Contraceptive Utilities, Intention, and Knowledge Scale

Abstract

The Contraceptive Utilities, Intention, and Knowledge Scale (CUIKS) is a psychological instrument designed to assess factors influencing women’s contraceptive choices and behaviors. Developed by Larry Condelli (1984), the CUIKS tests a comprehensive social psychological model that integrates three foundational theories: the Health Belief Model, Luker’s model of contraceptive risk-taking, and the Theory of Reasoned Action/Planned Behavior (behavioral intention model).

The scale is divided into three distinct parts: Part one measures perceived likelihood of pregnancy, attitudes toward pregnancy, and subjective social support for contraceptive use; Part two assesses attitudes regarding the effectiveness, convenience, and side effects (minor and major) of four specific contraceptive methods (diaphragm, IUD, the pill, and condoms); and Part three is a multiple-choice knowledge test covering both general conception knowledge and specific knowledge related to the respondent’s chosen birth control method. The CUIKS is suitable for use with diverse populations of women, having been validated in a family planning clinic setting.

Keywords

Contraceptive behavior, Social psychology, Health Belief Model, Behavioral intention, Contraceptive knowledge, Perceived susceptibility, Family planning, Contraception, Attitude survey

Authors

Larry Condelli

Purpose

The primary purpose of the CUIKS is to empirically test a unified social psychological framework of contraceptive behavior. This framework seeks to explain why women choose certain contraceptive methods and how reliably they intend to use them.

Beyond testing the unified model, the scale serves as a comprehensive tool to measure specific constructs pertinent to contraceptive usage, including women’s perceptions of various methods, their personal attitudes about pregnancy, and their objective knowledge base regarding conception and birth control efficacy.

Construct

The CUIKS is designed to measure several key constructs derived from established social psychological models, focusing on determinants of behavioral intention and subsequent behavior. The main constructs measured include:

• Perceived Susceptibility: The perceived likelihood of becoming pregnant both with and without using a chosen contraceptive method (Items 1 and 4).
• Intention to Use Contraception: The self-reported likelihood of using the chosen method during every act of intercourse over a defined future period (Item 3).
• Perceived Severity: The respondent’s attitude toward or perceived severity of becoming pregnant at the present time (Item 5).
• Subjective Normative Support: The degree of social support expected from important people regarding the use of specific contraceptive methods (Item 6).
• Attitudinal Beliefs: Perceptions of effectiveness, convenience, and concerns about minor and major side effects across various methods (Items 7 and 8).
• Knowledge: Both general knowledge of conception and specific knowledge of the respondent’s primary birth control method.

Validity

The validity of the CUIKS was established through its ability to significantly predict prospective contraceptive behavior and choice of method. Condelli (1984) employed multiple regression analysis using key scale items (1, 5, 6, 7, and 8) as predictor variables against four measures of contraceptive behavior collected approximately six months after scale completion.

The behavioral measures successfully predicted included whether the respondent had unprotected intercourse (R = .21), frequency of contraceptive use (R = .36), period of time sexually active without contraception (R = .42), and ranked actual effectiveness of the chosen method (R = .38). All multiple R values were statistically significant (p < .05). Furthermore, a discriminant function analysis (Condelli, 1986) demonstrated the scale’s ability to distinguish between women who chose the pill versus those who chose the diaphragm, accounting for over 60% of the variance between these groups based on beliefs about convenience, side effects, and knowledge level.

Reliability

Reliability assessment was specifically focused on the knowledge portion of the scale. Using responses from 632 women from a suburban family planning clinic, Condelli (1986) reported the Kuder Richardson 20 (KR-20) coefficient for the total knowledge scale was .62.

The author noted that this reliability index is considered somewhat low, which is attributed to the broad and varied nature of the topics covered within the knowledge subscales (general conception information alongside method-specific details).

Factor Analysis

The provided source content does not include information regarding a formal factor analysis of the CUIKS structure (Parts 1 and 2). The scale’s development was theoretically driven, combining elements from established models like the Health Belief Model and the behavioral intention model, rather than relying solely on psychometric factor derivation.

Instrument

Test Type: Self-report scale and objective knowledge test (Multiple Choice)

Format: Mixed format (Likert-type scales for attitudes/intentions, multiple choice for knowledge)

Language Available: English (Original development language)

Population Group: Women

Age Group: Not strictly defined, but tested on women of diverse ages.

Population Details: Tested on over 600 women with highly diverse age and educational backgrounds visiting a family planning clinic.

Test Methodology: Self-administered, individually or in a group setting. Responses are indicated by circling numbers (for attitudes) or letters (for knowledge). Completion time averages 15 minutes.

Keywords

CUIKS, Larry Condelli, Contraceptive intention, Risk perception, Sexual health, Subjective norm, Psychometrics, Attitude

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: [email protected]

Correspondence Address: Larry Condelli, American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007

Permissions & Fee and Test Year

The CUIKS may be copied and used without cost, provided appropriate citation is given to the author and original publications.

The scale was developed and initially tested around 1984 (Condelli, 1984 dissertation) and published in 1986 (Condelli, 1986).

Reference’s

Condelli, L. (1984). A unified social psychological model of contraceptive behavior. Unpublished doctoral dissertation, University of California, Santa Cruz.

Condelli, L. (1986). Social and attitudinal determinants of contraceptive choice: Using the health belief model. The Journal of Sex Research, 22, 478–491.

Fishbein, M., & Ajzen, I. (1975). Belief attitude intention and behavior: An introduction to theory and research. Reading, MA: Addison Wesley.

Kirby, D. (1979). An analysis of U.S. sex education programs and evaluation methods. Washington, DC: U.S. Department of Health, Education, and Welfare.

Luker, K. (1975). Taking chances: Abortion and the decision not to contracept. Berkeley, CA: University of California Press.

Rosenstock, I. (1974). The health belief model and preventive health behavior. Health Education Monographs, 2, 354–386.

Items of the Contraceptive Utilities, Intention, and Knowledge Scale

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The Contraceptive Utilities, Intention, and Knowledge Scale

Attitude Survey

1. If you were not to use birth control, how likely do you think it is that you would become pregnant during the next year? (Circle one category)

   1	2	3	4	5
   Very	Somewhat	Neutral	Somewhat	Very
   unlikely	unlikely	neither likely	likely	likely
   		or unlikely

2. What form of birth control have you chosen to use?                            

3. How likely do you think it is that you will use the above method every time you have intercourse over the next year?

   1	2	3	4	5
   Very	Somewhat	Neutral	Somewhat	Very
   unlikely	unlikely	neither likely	likely	likely
   		or unlikely

4. If you were to continue using this form of birth control, how likely do you think it is that you would become pregnant during the next year? (Circle one category)

   1	2	3	4	5
   Very	Somewhat	Neutral	Somewhat	Very
   unlikely	unlikely	neither likely	likely	likely
   		or unlikely

5. Below are a number of statements about how you might feel about becoming pregnant within the next year. Please place a check in front of the one that best represents how you feel. (Check one only)

   If I were to get pregnant within the next year:

        It would be the worst thing that could happen to me.

        It would be very bad.

        It would be sort of bad but not terrible.

        It would be O.K.

        It would be sort of good but not terrific.

        It would be very good.

        It would be the best thing that could happen to me.

6. People who are important to you may have feelings about the type of birth control you might use. For each birth control method below, please indicate how the people who are most important to you would feel about your using that form of contraception. (Circle the number from 1–5 that best represents their feelings.)

   They would be:

   1 = Very much opposed (would discourage use) 2 = Somewhat opposed

   3 = Neither opposed nor in favor (neutral) 4 = Somewhat in favor

   5 = Very much in favor (would encourage use)

   Foam/condoms	1	2	3	4	5
   Diaphragm	1	2	3	4	5
   IUD	1	2	3	4	5
   Birth control pills	1	2	3	4	5

7. Different birth control methods vary in how effective or ineffective they are in preventing pregnancy. They also vary in how convenient they are to use. For each birth control method listed below, please rate how effective you think they would be in preventing you from becoming pregnant, and how convenient or inconvenient they would be for you to use. (Circle the number from 1–5 that best represents your feelings).

   1 = Very effective 1 = Very convenient (definitely prevents pregnancy) (no trouble at all)

   2 = Pretty effective 2 = pretty convenient

   3 = Unsure 3 = Unsure

   4 = Pretty ineffective 4 = Pretty inconvenient

   5 = Ineffective 5 = Very inconvenient

   (would not prevent pregnancy) (too much trouble to use)

   Effectiveness Convenience

   Foams/condoms	1	2	3	4	5	1	2	3	4	5
   Diaphragm	1	2	3	4	5	1	2	3	4	5
   IUD	1	2	3	4	5	1	2	3	4	5
   Birth control pills	1	2	3	4	5	1	2	3	4	5

8. Different forms of birth control vary in terms of how likely they are to have side effects. Some side effects may be minor, such as irritation of or skin problems, while others may be major, such as increasing risk of serious illness. For each method of birth control below, please rate how concerned you would be about the occurrence of both minor and major side effects. (Circle the number from 1–5 that best represents your feelings.)

1 = Not at all concerned 2 = Slightly unconcerned 3 = Unsure

4 = Pretty concerned 5 = Very concerned

Minor side effects Major side effects

Knowledge Survey

Circle the correct response.

The pill:

1. *prevents ovulation
2. keeps cervical mucus very thin
3. changes the lining of the uterus to make implantation unlikely
4. both a & c
5. all of the above

According to the most accepted current thought, the IUD’s effectiveness is due to:

1. changing levels of hormones
2. changed functioning of the fallopian tubes
3. *preventing implantation of the fertilized egg
4. preventing ovulation
5. all of the above

A diaphragm should be used:

1. without any cream or jelly
2. with any type of lubricant
3. *with spermicidal jelly or cream inside it
4. either with or without spermicidal jelly

Contraceptive foam is most effect in preventing pregnancy when inserted inside the vagina:

1. * right before intercourse
2. 2–4 hours before intercourse
3. right after intercourse
4. all of the above

The use of a condom when having sexual intercourse is recommended because:

1. if used right, it usually prevents getting or giving gonorrhea
2. it can be bought in a drug store by both men and women
3. it does not have dangerous side effects
4. *all of the above

A woman can get pregnant:

1. a few minutes after sexual intercourse
2. a few hours after sexual intercourse
3. a few days after sexual intercourse
4. *all of the above
5. a and b

Over a one year period, what is the likelihood that a sexually active woman who uses no birth control will become pregnant?

1. 1 in 10
2. 5 in 10
3. 7 in 10
4. *9 in 10

A woman is most likely to become pregnant (no matter how long or short her menstrual cycle) if she has sexual intercourse about:

1. 1 week before menstruation begins
2. 2 weeks after menstruation begins
3. *2 weeks before menstruation begins
4. 1 week after menstruation begins

Answer these questions only if you decided on the pill as your primary method of birth control.

Some warning signs that may signal the onset of pill related problems are:

1. chest pain
2. yellowing of the skin
3. pain in the calf of the leg
4. * all of the above
5. none of the above

Medical conditions that make it dangerous for a woman to use the pill are:

1. high blood pressure
2. heavy smoking
3. diabetes
4. both a & b
5. * all of the above

Present evidence indicates that the most serious side effect of the pill is:

1. cancer
2. * blood clotting problems
3. chloasma
4. nausea
5. creating permanent sterility

Which of the following group of women has the highest risk of side effects if they use the pill?

1. women who have never had children
2. *. women over 40 who smoke
3.  women who have severe menstrual cramps and are 10–20 lbs. overweight
4. women who have been on the pill for more than 5 years.

This completes the survey. Thank You!

Answer these questions only if you have decided on the diaphragm as your primary method of birth control.

1. After intercourse, a diaphragm:

   a. should be removed immediately to prevent infection

   b. can be taken out after 2 hours

   *c. must be left in place for at least 8 hours

   d. must be left in place for at least 12 hours

2. A problem that may result from using a diaphragm is:

   a. increased pelvic infection

   b. increased cervical infection

   *c. increased urinary tract infection

   d. all of the above

   e. none of the above

3. When a diaphragm is properly in place:

   *a. the woman will not be able to feel it

   b. the woman will be able to feel it

   c. both partners will be able to feel it

   d. both b & c

4. A diaphragm must be fitted by a health professional because:

   1. the risk of complication is high

   2. *b. it must fit properly over the cervix

   3. it is a difficult and risky medical procedure

   4. all of the above

   5. both a and b

This completes the survey. Thank You!

Answer these questions only if you have decided on the foam and/or condoms as your primary method of birth control.

1. The actual user effectiveness rate of foam and condoms is equal to or better than the actual user rates of:

   1. an IUD

   2. a diaphragm

   3. the pill

   4. *all of the above

   5.  none of the above

2. To use a condom correctly, a person must:

   1. leave some space at the tip for the sperm

   2. use one every time sexual intercourse occurs

   3. hold it on the penis while withdrawing from the vagina

   4. *. all of the above

3. When having sexual intercourse, the use of both contraceptive foam and condoms is recommended because:

   1. the man and the woman are sharing the responsibility for avoiding pregnancy

   2. the woman is less likely to become pregnant than if only one of these is used

   3. they can both be purchased at the drug store without prescriptions

   4. *. all of the above

   5.  a and c

4. Contraceptive (birth control) foam is most effective for the repeated acts of sexual intercourse:

   1. if a single application is used

   2. *. if an additional application is used before each act of sexual intercourse

   3. if a woman douches after each act of intercourse

   4. all of the above

   5. b and c

This completes the survey. Thank You!