A Structural Equation Modeling on Reproductive Health Promoting Behavior of Unmarried Women: Based on the Theory of Planned Behavior

Eun Mi Ji; So Young Choi; Nam Joo Je

doi:10.4069/kjwhn.2016.22.4.210

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Ji, Choi, and Je: A Structural Equation Modeling on Reproductive Health Promoting Behavior of Unmarried Women: Based on the Theory of Planned Behavior

Original Article

Korean Journal of Women Health Nursing 2016; 22(4): 210-220.

Published online: 27 December 2016

DOI: https://doi.org/10.4069/kjwhn.2016.22.4.210

A Structural Equation Modeling on Reproductive Health Promoting Behavior of Unmarried Women: Based on the Theory of Planned Behavior

Eun Mi Ji¹, So Young Choi², Nam Joo Je³

¹Department of Nursing, Han Yeong College, Yeosu, Korea.

²College of Nursing · Institute of Health Science, Gyeongsang National University, Jinju, Korea.

³Department of Nursing, Gyeongju University, Gyeongju, Korea.

Corresponding author: Choi, So Young. College of Nursing, Gyeongsang National University, 15 Jinju-daero, 816 beon-gil, Jinju 52727, Korea. Tel: +82-55-772-8241, Fax: +82-55-772-8209, css4214@gnu.ac.kr

Received 6 July 2016 Revised 25 November 2016 Accepted 30 November 2016

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to construct and test a structural equation modeling on the reproductive health behavior of single women with sexual experiences. This study employed Ajzen's Theory of Planned Behavior (TPB).

Methods

The data were collected after receipt of consent from 250 single women with sexual experiences, and analyzed using SPSS 18.0 and AMOS 18.0.

Results

Model fit indices for the hypothetical model were suitable for the recommended level: x²=362.407, RMR=0.065, RMSEA=0.070, GFI=0.867. TLI=0.927, CFI=0.938, IFI=0.939, and x²/dF=2.237. Intention showed direct effect with the biggest effect being on reproductive health behavior. Attitude, subjective norm and perceived behavioral control were found to have a direct effect on intention. Among them, perceived behavioral control revealed the largest influence.

Conclusion

This study suggests that the TPB is a suitable model in explaining the reproductive health behavior of single women with sexual experience. Strategic plans for educational and intervention programs should be aimed to encourage single women to engage in reproductive health behavior.

Keywords: Reproductive Health, Behavior, Unmarried, Women

Figures and Tables

Figure 1

Conceptual framework based on a structural model of Ajzen.

Figure 2

Hypothetical model.

Figure 3

Path diagram for the hypothetical model.

Table 1

General Characteristics of Participants

Characteristics	Categories	n (%) or M±SD
Age (yr)		30.30±5.11
	20~29	111 (44.4)
	30~39	139 (55.6)
Residence	Seoul	130 (52.0)
	Geonggi-do	67 (26.8)
	Chungcheong-do	13 (5.2)
	Jeolla-do	14 (5.6)
	Gyeongsang-do	26 (10.4)
Job	Office worker	182 (72.8)
	Graduate/post graduate	41 (16.4)
	No	27 (10.8)
Religion	Yes	79 (31.6)
Religion	No	171 (68.4)
Sleep (hours)	≤5	30 (12.0)
	6~8	211 (84.4)
	≥9	9 (3.6)
Incomes (10,000 won)	<100	46 (18.4)
	100~<200	104 (41.6)
	200~<300	74 (29.6)
	≥300	26 (10.4)
Education	Middle school	2 (0.8)
	High school	29 (11.6)
	College	38 (15.2)
	Graduate	181 (72.4)
Alcohol	Yes	177 (70.8)
Alcohol	No	73 (29.2)
Smoking	Yes	40 (16.0)
Smoking	No	210 (84.0)
Living	With family	172 (68.8)
	Oneself	64 (25.6)
	Dormitory	6 (2.4)
	With partner	7 (2.8)
	Others	1 (0.4)
Menarche (yr)		13.12±1.80
The dating	Now	149 (59.6)
The dating	Past	101 (40.4)
Pregnancy experience	Yes	28 (11.2)
Pregnancy experience	No	222 (88.8)
Artificial abortion	Yes	24 (85.7)
Artificial abortion	No	4 (14.3)
Reproductive education	Yes	188 (75.2)
Reproductive education	No	62 (24.8)

Table 2

Effects of Hypothetical Model

Endogenous variables		Exogenous variables	CR (p)	SMC	Direct effect	Indirect effect	Total effect
Intention of reproductive health promotion behavior	←	Attitude of reductive health promotion behavior	5.148 (<.001)	.772	.290^***		.290^***
		Subjective norm	3.194 (.001)		.276^**		.276^**
		Perceived behavior control of reductive health promotion behavior	5.041 (<.001)		.436^***		.436^***
Reproductive health promotion behavior	←	Attitude of reductive health promotion behavior		.278		.197^*	.197^*
		Subjective norm				.187^*	.187^*
		Perceived behavior control of reductive health promotion behavior	−1.394 (.163)		−.202	.296^*	.093
		Intention of reproductive health promotion behavior	4.625 (<.001)		.679^***		.679^***

Notes

This manuscript is a condensed form of the first author's doctoral dissertation from Gyeongsang National University.

Summary Statement

▪ What is already known about this topic?

Reproductive health is a broad concept that includes sexual health with health problems associated with the reproductive organs. First sexual intercourse is happening at a younger age and age for first marriage is at a later age. There are many factors that interfere with reproductive health, including artificial abortion, sexually transmitted diseases and unmarried pregnant women.

▪ What this paper adds?

The theory of planned behavior is a suitable model in explaining the reproductive health promoting behavior of single women with sexual experience. Intention was the biggest factor with direct effect on the behavior of single women with sexual experience. In terms of factors having a direct effect on intention, “attitude”, “subjective norm” and “perceived behavioral control” were identified. Among them, “perceived behavioral control” revealed the largest influence.

▪ Implications for practice, education and/or policy

Strategic plans for educational and intervention programs should be aimed to encourage single women to engage in reproductive health behavior.

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