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Background    \  Most college women use the combined oral contraceptive pill (COC) despite more effective long-acting reversible contraceptive (LARC) methods (e.g., IUDs and implant) being available. Resistance to change methods may be impacted by how a woman identifies with being a COC-user.    Methods  Data were collected via 186 web-based surveys distributed to female students attending a university in the southeastern United States (Mean age = 20.0 ± 1.; range = 18–22). Structural equation modeling (SEM) determined TPB fit in understanding LARC intention.    Results  SEM results received acceptable fit (χ2 (670,  N  = 186)  p  < 0.01, Comparative Fit Index (CFI) of 0.84, and Normative Fit Index (NFI) of 0.75). A Root Mean Square Error of Approximation (RMSEA) of 0.09 was produced, with a 90% confidence interval of 0.08 to 0.09. Including self-identity in the model yielded similar fit, with χ2 (866,  N  = 186)  p  < 0.01, CFI of 0.83, and NFI of 0.73. Self-identity and attitude pathways were significant ( p  < 0.01) toward intention, extending the TPB model.    Conclusions  The TPB proved to be acceptable in understanding COC users’ intention to obtain LARC. Results provide direction for LARC messaging tailored toward COC users and self-identity.    Electronic supplementary material  The online version of this article (10.1186/s12905-019-0772-8) contains supplementary material, which is available to authorized users.

bmc women's health

Using the theory of planned behavior and self-identity to explore women’s decision-making and intention to switch from combined oral contraceptive pill (COC) to long-acting reversible contraceptive (LARC)