Fetal alcohol exposure is a serious public health problem and is 100% preventable. Traditionally, FASD prevention programs and research recommendations have targeted peri-conceptual or pregnant women. Another approach to the prevention of FASD involves preventing pregnancy in women who use alcohol. The purpose of this cross sectional study was to identify factors that predicted women’s intention to use contraception using the theory of planned behavior (TPB), to determine if predictors of the theoretical constructs varied in women depending on alcohol use, and to examine interactions between alcohol use and TPB constructs. Qualitative data was gathered to triangulate with the quantitative study. A sample of 207 women ages 18 to 49 years old and residing in one of five Southeast Alaska communities volunteered for the study. Results differed depending on the women’s alcohol group. Intention to use contraception was predicted by attitude toward contraception use for non-drinkers while perceived behavioral control and then attitude most strongly predicted drinkers’ intention. Bingers’ intention had no statistically significant predictors though this could have been due to small sample size for that group. The identification of important behavioral, normative, and control beliefs for each group provided additional understanding of factors that influenced women's intention to use contraception. Outcome beliefs were predictive of attitude for non-drinkers, and for drinkers, but not for bingers. Several beliefs were found to predict attitude. Control beliefs were also found to be predictors of perceived behavioral control for non-drinkers, and for drinkers, but not for bingers. Several beliefs were found to independently influence perceived behavioral control. Subjective norm didn’t influence women’s intention in any of the three drinking groups, but several normative beliefs influenced subjective norm, but this varied by alcohol use group. Qualitative data were consistent with the quantitative results. This study demonstrated that women’s intention to use contraception can be explored using the TPB, but future research should investigate intention and behavior. Practitioners may be able to help reduce fetal alcohol exposure by taking into account that women who drink may have different factors influencing their contraceptive use than women who do not.


School of Public Health

First Advisor

Jerry W. Lee

Second Advisor

Barbara Anderson

Third Advisor

Edward K. Fujimoto

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Fetal Alcohol Spectrum Disorders; Contraception; Contraception Behavior; Alcohol Drinking; Women; Public Health -- Alaska



Page Count

xiii; 157

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives