use (β = 0.67, p < 0.001) and an indirect effect via barriers (β_indirect = 0.013, p = 0.046). Barriers directly reduced contraceptive use (β = −0.06, p = 0.036). The indirect effect via attitudes was not significant (β_indirect = −0.013, p = 0.068).

Conclusion

Our findings demonstrate that knowledge fosters contraceptive use primarily by mitigating barriers rather than through attitude change alone. Interventions should therefore combine comprehensive contraceptive education with strategies to reduce access and social barriers among adolescents. This emphasizes the importance of addressing and mitigating barriers to enhance the effectiveness of knowledge-based family planning programmes towards achieving SDGs 3 and 5, such that women of reproductive age could have their family planning needs met.

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青少年避孕知识与使用之间关系的障碍和态度的中介分析：一项在Ho， Volta地区的横断面研究

背景尽管青少年怀孕和分娩的流行率很高，但避孕药具的使用率仍然很低，特别是在加纳等低收入和中等收入国家。为了了解避孕知识如何转化为青少年实际使用避孕药具，研究了障碍和态度的中介作用。方法采用结构化的、有效的问卷，对何市841名10-19岁的青少年进行了横断面调查。我们拟合了一个路径模型，通过障碍和态度来估计知识对避孕药具使用的直接和间接影响，使用双尾显著性水平为5%。结果女性516人（61.4%），男性325人（38.6%）；中位年龄16岁（IQR 14-18）。知识与避孕措施的使用呈正相关（r = 0.693, p < 0.001），与障碍呈负相关（r = - 0.246, p < 0.001）。在路径模型（CFI = 1.00, TLI = 1.00, RMSEA = 0.00, SRMR = 0.00）中，知识对避孕措施的使用有显著的直接影响（β = 0.67, p < 0.001），并通过障碍产生间接影响（β_indirect = 0.013, p = 0.046）。障碍直接减少了避孕措施的使用（β = - 0.06, p = 0.036）。态度的间接影响不显著（β_indirect = - 0.013, p = 0.068）。结论：我们的研究结果表明，知识促进避孕措施的使用主要是通过减少障碍，而不是仅仅通过态度的改变。因此，干预措施应将全面避孕教育与减少青少年获得避孕机会和社会障碍的战略结合起来。这强调了解决和减轻障碍的重要性，以提高以知识为基础的计划生育规划在实现可持续发展目标3和5方面的有效性，从而使育龄妇女的计划生育需求得到满足。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health & Social Care in the Community Multiple-

CiteScore

4.50

自引率

8.30%

发文量

423

期刊介绍： Health and Social Care in the community is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health economy, primary health care and the promotion of health. It is an international peer-reviewed journal supporting interdisciplinary collaboration on policy and practice within health and social care in the community. The journal publishes: - Original research papers in all areas of health and social care - Topical health and social care review articles - Policy and practice evaluations - Book reviews - Special issues