Original Study| Volume 29, ISSUE 1, P33-41, February 2016

Download started.


Comparisons of Contraceptive Use between Rural and Urban Teens


      Study Objective

      The purpose of the study was to determine if barriers in rural areas might decrease an adolescent’s likelihood of obtaining effective contraception. Previous studies have reported mixed results in comparisons of rural and urban contraception use.


      Electronic survey.


      Midwestern Public University.


      Undergraduate and graduate women.



      Main Outcome Measures

      Participants retrospectively recalled their contraceptive use and barriers to contraceptive use between the 9th and 12th grades.


      A Barriers to Contraception Use Scale was created using exploratory factor analysis and yielded 31 questions with 1 underlying factor: barriers. Participants were identified as rural or urban using the Office of Management and Budget (OMB) definition and the participant’s self-identification. Overall, rural participants endorsed more barriers to accessing contraceptives than urban participants using the OMB definition (χ2 (2; n = 388) = 2.04; P < .05), and self-identification (χ2 (2; n = 398) = 2.37; P < .05). However, no differences were found in contraception use according to the OMB definition, t (380) = −1.90; P = .06, or self-identification, t (380) = −2.11; P > .05. The Barriers to Contraception Use Scale total score predicted whether an individual would have a prescription for contraceptives 70.5% of the time compared to the base rate of 54.1%.


      Although no rural–urban differences in actual contraception use were found, rural participants reported more barriers to accessing contraception, and those who endorsed more barriers were less likely to obtain contraceptives while in high school. Pregnancy prevention programs should thus take these barriers into account when developing future interventions.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric and Adolescent Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Martin J.A.
        • Hamilton B.E.
        • Osterman M.J.
        • et al.
        Births: Final Data for 2013.
        Natl Vital Stat Rep. 2015; 64: 1
      1. Perper K, Peterson K, Manlove J: Diploma attainment among teen mothers. Available: Accessed August 3, 2012.

        • Manlove J.S.
        • Terry-Humen E.
        • Mincieli L.A.
        • et al.
        Outcomes for children of teen mothers from kindergarten through adolescence.
        in: Hoffman S.D. Maynard R.A. Kids Having Kids: Economic Costs and Social Consequences of Teen Pregnancy. 2nd ed. Urban Institute, Washington, DC2008: 161-220
      2. The National Campaign to Prevent Teen and Unplanned Pregnancy. National & State Data. Available: Accessed March 12, 2015

        • Hacker K.A.
        • Amare Y.
        • Strunk N.
        • et al.
        Listening to youth: teen perspectives on pregnancy prevention.
        J Adolesc Health. 2000; 26: 279
        • Noone J.
        • Young H.M.
        Preparing daughters: the context of rurality on mothers’ role in contraception.
        J Rural Health. 2009; 25: 282
        • Buzza C.
        • Ono S.S.
        • Turvey C.
        • et al.
        Distance is relative: unpacking a principal barrier in rural healthcare.
        J Gen Intern Med. 2011; 26: 648
        • Wagenfeld M.O.
        A snapshot of rural and frontier America.
        in: Stamm B.H. Rural Behavioral Health Care. American Psychological Association, Washington, DC2003: 33-40
        • Finley C.
        • Stewart A.
        Working with rural teens: adolescent reproductive health in rural america. Presented at the Third Annual Teen Pregnancy Prevention Grantee Conference May 20, 2013–May 22,.
        2013 (National Harbor, MD)
      3. Ng AS, Kaye K: The National Campaign to Prevent Teen and Unplanned Pregnancy. Science Says #47: Teen Childbearing in Rural America. Available: Accessed March 12, 2015

        • Tabachnick B.G.
        • Fidell L.S.
        Using Multivariate Statistics.
        Pearson, Upper Saddle River, NJ2013
        • Aquilino M.L.
        • Bragadottir H.
        Adolescent pregnancy: teen perspectives on prevention.
        MCN Am J Matern Child Nurs. 2000; 25: 192
        • Mulder P.L.
        • Shellenberger S.
        • Streiegel R.
        Adolescent Pregnancy Study Focuses on Rural Youth: Rural Teen Pregnancy As Prevalent As Urban.
        University of North Carolina at Chapel Hill, Chapel Hill, NC1996
        • Mohatt D.F.
        • Bradley M.M.
        • Adams S.J.
        • et al.
        Mental Health and Rural America: 1994-2005.
        U.S. Department of Health and Human Services, Washington (DC)2005