Contraceptive Knowledge and Influencing Factors Among University Students in Shanghai, China: A Cross-sectional Study

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Methods: A cross-sectional survey was conducted with 388 university students in Shanghai using consecutive sampling. Data were collected through an online survey that included demographic information, sexual behavior, and the Chinese version of the CKA Scale. The Chinese CKA scale, which was cross-culturally adapted and validated by the research team, consists of 22 items and demonstrates good internal consistency (Cronbach’s α = 0.793). Descriptive statistics, Chi-square tests, t-tests, and multivariate regression were used to identify predictors of adequate contraceptive knowledge, with statistical significance set at P < 0.05. Results: Among the 388 respondents (68.30% female, 31.70% male), 95.88% were undergraduates, and 45.10% were from medical-related majors. The average CKA score was 6.5 (SD = 3.36), indicating a low level of contraceptive knowledge. The highest levels of contraceptive knowledge were observed for condoms, emergency contraception, and oral contraceptives. However, misconceptions were prevalent, with 5.93% believing vaginal douching was a contraceptive method, and 8.76% unaware that unprotected sex can lead to pregnancy. Online platforms were the primary source of contraceptive information, while many students reported receiving insufficient information from schools or families. CKA scores were positively correlated with high self-perceived knowledge and correct knowledge of contraceptive methods. Conclusion: University students exhibit limited contraceptive knowledge, with notable misconceptions remaining. This highlights the need for comprehensive sexual education initiatives that involve collaboration between schools, families, communities, healthcare institutions, and society. contraception reproductive health sexual health contraceptive knowledge assessment university students Introduction Reproductive health is a crucial aspect of overall well-being, encompassing not only the absence of disease in the reproductive system but also the physical, emotional, mental and social well-being related to sexuality [ 1 ]. Enhancing reproductive health can significantly decrease the incidence of sexually transmitted infections (STIs) and maternal mortality, benefiting individuals across all life stages [ 2 ]. University students, at a critical phase of sexual and reproductive development, are particularly vulnerable to reproductive health risks [ 3 ]. Inadequate reproductive health knowledge and practices within this group can result in psychological distress, anxiety, and academic challenges [ 3 ]. In China, trends such as early sexual initiation and unprotected intercourse have exacerbated these risks, leading to higher rates of unintended pregnancies, STIs, and unsafe abortions among university students [ 4 ]. Contraceptive knowledge is a multifaceted domain, including awareness of various contraceptive methods, their mechanisms of action, and their effectiveness in preventing unintended pregnancies and STIs [ 5 ]. The ability to make informed decisions about sexuality and reproduction, along with access to safe reproductive health services, are crucial components of reproductive health [ 6 ]. Among university students, contraceptive knowledge plays a vital role, as it directly influences their ability to make informed choices regarding sexual behavior and contraceptive use [ 7 ]. A solid understanding of the effectiveness, proper use, and potential side effects of various contraceptive methods can significantly reduce the incidence of unintended pregnancies and STIs, which are major concerns for university students worldwide. However, studies suggest that many university students lack adequate contraceptive knowledge, thereby increasing their vulnerability to reproductive health risks [ 8 ]. For instance, a survey in the United States found that 30.6% of sexually active students had never used contraception, highlighting critical gaps in both safe sex practices and contraceptive awareness [ 9 ]. The situation in China is even more concerning, with only 55.6% of university students having received formal sexual education, the quality of which remains inconsistent [ 10 ]. A study by Wang further revealed that many Chinese university students lack essential knowledge about the effectiveness, side effects, and proper use of common contraceptives, such as condoms and oral pills [ 4 ]. Addressing these challenges requires urgent improvements in the quality and accessibility of sexual and reproductive health education for Chinese university students. The reproductive health of university students is fundamental to their overall development, and a thorough understanding of contraception is essential for safeguarding their health and mitigating sex-related risks. With over 47 million university students, China represents a significant portion of the global student population, underscoring the importance of assessing contraceptive knowledge within this group [ 11 ]. Most existing studies in China have relied heavily on self-administered questionnaires to assess university students' contraceptive knowledge, compromising the authenticity and reliability of their findings. Additionally, while these studies have identified the general deficiencies in contraceptive knowledge, they have inadequately explored the factors influencing this knowledge. There has been limited investigation into how gender, academic background, family education, and cultural attitudes collectively shape students' understanding of contraception. The Contraceptive Knowledge Assessment (CKA) scale, validated across various cultural contexts, including Turkey, Vietnam and several African countries, has proven effective in measuring students' contraceptive knowledge with strong reliability and validity. This study aimed to assess the contraceptive knowledge of Chinese university students using the CKA scale, with a particular focus on how gender, academic background, and cultural perceptions influence this knowledge. By identifying knowledge levels, influential factors, and existing gaps, this study aimed to provide evidence-based insights to guide the development of targeted reproductive health education policies and interventions, ultimately enhancing sexual health knowledge and promoting safer sexual behaviors among university students. Methods Study Design and Purposes This study employed a cross-sectional design to assess contraceptive knowledge and its influencing factors among university students. The primary objective was to evaluate students' understanding of various contraceptive methods and identify the factors associated with their level of contraceptive knowledge. By analyzing the survey results, the study aimed to provide insights that can help improve reproductive health education and promote safe contraception use among university students. Participants The study was conducted from October to December 2021 across multiple universities in Shanghai, China. Shanghai was selected as the research site due to its status as one of China's most populous and economically developed cities, with a diverse population and a high concentration of universities. This metropolitan setting offers a broad representation of university students from various educational backgrounds, regions, and socio-economic statuses, making it an ideal setting for studying contraceptive knowledge and its influencing factors. Participants were recruited using consecutive sampling, targeting both undergraduate and graduate students enrolled at the universities. Students who met the inclusion criteria and expressed interest in the study were invited to participate. The inclusion criteria were: (a) Currently enrolled university students in Shanghai. (b) Ability to read and understand Chinese. (c) Willingness to voluntarily participate. (d) Completion of the entire survey questionnaire. Research instrument The study used two main instruments for data collection: (a) General Information Questionnaire: This section gathered demographic information (e.g., gender, academic year, major, place of origin), personal experiences related to contraception (e.g., previous exposure to sex education, knowledge sources), and behavioral factors (e.g., smoking, alcohol use). It was developed through a literature review and expert consultations to identify relevant factors influencing contraceptive knowledge among university students. (b) Chinese version of the Contraceptive Knowledge Assessment (CKA) Scale: Developed by Haynes et al. in 2017, the original CKA scale assesses knowledge in areas such as reproductive physiology, contraceptive mechanisms, efficacy, side effects, medical contraindications, common misconceptions, sexually transmitted diseases, and emergency contraception [ 12 ]. In our previous study, as no validated contraceptive knowledge assessment tool was available for Chinese university students, the study team adapted and validated the CKA scale for this context following internationally recognized guidelines [ 12 , 13 ]. The Chinese version of the scale consists of 22 items, with an item-level content validity index (I-CVI) ranging from 0.800 to 1.000, an internal consistency (Cronbach’s α) of 0.793, and a test-retest reliability (Pearson correlation) of 0.743 [ 13 ]. These results confirm that the Chinese version of the CKA scale is a reliable and valid tool for assessing contraceptive knowledge among Chinese university students. Specifically, participants scored one point for each correct answer, yielding a total score ranging from 0 to 22. Study size estimation The sample size was calculated based on the number of items in the questionnaire. It is recommended that the sample size be at least 10 times the number of items in the survey [ 14 ], with an additional 20% added to account for potential non-responses and incomplete data. Given that the Chinese version of the CKA scale consists of 22 items, the minimum required sample size was calculated to be 264 participants. Data collection and analysis Data were collected online using Wenjuanxing, a widely used Chinese survey platform, ensuring anonymity, accessibility, and convenience for participants. The survey link was distributed via university social media groups and student forums, inviting students to voluntarily participate after reading the study's purpose and providing informed consent. To improve response accuracy, participants were required to complete the questionnaire in one sitting, and duplicate submissions were restricted. After data collection, all responses were screened for completeness and validity before analysis. Statistical analyses were performed using IBM SPSS 29.0. Descriptive statistics, including means, standard deviations, and frequencies, were calculated to summarize demographic characteristics and contraceptive knowledge levels. Univariate linear regression analysis was initially used to examine factors influencing CKA scores, and variables with P < 0.05 were entered into a multivariate linear regression model to identify significant predictors. Additionally, independent sample t-tests and one-way ANOVA were applied to compare differences in contraceptive knowledge based on demographic and behavioral characteristics. Statistical significance was set at P < 0.05 for all analyses. Results Demographic characteristics A total of 388 university students participated in the study, including 123 males (31.70%) and 265 females (68.30%). The majority were undergraduate students (n = 372, 95.88%), while graduate students accounted for 4.12% (n = 16). Regarding academic background, 175 participants (45.10%) were from medical-related majors, and 213 (54.90%) were from non-medical fields. Detailed information is provided in Table 1 . Table 1 Descriptive characteristics of participants and the relationship between socio-demographic factors and CKA scores(n = 388) Characteristics n (%) CKA score t/F P value Gender Male 123(31.70) 6.45 ± 3.40 -0.221 0.825 Female 265(68.30) 6.53 ± 3.35 Grade Freshman 170(43.81) 6.19 ± 3.19 5.729 <0.001 Sophomore 138(35.57) 6.07 ± 3.52 Junior 39(10.05) 8.13 ± 2.52 Senior 25(6.44) 8.52 ± 3.44 Graduate degree or above 16(4.12) 6.38 ± 3.44 Major Medical related majors 175(45.10) 6.66 ± 3.56 0.851 0.395 Non-medical related majors 213(54.90) 6.37 ± 3.19 Origin Urban 157(40.46) 6.09 ± 3.60 -2.005 0.046 Rural 231(59.54) 6.78 ± 3.17 Monthly expenses ¥2000( $ 287.60) 147(37.89) 6.76 ± 3.12 Amount of alcohol consumed Do not drink alcohol 269(69.33) 6.51 ± 3.46 0.975 0.405 Drinking frequency 7 times a week (daily drinking) 2(0.52) 2.50 ± 3.54 Smoking habit Yes 28(7.22) 6.79 ± 2.69 0.462 0.644 No 360(92.78) 6.48 ± 3.41 History of romantic involvement Yes 221(56.96) 6.71 ± 3.40 1.434 0.152 No 167(43.04) 6.22 ± 3.29 Sexual experience Yes 71(18.30) 7.52 ± 3.23 2.851 0.005 No 317(81.70) 6.27 ± 3.35 Attention to contraceptive knowledge Intentional Concern 131(33.76) 7.60 ± 3.07 13.595 <0.001 Unintentional Concern 193(49.74) 6.04 ± 3.26 Both Concern 36(9.28) 7.14 ± 3.44 Never 28(7.22) 3.79 ± 3.13 Self-assessment of contraceptive knowledge Almost nothing 32(8.25) 3.09 ± 3.15 39.179 <0.001 A little 228(58.76) 6.08 ± 3.04 Mostly 128(32.99) 8.10 ± 3.11 All 388(100.00) 6.50 ± 3.36 n: number of participants. CKA scores and distribution The CKA scores ranged from 0 to 15, with a mean score of 6.50 (SD = 3.36), indicating a low level of contraceptive knowledge. The score distribution followed an approximately normal pattern, with most participants scoring between 4 and 10 points. Socio-demographic factors (Table 1 ) significantly influenced CKA scores. Academic years were associated with CKA scores, with juniors and seniors scoring higher than freshmen and sophomores ( P < 0.001). Students from rural areas had higher CKA scores compared to those from urban areas ( P = 0.046). Additionally, students with sexual experience exhibited significantly higher CKA scores ( P = 0.005). The level of attention paid to contraceptive knowledge and self-assessment of contraceptive knowledge were also significantly associated with CKA scores, with students who expressed more concern and had higher self-assessments scoring higher ( P < 0.001). Contraceptive knowledge by specific topics To further analyze participants' understanding of contraception, knowledge was categorized into various topics, including awareness of contraceptive methods, misconceptions, side effects, and sources of contraceptive knowledge. The results are summarized in Table 2 and Table 3 . Table 2 Contraceptive knowledge by specific topics statistics of responses and the relationship with CKA scores (n = 388) Characteristics n (%) CKA score t/F P value Sources of contraceptive knowledge Attended physiology lectures/courses during middle school Yes 242(62.37) 6.55 ± 3.38 0.385 0.700 No 146(37.63) 6.42 ± 3.33 Necessity of contraceptive education in schools Yes 352(90.72) 6.65 ± 3.30 2.681 0.008 No 36(9.28) 5.08 ± 3.68 Knowledge of different contraceptive methods Awareness of dual function of condoms: contraception and prevention of some STD infections Yes 367(94.59) 6.69 ± 3.29 4.628 <0.001 No 21(5.41) 3.29 ± 3.08 Awareness of Pearl Index Yes 50(12.89) 7.10 ± 3.28 1.348 0.178 No 338(87.11) 6.41 ± 3.37 Relationship between Pearl Index and contraceptive effectiveness Yes 96(24.74) 7.04 ± 3.22 1.817 0.070 No 292(75.26) 6.33 ± 3.39 Knowledge of condom usage Yes 237(61.08) 7.53 ± 3.08 8.134 <0.001 No 151(38.92) 4.89 ± 3.15 Misconceptions about contraception Occasional sexual intercourse does not lead to pregnancy Yes 34(8.76) 5.82 ± 3.55 -1.234 0.218 No 354(91.24) 6.57 ± 3.34 Vaginal irrigation after sexual intercourse can prevent pregnancy Yes 23(5.93) 5.87 ± 3.85 -0.931 0.352 No 365(94.07) 6.54 ± 3.33 Jumping after sexual intercourse can prevent pregnancy Yes 11(2.84) 4.27 ± 3.26 -2.244 0.025 No 377(97.16) 6.57 ± 3.35 Knowledge of contraceptive side effects Intermittent use of modern oral contraceptives Yes 269(69.33) 6.15 ± 3.19 -3.154 0.002 No 119(30.67) 7.30 ± 3.60 Teratogenic effects of oral contraceptives during pregnancy Yes 284(73.20) 6.10 ± 3.22 -3.951 <0.001 No 104(26.80) 7.60 ± 3.51 Oral contraceptives reduce fertility Yes 245(63.14) 5.76 ± 3.18 -5.951 <0.001 No 143(36.86) 7.78 ± 3.29 Long-term use of oral contraceptives increases risk of gynecologic cancer and cardiovascular disease Yes 281(72.42) 6.05 ± 3.25 -4.365 <0.001 No 107(27.58) 7.68 ± 3.37 Oral contraceptives cause significant weight gain Yes 179(46.13) 6.00 ± 3.35 -2.749 0.006 No 209(53.87) 6.93 ± 3.32 Oral contraceptives improve hirsutism and acne Yes 110(28.35) 7.55 ± 3.76 3.915 <0.001 No 278(71.65) 6.09 ± 3.10 All 388(100.00) 6.50 ± 3.36 n: number of participants. Table 3 Contraceptive knowledge by specific topics statistics of multiple-choice questions (n = 388) Characteristics n % Sources of contraceptive knowledge Discussing sexual and reproductive health knowledge No one 97 25.00 Peers 249 64.18 Elders 51 13.14 Healthcare professionals 56 14.43 Knowledge of different contraceptive methods Identification of Emergency Contraception Methods Emergency contraceptive pills 372 95.88 Contraceptive patch 63 16.24 Vaginal contraceptive ring 28 7.22 Intrauterine device 21 5.41 Condom 112 28.87 Vaginal irrigation 103 26.55 Spermicide 102 26.29 Subdermal implant 21 5.41 Fertility awareness method 39 10.05 Identification of routine contraception methods Emergency contraceptive pills 86 22.20 Contraceptive patch 88 22.70 Vaginal contraceptive ring 190 49.00 Intrauterine device 187 48.20 Condom 332 85.60 Vaginal irrigation 43 11.10 Spermicide 28 7.20 Subdermal implant 92 23.70 Fertility awareness method 156 40.20 Desired contraceptive knowledge Method of taking oral contraceptives 191 49.23 Contraceptive effectiveness 256 65.98 Male contraceptives 209 53.87 Female condom 181 46.65 Adverse reactions 234 60.31 Long-acting contraceptives 153 39.43 Short-acting contraceptives 142 36.60 Differences in emergency contraceptive pills 188 48.45 Prevention of sexually transmitted infections 250 64.43 Menstrual health 230 59.28 Knowledge of contraceptive side effects Adverse reactions to oral contraceptives Irregular menstruation 341 87.89 Irregular vaginal bleeding 262 67.53 Nausea and vomiting 254 65.46 Ectopic pregnancy 148 38.14 Uterine fibroids 146 37.63 Infertility 198 51.03 All 388 100.00 n: number of participants. Sources of contraceptive knowledge Most participants (62.37%) reported having attended physiology lectures or courses during middle school. Furthermore, 90.72% of respondents agreed that contraceptive education should be integrated into school curricula. Regarding discussions on sexual and reproductive health, most participants (64.18%) reported conversing with peers, while fewer students reported discussing these topics with healthcare professionals (14.31%) or elders (13.14%). Participants were also asked to rank the most common sources of contraceptive knowledge based on frequency of use. The ranking included ten options: the internet, social media platforms such as Weibo, television, books and newspapers, school courses, reproductive health lectures, doctors, family, friends and others. The sources were ranked by assigning 1 point to the most frequently used source, 10 points to the least, and calculating the mean score for each source. The lower the mean score, the higher the ranking of that source. The final rankings revealed that the internet (including websites and online information) and social media platforms like Weibo were identified as the most frequently used sources, followed by books and newspapers. In contrast, doctors, family members, and television were ranked as the least common sources of contraceptive knowledge. Knowledge of different contraceptive methods The study assessed participants' knowledge of various contraceptive methods. A significant proportion of students (94.59%) were aware that condoms serve as both a contraceptive method and protection against some sexually transmitted diseases. However, only 12.89% of participants were familiar with the Pearl Index, the World Health Organization's (WHO) gold standard for evaluating the effectiveness of contraceptive methods. Additionally, 61.08% of respondents knew the correct way to use condoms. In terms of emergency contraception, 95.88% of participants correctly identified emergency contraceptive pills as a form of emergency contraception. However, only 5.41% were aware that intrauterine devices (IUDs) can also serve as an emergency contraception. Many students mistakenly considered methods such as the safe period (40.20%) and vaginal douching (11.10%) as reliable contraceptive methods. When asked about their interest in further learning, 65.98% of students expressed a desire to learn more about the effectiveness of different contraceptive methods, and 64.43% wanted additional information on how contraceptive methods can prevent sexually transmitted infections. Regarding familiarity with different contraceptive methods, participants ranked eight methods based on their level of knowledge. These methods included long-term oral contraceptives, IUDs, tubal ligation, subdermal contraceptive implants, condoms, withdrawal, periodic abstinence, and emergency contraceptive pills. The ranking showed that condoms (1st ) and emergency contraceptive pills (2nd ) were the most well-known methods, while IUDs and subdermal contraceptive implants were among the least familiar. Misconceptions about contraception While most participants (91.24%) correctly recognized that even a single instance of sexual intercourse can result in pregnancy, there were notable misconceptions about contraceptive methods. For example, a small proportion of students mistakenly believed that certain practices, such as douching (5.93%) or jumping after intercourse (2.84%), could serve as effective forms of contraception. Knowledge of contraceptive side effects A significant proportion of participants exhibited misconceptions about the side effects of contraceptive use. For instance, 69.33% of students incorrectly believed that long-term use of modern oral contraceptives could be harmful and should be taken intermittently. Additionally, 73.20% thought that if a pregnant woman mistakenly takes oral contraceptives, it could cause defects in the newborn. Further misconceptions were observed regarding fertility and health risks. A notable 63.14% of students believed that oral contraceptives could reduce female fertility, and 72.42% were unaware that long-term use of oral contraceptives does not increase the risk of gynecological cancers or cardiovascular diseases. Many students also incorrectly believed that oral contraceptives caused weight gain (46.13%), and only 28.35% correctly understood that they could improve conditions like hirsutism and acne. Common side effects such as menstrual irregularities (87.89%), irregular vaginal bleeding (67.53%), and nausea/vomiting (65.46%) were widely recognized as adverse reactions to oral contraceptive use. Analysis of factors influencing CKA scores To explore the factors influencing contraceptive knowledge among university students, both univariate and multivariate regression analyses were conducted. Variables that showed significant associations with CKA scores ( P < 0.05) in the univariate analysis were subsequently included in the multivariate regression model to identify independent predictors of contraceptive knowledge. The univariate analysis revealed several factors significantly associated with CKA scores ( P < 0.05), including self-assessment of contraceptive knowledge, awareness of contraceptive education in schools, knowledge of condoms, and several misconceptions about oral contraceptives. The multivariate regression analysis identified several significant predictors of CKA scores ( P < 0.05). Specifically, self-assessment of contraceptive knowledge (β = 0.202, P < 0.001) was significantly associated with higher CKA scores, indicating that students with a positive self-assessment of their knowledge were likely to have a better understanding of contraceptive methods. Recognition of the importance of contraceptive education in schools (β = 0.108, P = 0.016) was also associated with higher scores. Both awareness of the dual function of condoms (β = 0.143, P = 0.001) and knowledge of condom usage (β = 0.185, P < 0.001) were significantly linked to higher CKA scores. However, the belief that oral contraceptives reduce fertility (β = -0.137, P = 0.009) was associated with lower scores, suggesting that misconceptions about contraceptives negatively impacted knowledge. Students who believed that oral contraceptives improve hirsutism and acne (β = 0.112, P = 0.018) had significantly higher knowledge levels. In contrast, the belief that jumping after sex could prevent pregnancy (β= -0.095, P = 0.035) was associated with lower CKA scores, highlighting the detrimental effect of common misconceptions on contraceptive understanding. Other variables, including academic grade, place of origin, sexual experience, attention to contraceptive knowledge, intermittent use of modern oral contraceptives, teratogenic effects of oral contraceptives during pregnancy, long-term use of oral contraceptives, and concerns about weight gain from oral contraceptives, were not significant predictors in the multivariate model. Table 4 provides a detailed overview of the multivariate analysis results. Table 4 Multivariable analysis of factors influencing CKA scores among university students (n = 388) Characteristics β P value Grade 0.032 0.497 Origin 0.008 0.856 Sexual experience -0.043 0.388 Attention to contraceptive knowledge 0.076 0.115 Self-assessment of contraceptive knowledge 0.202 <0.001 Necessity of contraceptive education in schools 0.108 0.016 Awareness of dual function of condoms 0.143 0.001 Knowledge of condom usage 0.185 <0.001 Jumping after sexual intercourse can prevent pregnancy -0.095 0.035 Intermittent use of modern oral contraceptives 0.035 0.502 Teratogenic effects of oral contraceptives during pregnancy -0.055 0.265 Oral contraceptives reduce fertility -0.137 0.009 Long-term use of oral contraceptives increases risk of gynecologic cancer and cardiovascular disease -0.046 0.405 Oral contraceptives cause significant weight gain -0.052 0.273 Oral contraceptives improve hirsutism and acne 0.112 0.018 β: Standardized beta coefficient. Discussion Low level of contraceptive knowledge with room for improvement This study assessed contraceptive knowledge among university students in China using the Chinese version of the Contraceptive Knowledge Assessment (CKA) scale. The results revealed that students demonstrated a low level of contraceptive knowledge, with an average CKA score of 6.50 ± 3.36 out of 22. While this indicated some basic awareness, it also highlighted significant gaps in knowledge. Students showed a high level of awareness of commonly used contraceptive methods, such as condoms (94.59%) and emergency contraceptive pills (95.88%), while knowledge of long-acting reversible contraceptives (LARCs), such as IUDs, was much lower at 29.90%. This discrepancy suggests a gap between basic awareness and a deeper understanding of contraceptive options. Such gaps appear more pronounced among Chinese students when compared to their peers in other countries. For instance, a study by Rebecca Cohen found that 76.5% of U.S. adolescents and young women had heard of IUDs [ 15 ]. This finding further underscores the need for more comprehensive education on a broader range of contraceptive methods. Furthermore, the study showed that students in higher academic year (third- and fourth-years students) scored better than their first and second-year counterparts. This is consistent with research by Elif Balkan, which found that contraceptive knowledge increases with academic year [ 16 ]. The greater exposure to educational content, along with more sexual experience and self-directed learning opportunities, likely contribute to this improvement. Interestingly, the study found that students from rural areas exhibited higher contraceptive knowledge than their urban counterparts, contrary to findings from previous research. For example, Mahande reported that urban women generally have better access to information, education, and healthcare services, all of which are linked to higher contraceptive knowledge and usage rates [ 17 ]. Similarly, Curry identified rural areas as “contraceptive deserts” due to limited healthcare services and access to reproductive health information [ 18 ]. This disparity in findings may be due to regional differences in health service availability and local contraceptive education, which warrants further exploration. Expanding the sample size to include students from more diverse geographical areas would provide more accurate insights into these differences. In conclusion, these findings emphasized the need for comprehensive and balanced educational programs that not only focus on widely used contraceptive methods but also provide more information about less-known methods in Chinese university students like LARCs. Ensuring students are fully informed about all available contraceptive methods is essential for promoting well-rounded, informed decision-making and ultimately reducing unintended pregnancies. Sources of contraceptive knowledge and gaps in formal education A key finding from this study is that university students primarily rely on the internet and social media platforms (89.18%) for contraceptive information, with fewer students seeking guidance from healthcare professionals (14.31%) or family members (17.78%). This shift toward digital sources raises concerns about the accuracy and reliability of the information students are accessing. Studies by Carley Zeal had noted similar trends, with university students relying heavily on online platforms for reproductive health knowledge, often without verifying the credibility of the sources [ 19 ]. In contrast, traditional sources such as family and healthcare professionals remained underutilized. This gap suggested that cultural barriers in China, particularly around open discussions about contraception, hinder the effectiveness of family and medical sources of information. The limited engagement with authoritative sources points to a need for educational reforms that incorporate formal, structured contraceptive education into the university curriculum. Church suggested that addressing sociocultural barriers and normalizing conversations about reproductive health in both families and schools could significantly improve the quality and reach of sexual health education [ 20 ]. Misconceptions about contraceptive methods and lack of in-depth knowledge Our study found that serious misconceptions about contraception are prevalent among Chinese university students. Specifically, 5.93% of students mistakenly believed that vaginal douching can prevent pregnancy, and 63.14% wrongly believed that long-term use of oral contraceptives impairs fertility. These misconceptions highlight a concerning lack of understanding regarding the effectiveness and mechanisms of various contraceptive methods. The persistence of such misconceptions may contribute to suboptimal contraceptive practices and ultimately lead to unintended pregnancies. These findings align with those from Santos in Portugal, where university students also exhibited misunderstandings about contraceptive methods, particularly regarding the effectiveness of traditional methods like withdrawal and douching [ 21 ]. In addition, Miller found that some students were reluctant to use hormonal contraception due to fears of birth defects and infertility [ 22 ]. These fears were consistent with our findings, where widespread misconceptions about hormonal contraceptives persist, despite evidence showing their safety and effectiveness. The analysis also revealed that students' misconceptions about oral contraceptives were negatively correlated with their CKA scores, indicating that misinformation about contraceptive methods impedes the acquisition of accurate knowledge. Addressing these misconceptions early on is crucial to prevent them from becoming deeply ingrained and influencing future contraceptive choices [ 23 ]. These findings underscore the need for comprehensive sexual and reproductive health education that provides accurate information about the safety, effectiveness, and proper use of contraceptives. To address these gaps, it is essential to develop standardized curricula for contraceptive counseling that align with evidence-based guidelines [ 24 ]. This curriculum should provide clear, accurate, and easily understandable information about all available contraceptive methods, side effects, and the importance of proper use. Moreover, various communication channels should be employed to disseminate this information [ 25 ]. Educational materials should simplify complex information, ensuring that students can fully understand the efficacy, safety, and correct usage of different contraceptive methods. Limitations This study has several limitations. First, the sample was drawn from a single city in China, limiting the generalizability of the findings to students from other regions. As Shanghai is one of the most economically developed cities in China, it may have higher levels of contraceptive knowledge compared to less resource-rich areas. Second, self-reported data may introduce recall and social desirability biases, which could affect the accuracy of the responses. Third, the cross-sectional design prevents causal inferences, meaning we cannot determine if certain factors influence contraceptive knowledge over time. Lastly, the study focused on knowledge rather than actual contraceptive behaviors, limiting insights into how knowledge translates into practice. Future research should address these limitations by including a broader, more representative sample from various regions of China to better capture regional differences, particularly given the economic and educational disparities between urban and rural areas. Longitudinal studies could also be conducted to assess how contraceptive knowledge evolves over time and whether it leads to changes in contraceptive behaviors. Additionally, future studies should assess actual contraceptive behaviors and consider a variety of behavioral outcomes to fully understand how contraceptive knowledge impacts real-world decision-making. Conclusion This study provides valuable insights into the contraceptive knowledge of Chinese university students, identifying key factors that influence their understanding. These factors include socio-demographic elements, such as grade and sexual experience, the level of attention given to contraceptive knowledge, and the accuracy of understanding various contraceptive methods. While students demonstrated awareness of common contraceptive methods, their overall knowledge was low, and significant misconceptions about certain methods were prevalent. These challenges underscore the need for structured and comprehensive reproductive health education at universities, focusing not only on widely used methods but also addressing common misconceptions. To improve contraceptive knowledge and reduce unintended pregnancies, universities should incorporate formal curricula on contraception, increase access to accurate digital resources, and promote open discussions about sexual and reproductive health in both academic and family settings. This multi-faceted approach will play a crucial role in promoting safer sexual behaviors and improving reproductive health outcomes in China. Abbreviations CKA Contraceptive Knowledge Assessment Declarations Consent for publication Written informed consent was obtained from the participants for publication of this study. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Ethical approval and consent to participate All procedures involving human participants were conducted in accordance with the ethical standards set by the Institutional Review Board (IRB) of Fudan University School of Nursing and in compliance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was reviewed and approved by the IRB of Fudan University School of Nursing (IRB#2021-07-05) before data collection commenced. Informed consent was obtained from all participants, who were fully briefed on the study's purpose, procedures, potential benefits, and risks of the study. Participation was entirely voluntary, and students were assured that they could withdraw at any time without consequences. The survey was anonymous, and all collected data were securely stored and treated with strict confidentiality, used solely for research purposes. Funding This study was supported by the Hu Hang Project of “Fudan’s Undergraduate Research Endowment Program” (HH202105). Competing interests The authors have no conflicts of interest. Availability of Data and Materials The datasets generated and analyzed during the current study are not publicly available since the names and the schools of the participants are mentioned. But the data are available from the corresponding author on reasonable request. Contributions Maoting Tian and Jiayang Zhang contributed equally to this work. They were responsible for conceptualization, methodology, investigation, data collection, formal analysis, data curation, validation, and visualization. Maoting Tian wrote the first draft of the manuscript, while Jiayang Zhang contributed to writing – review & editing. Yan Hu and Lei Xu provided supervision, critical revisions, and contributed to the interpretation of the findings. All authors have read and approved the final version of the manuscript. Maoting Tian and Jiayang Zhang directly accessed and verified the underlying data reported in this manuscript. Acknowledgments We sincerely thank all the participants and experts who contributed to this study. Special thanks to Dr. Mona Saleh and her colleagues for authorizing the adaptation of the CKA scale. References World Health Organization. Redefining sexual health for benefits throughout life. 2022. https://www.who.int/news/item/11-02-2022-redefining-sexual-health-for-benefits-throughout-life . Accessed 7 Jan 2025. Kanem N. Sexual and reproductive health and rights must be enshrined in universal healthcare. Nat Med. 2023;29:1061–1061. Goldfarb ES, Lieberman LD. Three Decades of Research: The Case for Comprehensive Sex Education. J Adolesc Health. 2021;68:13–27. Wang Y, Qiao J. Trends and social determinants of adolescent marriage and fertility in China. Lancet Global Health. 2020;8:e873–4. World Health Organization. Family planning/contraception methods. 2023. https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception . Accessed 8 Feb 2025. Eisenberg DL, Secura GM, Madden TE, Allsworth JE, Zhao Q, Peipert JF. Knowledge of contraceptive effectiveness. American Journal of Obstetrics & Gynecology. 2012;206:479.e1-479.e9. Jaramillo N, Buhi ER, Elder JP, Corliss HL. Associations Between Sex Education and Contraceptive Use Among Heterosexually Active, Adolescent Males in the United States. J Adolesc Health. 2017;60:534–40. World Health Organization. A global study of men and women’s male contraceptive knowledge, attitudes, and behaviors using mixed methods. 2022. https://www.who.int/publications/m/item/global-study-men-and-women-male-contraceptive-knowledge-using-mixed-methods . Accessed 8 Feb 2025. Jahanfar S, Zendehdel M. Contraceptive knowledge, prevalence of contraception use, and the association between sex education and contraception knowledge among university students in Michigan, USA. J Family Med Prim Care. 2024;13:1676–82. Li C, Cheng Z, Wu T, Liang X, Gaoshan J, Li L, et al. The relationships of school-based sexuality education, sexual knowledge and sexual behaviors-a study of 18,000 Chinese college students. Reprod Health. 2017;14:103. The PEOPLE’S REPUBLIC OF CHINA. China has over 47 mln higher-education students in 2023. 2024. https://english.www.gov.cn/archive/statistics/202403/01/content_WS65e1d71dc6d0868f4e8e487a.html . Accessed 4 Feb 2025. Haynes MC, Ryan N, Saleh M, Winkel AF, Ades V. Contraceptive Knowledge Assessment: validity and reliability of a novel contraceptive research tool. Contraception. 2017;95:190–7. Zhang J, Tian M, Xu L. Reliability and validity of the Chinese version of the contraceptive knowledge assessment scale in college students. BMC Public Health. 2024;24:2810. Bentler P, Chou C-P. Practical Issues in Structural Equation Modeling. Sociol Methods Res. 1987;16:78–117. Cohen R, Sheeder J, Kane M, Teal SB. Factors Associated With Contraceptive Method Choice and Initiation in Adolescents and Young Women. J Adolesc Health. 2017;61:454–60. Balkan E, Genç Koyucu R. The knowledge levels of midwifery students on contraceptive methods: A cross-sectional study. Nurse Educ Today. 2022;119:105605. Mahande MJ, Shayo E, Amour C, Mshana G, Msuya S. Factors associated with modern contraceptives use among postpartum women in Bukombe district, Geita region, Tanzania. PLoS ONE. 2020;15:e0239903. Curry CG, Hensel DJ, Imburgia TM, Ott MA. Targeting Rural Adolescent Pregnancy: Modifiable Protective Factors and Contraceptive Use. J Adolesc Health. 2024;75:947–51. Zeal C, Paul R, Dorsey M, Politi MC, Madden T. Young women’s preferences for contraceptive education & development of an online educational resource. PEC Innov. 2022;1:100046. Church S, Ejder Apay S, Gurol A, Slaveva Y, Mills R. Student midwives’ perspectives of women’s sexual and reproductive health literacy in Turkey. Sex Reprod Healthc. 2023;37:100864. Santos Mj, Ferreira E, Duarte J, Ferreira M. Risk factors that influence sexual and reproductive health in Portuguese university students. Int Nurs Rev. 2018;65:225–33. Miller KK, Saftner MA, McNamara M, McMorris B, Olupot-Olupot P. Provision of adolescent health care in Resource-Limited Settings: Perceptions, practices and training needs of Ugandan health care workers. Child Youth Serv Rev. 2022;132:106310. Gichangi P, Gonsalves L, Mwaisaka J, Thiongo M, Habib N, Waithaka M, et al. Busting contraception myths and misconceptions among youth in Kwale County, Kenya: results of a digital health randomised control trial. BMJ Open. 2022;12:e047426. Lee ASD, Burke AE. Integration of a Comprehensive Contraception Education Program Into Clinical Practice in a Family Planning Clinic. Nurs Women’s Health. 2019;23:414–23. Singh S, Shekhar C, Bankole A, Acharya R, Audam S, Akinade T. Key drivers of fertility levels and differentials in India, at the national, state and population subgroup levels, 2015–2016: An application of Bongaarts’ proximate determinants model. PLoS ONE. 2022;17:e0263532. Additional Declarations No competing interests reported. Supplementary Files EnglishtranslationoftheChineseversionoftheCKAscale.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6394972","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":463152463,"identity":"e2299c1a-4d0c-4baa-a5d2-a8166d0853a6","order_by":0,"name":"Maoting Tian","email":"","orcid":"","institution":"School of Nursing, Fudan University","correspondingAuthor":false,"prefix":"","firstName":"Maoting","middleName":"","lastName":"Tian","suffix":""},{"id":463152464,"identity":"a787aa99-ee89-41ef-8524-d8504df7d9de","order_by":1,"name":"Jiayang Zhang","email":"","orcid":"","institution":"Fudan University Shanghai Cancer Center","correspondingAuthor":false,"prefix":"","firstName":"Jiayang","middleName":"","lastName":"Zhang","suffix":""},{"id":463152465,"identity":"4e5aa785-da88-4e69-a1f9-dd6ca5446d96","order_by":2,"name":"Yan Hu","email":"","orcid":"","institution":"JBI Fudan University Centre for Evidence Based Nursing, School of Nursing, Fudan University","correspondingAuthor":false,"prefix":"","firstName":"Yan","middleName":"","lastName":"Hu","suffix":""},{"id":463152466,"identity":"4de05514-8a81-40fb-9e76-40c4115cbf48","order_by":3,"name":"Lei Xu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAApElEQVRIiWNgGAWjYBACPhDxgYGBh0GCAUQSAdiAmHEGyVqYwSqJ18LeYyZt27ZNhn92A+ODt23EaOE5liad23abR+LOAWbDuURpkUg+BtZiIJHAJs1LlBb5h23SlhAt7L+J0yLBfEyaEWoLM3FaeNKSLXvOAf1yI7FZcs45IrTws58xvPGj7LY9/4zkgx/elBGhBQkwNpCmfhSMglEwCkYBbgAAocosBeWX5tYAAAAASUVORK5CYII=","orcid":"","institution":"University of Michigan","correspondingAuthor":true,"prefix":"","firstName":"Lei","middleName":"","lastName":"Xu","suffix":""}],"badges":[],"createdAt":"2025-04-07 13:53:29","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6394972/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6394972/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":97324621,"identity":"ebc43fe0-1352-4b69-a46a-dfc637308f46","added_by":"auto","created_at":"2025-12-03 08:25:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1176631,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6394972/v1/4938dbcf-4d4f-4636-ba25-5440b4c24208.pdf"},{"id":83663336,"identity":"eb731f8e-709c-4f22-bff7-fd7ce3ca88aa","added_by":"auto","created_at":"2025-05-30 10:40:31","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":22604,"visible":true,"origin":"","legend":"","description":"","filename":"EnglishtranslationoftheChineseversionoftheCKAscale.docx","url":"https://assets-eu.researchsquare.com/files/rs-6394972/v1/4cfdfb31472d2e881f252f9a.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Contraceptive Knowledge and Influencing Factors Among University Students in Shanghai, China: A Cross-sectional Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eReproductive health is a crucial aspect of overall well-being, encompassing not only the absence of disease in the reproductive system but also the physical, emotional, mental and social well-being related to sexuality [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Enhancing reproductive health can significantly decrease the incidence of sexually transmitted infections (STIs) and maternal mortality, benefiting individuals across all life stages [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. University students, at a critical phase of sexual and reproductive development, are particularly vulnerable to reproductive health risks [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Inadequate reproductive health knowledge and practices within this group can result in psychological distress, anxiety, and academic challenges [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In China, trends such as early sexual initiation and unprotected intercourse have exacerbated these risks, leading to higher rates of unintended pregnancies, STIs, and unsafe abortions among university students [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eContraceptive knowledge is a multifaceted domain, including awareness of various contraceptive methods, their mechanisms of action, and their effectiveness in preventing unintended pregnancies and STIs [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The ability to make informed decisions about sexuality and reproduction, along with access to safe reproductive health services, are crucial components of reproductive health [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Among university students, contraceptive knowledge plays a vital role, as it directly influences their ability to make informed choices regarding sexual behavior and contraceptive use [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. A solid understanding of the effectiveness, proper use, and potential side effects of various contraceptive methods can significantly reduce the incidence of unintended pregnancies and STIs, which are major concerns for university students worldwide. However, studies suggest that many university students lack adequate contraceptive knowledge, thereby increasing their vulnerability to reproductive health risks [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. For instance, a survey in the United States found that 30.6% of sexually active students had never used contraception, highlighting critical gaps in both safe sex practices and contraceptive awareness [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The situation in China is even more concerning, with only 55.6% of university students having received formal sexual education, the quality of which remains inconsistent [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. A study by Wang further revealed that many Chinese university students lack essential knowledge about the effectiveness, side effects, and proper use of common contraceptives, such as condoms and oral pills [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Addressing these challenges requires urgent improvements in the quality and accessibility of sexual and reproductive health education for Chinese university students.\u003c/p\u003e \u003cp\u003eThe reproductive health of university students is fundamental to their overall development, and a thorough understanding of contraception is essential for safeguarding their health and mitigating sex-related risks. With over 47\u0026nbsp;million university students, China represents a significant portion of the global student population, underscoring the importance of assessing contraceptive knowledge within this group [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Most existing studies in China have relied heavily on self-administered questionnaires to assess university students' contraceptive knowledge, compromising the authenticity and reliability of their findings. Additionally, while these studies have identified the general deficiencies in contraceptive knowledge, they have inadequately explored the factors influencing this knowledge. There has been limited investigation into how gender, academic background, family education, and cultural attitudes collectively shape students' understanding of contraception. The Contraceptive Knowledge Assessment (CKA) scale, validated across various cultural contexts, including Turkey, Vietnam and several African countries, has proven effective in measuring students' contraceptive knowledge with strong reliability and validity. This study aimed to assess the contraceptive knowledge of Chinese university students using the CKA scale, with a particular focus on how gender, academic background, and cultural perceptions influence this knowledge. By identifying knowledge levels, influential factors, and existing gaps, this study aimed to provide evidence-based insights to guide the development of targeted reproductive health education policies and interventions, ultimately enhancing sexual health knowledge and promoting safer sexual behaviors among university students.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n\u003ch2\u003eStudy Design and Purposes\u003c/h2\u003e\n\u003cp\u003eThis study employed a cross-sectional design to assess contraceptive knowledge and its influencing factors among university students. The primary objective was to evaluate students' understanding of various contraceptive methods and identify the factors associated with their level of contraceptive knowledge. By analyzing the survey results, the study aimed to provide insights that can help improve reproductive health education and promote safe contraception use among university students.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eThe study was conducted from October to December 2021 across multiple universities in Shanghai, China. Shanghai was selected as the research site due to its status as one of China's most populous and economically developed cities, with a diverse population and a high concentration of universities. This metropolitan setting offers a broad representation of university students from various educational backgrounds, regions, and socio-economic statuses, making it an ideal setting for studying contraceptive knowledge and its influencing factors. Participants were recruited using consecutive sampling, targeting both undergraduate and graduate students enrolled at the universities. Students who met the inclusion criteria and expressed interest in the study were invited to participate. The inclusion criteria were:\u003c/p\u003e\n\u003cp\u003e(a) Currently enrolled university students in Shanghai.\u003c/p\u003e\n\u003cp\u003e(b) Ability to read and understand Chinese.\u003c/p\u003e\n\u003cp\u003e(c) Willingness to voluntarily participate.\u003c/p\u003e\n\u003cp\u003e(d) Completion of the entire survey questionnaire.\u003c/p\u003e\n\u003ch3\u003eResearch instrument\u003c/h3\u003e\n\u003cp\u003eThe study used two main instruments for data collection:\u003c/p\u003e\n\u003cp\u003e(a) General Information Questionnaire: This section gathered demographic information (e.g., gender, academic year, major, place of origin), personal experiences related to contraception (e.g., previous exposure to sex education, knowledge sources), and behavioral factors (e.g., smoking, alcohol use). It was developed through a literature review and expert consultations to identify relevant factors influencing contraceptive knowledge among university students.\u003c/p\u003e\n\u003cp\u003e(b) Chinese version of the Contraceptive Knowledge Assessment (CKA) Scale: Developed by Haynes et al. in 2017, the original CKA scale assesses knowledge in areas such as reproductive physiology, contraceptive mechanisms, efficacy, side effects, medical contraindications, common misconceptions, sexually transmitted diseases, and emergency contraception [\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e]. In our previous study, as no validated contraceptive knowledge assessment tool was available for Chinese university students, the study team adapted and validated the CKA scale for this context following internationally recognized guidelines [\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e]. The Chinese version of the scale consists of 22 items, with an item-level content validity index (I-CVI) ranging from 0.800 to 1.000, an internal consistency (Cronbach\u0026rsquo;s \u0026alpha;) of 0.793, and a test-retest reliability (Pearson correlation) of 0.743 [\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e]. These results confirm that the Chinese version of the CKA scale is a reliable and valid tool for assessing contraceptive knowledge among Chinese university students. Specifically, participants scored one point for each correct answer, yielding a total score ranging from 0 to 22.\u003c/p\u003e\n\u003ch3\u003eStudy size estimation\u003c/h3\u003e\n\u003cp\u003eThe sample size was calculated based on the number of items in the questionnaire. It is recommended that the sample size be at least 10 times the number of items in the survey [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e], with an additional 20% added to account for potential non-responses and incomplete data. Given that the Chinese version of the CKA scale consists of 22 items, the minimum required sample size was calculated to be 264 participants.\u003c/p\u003e\n\u003ch3\u003eData collection and analysis\u003c/h3\u003e\n\u003cp\u003eData were collected online using Wenjuanxing, a widely used Chinese survey platform, ensuring anonymity, accessibility, and convenience for participants. The survey link was distributed via university social media groups and student forums, inviting students to voluntarily participate after reading the study's purpose and providing informed consent. To improve response accuracy, participants were required to complete the questionnaire in one sitting, and duplicate submissions were restricted. After data collection, all responses were screened for completeness and validity before analysis. Statistical analyses were performed using IBM SPSS 29.0. Descriptive statistics, including means, standard deviations, and frequencies, were calculated to summarize demographic characteristics and contraceptive knowledge levels. Univariate linear regression analysis was initially used to examine factors influencing CKA scores, and variables with \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were entered into a multivariate linear regression model to identify significant predictors. Additionally, independent sample t-tests and one-way ANOVA were applied to compare differences in contraceptive knowledge based on demographic and behavioral characteristics. Statistical significance was set at \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 for all analyses.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eDemographic characteristics\u003c/h2\u003e \u003cp\u003eA total of 388 university students participated in the study, including 123 males (31.70%) and 265 females (68.30%). The majority were undergraduate students (n\u0026thinsp;=\u0026thinsp;372, 95.88%), while graduate students accounted for 4.12% (n\u0026thinsp;=\u0026thinsp;16). Regarding academic background, 175 participants (45.10%) were from medical-related majors, and 213 (54.90%) were from non-medical fields. Detailed information is provided in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive characteristics of participants and the relationship between socio-demographic factors and CKA scores(n\u0026thinsp;=\u0026thinsp;388)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCKA score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003et/F\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e123(31.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.45\u0026thinsp;\u0026plusmn;\u0026thinsp;3.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.825\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e265(68.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.53\u0026thinsp;\u0026plusmn;\u0026thinsp;3.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eGrade\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFreshman\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e170(43.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.19\u0026thinsp;\u0026plusmn;\u0026thinsp;3.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.729\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSophomore\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e138(35.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.07\u0026thinsp;\u0026plusmn;\u0026thinsp;3.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJunior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39(10.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.13\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25(6.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.52\u0026thinsp;\u0026plusmn;\u0026thinsp;3.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGraduate degree or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16(4.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.38\u0026thinsp;\u0026plusmn;\u0026thinsp;3.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eMajor\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedical related majors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e175(45.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.66\u0026thinsp;\u0026plusmn;\u0026thinsp;3.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.851\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.395\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-medical related majors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e213(54.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.37\u0026thinsp;\u0026plusmn;\u0026thinsp;3.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eOrigin\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e157(40.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.09\u0026thinsp;\u0026plusmn;\u0026thinsp;3.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-2.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e231(59.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.78\u0026thinsp;\u0026plusmn;\u0026thinsp;3.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eMonthly expenses\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026yen;1000(\u003cspan\u003e$\u003c/span\u003e143.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22(5.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.14\u0026thinsp;\u0026plusmn;\u0026thinsp;3.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.715\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.490\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026yen;1000-\u0026yen;2000(\u003cspan\u003e$\u003c/span\u003e143.80-\u003cspan\u003e$\u003c/span\u003e287.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e219(56.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.37\u0026thinsp;\u0026plusmn;\u0026thinsp;3.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026yen;2000(\u003cspan\u003e$\u003c/span\u003e287.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e147(37.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.76\u0026thinsp;\u0026plusmn;\u0026thinsp;3.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eAmount of alcohol consumed\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo not drink alcohol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e269(69.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.51\u0026thinsp;\u0026plusmn;\u0026thinsp;3.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.975\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.405\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrinking frequency\u0026thinsp;\u0026lt;\u0026thinsp;3 times a week (occasional drinking)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e112(28.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.57\u0026thinsp;\u0026plusmn;\u0026thinsp;3.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrinking frequency 3\u0026ndash;7 times a week (regular drinking)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5(1.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.20\u0026thinsp;\u0026plusmn;\u0026thinsp;2.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrinking frequency\u0026thinsp;\u0026gt;\u0026thinsp;7 times a week (daily drinking)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(0.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.50\u0026thinsp;\u0026plusmn;\u0026thinsp;3.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eSmoking habit\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28(7.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.79\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.462\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.644\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e360(92.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.48\u0026thinsp;\u0026plusmn;\u0026thinsp;3.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eHistory of romantic involvement\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e221(56.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.71\u0026thinsp;\u0026plusmn;\u0026thinsp;3.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.434\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.152\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e167(43.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.22\u0026thinsp;\u0026plusmn;\u0026thinsp;3.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eSexual experience\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71(18.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.52\u0026thinsp;\u0026plusmn;\u0026thinsp;3.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.851\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e317(81.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.27\u0026thinsp;\u0026plusmn;\u0026thinsp;3.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eAttention to contraceptive knowledge\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntentional Concern\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e131(33.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.60\u0026thinsp;\u0026plusmn;\u0026thinsp;3.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnintentional Concern\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e193(49.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.04\u0026thinsp;\u0026plusmn;\u0026thinsp;3.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoth Concern\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36(9.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.14\u0026thinsp;\u0026plusmn;\u0026thinsp;3.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28(7.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.79\u0026thinsp;\u0026plusmn;\u0026thinsp;3.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eSelf-assessment of contraceptive knowledge\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlmost nothing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32(8.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.09\u0026thinsp;\u0026plusmn;\u0026thinsp;3.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39.179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA little\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e228(58.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.08\u0026thinsp;\u0026plusmn;\u0026thinsp;3.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMostly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e128(32.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.10\u0026thinsp;\u0026plusmn;\u0026thinsp;3.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e388(100.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.50\u0026thinsp;\u0026plusmn;\u0026thinsp;3.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003en: number of participants.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eCKA scores and distribution\u003c/h3\u003e\n\u003cp\u003eThe CKA scores ranged from 0 to 15, with a mean score of 6.50 (SD\u0026thinsp;=\u0026thinsp;3.36), indicating a low level of contraceptive knowledge. The score distribution followed an approximately normal pattern, with most participants scoring between 4 and 10 points. Socio-demographic factors (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) significantly influenced CKA scores. Academic years were associated with CKA scores, with juniors and seniors scoring higher than freshmen and sophomores (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Students from rural areas had higher CKA scores compared to those from urban areas (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.046). Additionally, students with sexual experience exhibited significantly higher CKA scores (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.005). The level of attention paid to contraceptive knowledge and self-assessment of contraceptive knowledge were also significantly associated with CKA scores, with students who expressed more concern and had higher self-assessments scoring higher (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eContraceptive knowledge by specific topics\u003c/h2\u003e \u003cp\u003eTo further analyze participants' understanding of contraception, knowledge was categorized into various topics, including awareness of contraceptive methods, misconceptions, side effects, and sources of contraceptive knowledge. The results are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eContraceptive knowledge by specific topics statistics of responses and the relationship with CKA scores (n\u0026thinsp;=\u0026thinsp;388)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCKA score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003et/F\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eSources of contraceptive knowledge\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAttended physiology lectures/courses during middle school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e242(62.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.55\u0026thinsp;\u0026plusmn;\u0026thinsp;3.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.385\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.700\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e146(37.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.42\u0026thinsp;\u0026plusmn;\u0026thinsp;3.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNecessity of contraceptive education in schools\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e352(90.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.65\u0026thinsp;\u0026plusmn;\u0026thinsp;3.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.681\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36(9.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.08\u0026thinsp;\u0026plusmn;\u0026thinsp;3.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eKnowledge of different contraceptive methods\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness of dual function of condoms: contraception and prevention of some STD infections\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e367(94.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.69\u0026thinsp;\u0026plusmn;\u0026thinsp;3.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.628\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(5.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.29\u0026thinsp;\u0026plusmn;\u0026thinsp;3.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness of Pearl Index\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50(12.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.10\u0026thinsp;\u0026plusmn;\u0026thinsp;3.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.348\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.178\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e338(87.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.41\u0026thinsp;\u0026plusmn;\u0026thinsp;3.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship between Pearl Index and contraceptive effectiveness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96(24.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.04\u0026thinsp;\u0026plusmn;\u0026thinsp;3.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.817\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.070\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e292(75.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.33\u0026thinsp;\u0026plusmn;\u0026thinsp;3.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge of condom usage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e237(61.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.53\u0026thinsp;\u0026plusmn;\u0026thinsp;3.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e151(38.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.89\u0026thinsp;\u0026plusmn;\u0026thinsp;3.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eMisconceptions about contraception\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccasional sexual intercourse does not lead to pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34(8.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.82\u0026thinsp;\u0026plusmn;\u0026thinsp;3.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-1.234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.218\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e354(91.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.57\u0026thinsp;\u0026plusmn;\u0026thinsp;3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVaginal irrigation after sexual intercourse can prevent pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23(5.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.87\u0026thinsp;\u0026plusmn;\u0026thinsp;3.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.931\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.352\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e365(94.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.54\u0026thinsp;\u0026plusmn;\u0026thinsp;3.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJumping after sexual intercourse can prevent pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(2.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.27\u0026thinsp;\u0026plusmn;\u0026thinsp;3.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.244\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e377(97.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.57\u0026thinsp;\u0026plusmn;\u0026thinsp;3.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eKnowledge of contraceptive side effects\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntermittent use of modern oral contraceptives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e269(69.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.15\u0026thinsp;\u0026plusmn;\u0026thinsp;3.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-3.154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e119(30.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.30\u0026thinsp;\u0026plusmn;\u0026thinsp;3.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeratogenic effects of oral contraceptives during pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e284(73.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.10\u0026thinsp;\u0026plusmn;\u0026thinsp;3.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-3.951\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e104(26.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.60\u0026thinsp;\u0026plusmn;\u0026thinsp;3.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOral contraceptives reduce fertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e245(63.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.76\u0026thinsp;\u0026plusmn;\u0026thinsp;3.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-5.951\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e143(36.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.78\u0026thinsp;\u0026plusmn;\u0026thinsp;3.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLong-term use of oral contraceptives increases risk of gynecologic cancer and cardiovascular disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e281(72.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.05\u0026thinsp;\u0026plusmn;\u0026thinsp;3.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-4.365\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e107(27.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.68\u0026thinsp;\u0026plusmn;\u0026thinsp;3.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOral contraceptives cause significant weight gain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e179(46.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.00\u0026thinsp;\u0026plusmn;\u0026thinsp;3.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.749\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e209(53.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.93\u0026thinsp;\u0026plusmn;\u0026thinsp;3.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOral contraceptives improve hirsutism and acne\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e110(28.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.55\u0026thinsp;\u0026plusmn;\u0026thinsp;3.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.915\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e278(71.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.09\u0026thinsp;\u0026plusmn;\u0026thinsp;3.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e388(100.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.50\u0026thinsp;\u0026plusmn;\u0026thinsp;3.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003en: number of participants.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eContraceptive knowledge by specific topics statistics of multiple-choice questions (n\u0026thinsp;=\u0026thinsp;388)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eSources of contraceptive knowledge\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiscussing sexual and reproductive health knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo one\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePeers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e64.18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eElders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHealthcare professionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eKnowledge of different contraceptive methods\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIdentification of Emergency Contraception Methods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEmergency contraceptive pills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e372\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e95.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eContraceptive patch\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eVaginal contraceptive ring\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIntrauterine device\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCondom\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eVaginal irrigation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.55\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSpermicide\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSubdermal implant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFertility awareness method\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIdentification of routine contraception methods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEmergency contraceptive pills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eContraceptive patch\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eVaginal contraceptive ring\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIntrauterine device\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCondom\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e332\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e85.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eVaginal irrigation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSpermicide\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSubdermal implant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFertility awareness method\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDesired contraceptive knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMethod of taking oral contraceptives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eContraceptive effectiveness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e256\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMale contraceptives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53.87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale condom\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e46.65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAdverse reactions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLong-acting contraceptives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e39.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eShort-acting contraceptives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDifferences in emergency contraceptive pills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48.45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePrevention of sexually transmitted infections\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e64.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMenstrual health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59.28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eKnowledge of contraceptive side effects\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdverse reactions to oral contraceptives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIrregular menstruation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e341\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e87.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIrregular vaginal bleeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67.53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNausea and vomiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEctopic pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38.14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUterine fibroids\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInfertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e198\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e388\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e100.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003en: number of participants.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eSources of contraceptive knowledge\u003c/h2\u003e \u003cp\u003eMost participants (62.37%) reported having attended physiology lectures or courses during middle school. Furthermore, 90.72% of respondents agreed that contraceptive education should be integrated into school curricula. Regarding discussions on sexual and reproductive health, most participants (64.18%) reported conversing with peers, while fewer students reported discussing these topics with healthcare professionals (14.31%) or elders (13.14%).\u003c/p\u003e \u003cp\u003eParticipants were also asked to rank the most common sources of contraceptive knowledge based on frequency of use. The ranking included ten options: the internet, social media platforms such as Weibo, television, books and newspapers, school courses, reproductive health lectures, doctors, family, friends and others. The sources were ranked by assigning 1 point to the most frequently used source, 10 points to the least, and calculating the mean score for each source. The lower the mean score, the higher the ranking of that source. The final rankings revealed that the internet (including websites and online information) and social media platforms like Weibo were identified as the most frequently used sources, followed by books and newspapers. In contrast, doctors, family members, and television were ranked as the least common sources of contraceptive knowledge.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eKnowledge of different contraceptive methods\u003c/h2\u003e \u003cp\u003eThe study assessed participants' knowledge of various contraceptive methods. A significant proportion of students (94.59%) were aware that condoms serve as both a contraceptive method and protection against some sexually transmitted diseases. However, only 12.89% of participants were familiar with the Pearl Index, the World Health Organization's (WHO) gold standard for evaluating the effectiveness of contraceptive methods. Additionally, 61.08% of respondents knew the correct way to use condoms.\u003c/p\u003e \u003cp\u003eIn terms of emergency contraception, 95.88% of participants correctly identified emergency contraceptive pills as a form of emergency contraception. However, only 5.41% were aware that intrauterine devices (IUDs) can also serve as an emergency contraception. Many students mistakenly considered methods such as the safe period (40.20%) and vaginal douching (11.10%) as reliable contraceptive methods. When asked about their interest in further learning, 65.98% of students expressed a desire to learn more about the effectiveness of different contraceptive methods, and 64.43% wanted additional information on how contraceptive methods can prevent sexually transmitted infections.\u003c/p\u003e \u003cp\u003eRegarding familiarity with different contraceptive methods, participants ranked eight methods based on their level of knowledge. These methods included long-term oral contraceptives, IUDs, tubal ligation, subdermal contraceptive implants, condoms, withdrawal, periodic abstinence, and emergency contraceptive pills. The ranking showed that condoms (1st ) and emergency contraceptive pills (2nd ) were the most well-known methods, while IUDs and subdermal contraceptive implants were among the least familiar.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eMisconceptions about contraception\u003c/h2\u003e \u003cp\u003eWhile most participants (91.24%) correctly recognized that even a single instance of sexual intercourse can result in pregnancy, there were notable misconceptions about contraceptive methods. For example, a small proportion of students mistakenly believed that certain practices, such as douching (5.93%) or jumping after intercourse (2.84%), could serve as effective forms of contraception.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eKnowledge of contraceptive side effects\u003c/h2\u003e \u003cp\u003eA significant proportion of participants exhibited misconceptions about the side effects of contraceptive use. For instance, 69.33% of students incorrectly believed that long-term use of modern oral contraceptives could be harmful and should be taken intermittently. Additionally, 73.20% thought that if a pregnant woman mistakenly takes oral contraceptives, it could cause defects in the newborn. Further misconceptions were observed regarding fertility and health risks. A notable 63.14% of students believed that oral contraceptives could reduce female fertility, and 72.42% were unaware that long-term use of oral contraceptives does not increase the risk of gynecological cancers or cardiovascular diseases. Many students also incorrectly believed that oral contraceptives caused weight gain (46.13%), and only 28.35% correctly understood that they could improve conditions like hirsutism and acne. Common side effects such as menstrual irregularities (87.89%), irregular vaginal bleeding (67.53%), and nausea/vomiting (65.46%) were widely recognized as adverse reactions to oral contraceptive use.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eAnalysis of factors influencing CKA scores\u003c/h2\u003e \u003cp\u003eTo explore the factors influencing contraceptive knowledge among university students, both univariate and multivariate regression analyses were conducted. Variables that showed significant associations with CKA scores (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) in the univariate analysis were subsequently included in the multivariate regression model to identify independent predictors of contraceptive knowledge.\u003c/p\u003e \u003cp\u003eThe univariate analysis revealed several factors significantly associated with CKA scores (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), including self-assessment of contraceptive knowledge, awareness of contraceptive education in schools, knowledge of condoms, and several misconceptions about oral contraceptives. The multivariate regression analysis identified several significant predictors of CKA scores (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Specifically, self-assessment of contraceptive knowledge (β\u0026thinsp;=\u0026thinsp;0.202, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) was significantly associated with higher CKA scores, indicating that students with a positive self-assessment of their knowledge were likely to have a better understanding of contraceptive methods. Recognition of the importance of contraceptive education in schools (β\u0026thinsp;=\u0026thinsp;0.108, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.016) was also associated with higher scores. Both awareness of the dual function of condoms (β\u0026thinsp;=\u0026thinsp;0.143, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001) and knowledge of condom usage (β\u0026thinsp;=\u0026thinsp;0.185, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were significantly linked to higher CKA scores. However, the belief that oral contraceptives reduce fertility (β = -0.137, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.009) was associated with lower scores, suggesting that misconceptions about contraceptives negatively impacted knowledge. Students who believed that oral contraceptives improve hirsutism and acne (β\u0026thinsp;=\u0026thinsp;0.112, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.018) had significantly higher knowledge levels. In contrast, the belief that jumping after sex could prevent pregnancy (β= -0.095, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.035) was associated with lower CKA scores, highlighting the detrimental effect of common misconceptions on contraceptive understanding. Other variables, including academic grade, place of origin, sexual experience, attention to contraceptive knowledge, intermittent use of modern oral contraceptives, teratogenic effects of oral contraceptives during pregnancy, long-term use of oral contraceptives, and concerns about weight gain from oral contraceptives, were not significant predictors in the multivariate model. Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e provides a detailed overview of the multivariate analysis results.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariable analysis of factors influencing CKA scores among university students (n\u0026thinsp;=\u0026thinsp;388)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.497\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOrigin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.856\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSexual experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.043\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.388\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAttention to contraceptive knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.115\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-assessment of contraceptive knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNecessity of contraceptive education in schools\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness of dual function of condoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge of condom usage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJumping after sexual intercourse can prevent pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.035\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntermittent use of modern oral contraceptives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.502\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeratogenic effects of oral contraceptives during pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.055\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.265\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOral contraceptives reduce fertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLong-term use of oral contraceptives increases risk of gynecologic cancer and cardiovascular disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.405\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOral contraceptives cause significant weight gain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.273\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOral contraceptives improve hirsutism and acne\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eβ: Standardized beta coefficient.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eLow level of contraceptive knowledge with room for improvement\u003c/h2\u003e \u003cp\u003eThis study assessed contraceptive knowledge among university students in China using the Chinese version of the Contraceptive Knowledge Assessment (CKA) scale. The results revealed that students demonstrated a low level of contraceptive knowledge, with an average CKA score of 6.50\u0026thinsp;\u0026plusmn;\u0026thinsp;3.36 out of 22. While this indicated some basic awareness, it also highlighted significant gaps in knowledge. Students showed a high level of awareness of commonly used contraceptive methods, such as condoms (94.59%) and emergency contraceptive pills (95.88%), while knowledge of long-acting reversible contraceptives (LARCs), such as IUDs, was much lower at 29.90%. This discrepancy suggests a gap between basic awareness and a deeper understanding of contraceptive options. Such gaps appear more pronounced among Chinese students when compared to their peers in other countries. For instance, a study by Rebecca Cohen found that 76.5% of U.S. adolescents and young women had heard of IUDs [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. This finding further underscores the need for more comprehensive education on a broader range of contraceptive methods. Furthermore, the study showed that students in higher academic year (third- and fourth-years students) scored better than their first and second-year counterparts. This is consistent with research by Elif Balkan, which found that contraceptive knowledge increases with academic year [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The greater exposure to educational content, along with more sexual experience and self-directed learning opportunities, likely contribute to this improvement.\u003c/p\u003e \u003cp\u003eInterestingly, the study found that students from rural areas exhibited higher contraceptive knowledge than their urban counterparts, contrary to findings from previous research. For example, Mahande reported that urban women generally have better access to information, education, and healthcare services, all of which are linked to higher contraceptive knowledge and usage rates [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Similarly, Curry identified rural areas as \u0026ldquo;contraceptive deserts\u0026rdquo; due to limited healthcare services and access to reproductive health information [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. This disparity in findings may be due to regional differences in health service availability and local contraceptive education, which warrants further exploration. Expanding the sample size to include students from more diverse geographical areas would provide more accurate insights into these differences.\u003c/p\u003e \u003cp\u003eIn conclusion, these findings emphasized the need for comprehensive and balanced educational programs that not only focus on widely used contraceptive methods but also provide more information about less-known methods in Chinese university students like LARCs. Ensuring students are fully informed about all available contraceptive methods is essential for promoting well-rounded, informed decision-making and ultimately reducing unintended pregnancies.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eSources of contraceptive knowledge and gaps in formal education\u003c/h2\u003e \u003cp\u003eA key finding from this study is that university students primarily rely on the internet and social media platforms (89.18%) for contraceptive information, with fewer students seeking guidance from healthcare professionals (14.31%) or family members (17.78%). This shift toward digital sources raises concerns about the accuracy and reliability of the information students are accessing. Studies by Carley Zeal had noted similar trends, with university students relying heavily on online platforms for reproductive health knowledge, often without verifying the credibility of the sources [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In contrast, traditional sources such as family and healthcare professionals remained underutilized. This gap suggested that cultural barriers in China, particularly around open discussions about contraception, hinder the effectiveness of family and medical sources of information. The limited engagement with authoritative sources points to a need for educational reforms that incorporate formal, structured contraceptive education into the university curriculum. Church suggested that addressing sociocultural barriers and normalizing conversations about reproductive health in both families and schools could significantly improve the quality and reach of sexual health education [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eMisconceptions about contraceptive methods and lack of in-depth knowledge\u003c/h2\u003e \u003cp\u003eOur study found that serious misconceptions about contraception are prevalent among Chinese university students. Specifically, 5.93% of students mistakenly believed that vaginal douching can prevent pregnancy, and 63.14% wrongly believed that long-term use of oral contraceptives impairs fertility. These misconceptions highlight a concerning lack of understanding regarding the effectiveness and mechanisms of various contraceptive methods. The persistence of such misconceptions may contribute to suboptimal contraceptive practices and ultimately lead to unintended pregnancies. These findings align with those from Santos in Portugal, where university students also exhibited misunderstandings about contraceptive methods, particularly regarding the effectiveness of traditional methods like withdrawal and douching [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. In addition, Miller found that some students were reluctant to use hormonal contraception due to fears of birth defects and infertility [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. These fears were consistent with our findings, where widespread misconceptions about hormonal contraceptives persist, despite evidence showing their safety and effectiveness. The analysis also revealed that students' misconceptions about oral contraceptives were negatively correlated with their CKA scores, indicating that misinformation about contraceptive methods impedes the acquisition of accurate knowledge. Addressing these misconceptions early on is crucial to prevent them from becoming deeply ingrained and influencing future contraceptive choices [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. These findings underscore the need for comprehensive sexual and reproductive health education that provides accurate information about the safety, effectiveness, and proper use of contraceptives. To address these gaps, it is essential to develop standardized curricula for contraceptive counseling that align with evidence-based guidelines [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. This curriculum should provide clear, accurate, and easily understandable information about all available contraceptive methods, side effects, and the importance of proper use. Moreover, various communication channels should be employed to disseminate this information [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Educational materials should simplify complex information, ensuring that students can fully understand the efficacy, safety, and correct usage of different contraceptive methods.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThis study has several limitations. First, the sample was drawn from a single city in China, limiting the generalizability of the findings to students from other regions. As Shanghai is one of the most economically developed cities in China, it may have higher levels of contraceptive knowledge compared to less resource-rich areas. Second, self-reported data may introduce recall and social desirability biases, which could affect the accuracy of the responses. Third, the cross-sectional design prevents causal inferences, meaning we cannot determine if certain factors influence contraceptive knowledge over time. Lastly, the study focused on knowledge rather than actual contraceptive behaviors, limiting insights into how knowledge translates into practice.\u003c/p\u003e \u003cp\u003eFuture research should address these limitations by including a broader, more representative sample from various regions of China to better capture regional differences, particularly given the economic and educational disparities between urban and rural areas. Longitudinal studies could also be conducted to assess how contraceptive knowledge evolves over time and whether it leads to changes in contraceptive behaviors. Additionally, future studies should assess actual contraceptive behaviors and consider a variety of behavioral outcomes to fully understand how contraceptive knowledge impacts real-world decision-making.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study provides valuable insights into the contraceptive knowledge of Chinese university students, identifying key factors that influence their understanding. These factors include socio-demographic elements, such as grade and sexual experience, the level of attention given to contraceptive knowledge, and the accuracy of understanding various contraceptive methods. While students demonstrated awareness of common contraceptive methods, their overall knowledge was low, and significant misconceptions about certain methods were prevalent. These challenges underscore the need for structured and comprehensive reproductive health education at universities, focusing not only on widely used methods but also addressing common misconceptions. To improve contraceptive knowledge and reduce unintended pregnancies, universities should incorporate formal curricula on contraception, increase access to accurate digital resources, and promote open discussions about sexual and reproductive health in both academic and family settings. This multi-faceted approach will play a crucial role in promoting safer sexual behaviors and improving reproductive health outcomes in China.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCKA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eContraceptive Knowledge Assessment\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from the participants for publication of this study. A copy of the written consent is available for review by the Editor-in-Chief of this journal.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthical approval and consent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll procedures involving human participants were conducted in accordance with the ethical standards set by the Institutional Review Board (IRB) of Fudan University School of Nursing and in compliance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was reviewed and approved by the IRB of Fudan University School of Nursing (IRB#2021-07-05) before data collection commenced. Informed consent was obtained from all participants, who were fully briefed on the study's purpose, procedures, potential benefits, and risks of the study. Participation was entirely voluntary, and students were assured that they could withdraw at any time without consequences. The survey was anonymous, and all collected data were securely stored and treated with strict confidentiality, used solely for research purposes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Hu Hang Project of “Fudan’s Undergraduate Research Endowment Program” (HH202105).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of Data and Materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and analyzed during the current study are not publicly available since the names and the schools of the participants are mentioned. But the data are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMaoting Tian and Jiayang Zhang contributed equally to this work. They were responsible for conceptualization, methodology, investigation, data collection, formal analysis, data curation, validation, and visualization. Maoting Tian wrote the first draft of the manuscript, while Jiayang Zhang contributed to writing – review \u0026amp; editing. Yan Hu and Lei Xu provided supervision, critical revisions, and contributed to the interpretation of the findings. All authors have read and approved the final version of the manuscript. Maoting Tian and Jiayang Zhang directly accessed and verified the underlying data reported in this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe sincerely thank all the participants and experts who contributed to this study. Special thanks to Dr. Mona Saleh and her colleagues for authorizing the adaptation of the CKA scale.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. Redefining sexual health for benefits throughout life. 2022. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/news/item/11-02-2022-redefining-sexual-health-for-benefits-throughout-life\u003c/span\u003e\u003cspan address=\"https://www.who.int/news/item/11-02-2022-redefining-sexual-health-for-benefits-throughout-life\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. 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Accessed 4 Feb 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaynes MC, Ryan N, Saleh M, Winkel AF, Ades V. Contraceptive Knowledge Assessment: validity and reliability of a novel contraceptive research tool. Contraception. 2017;95:190\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang J, Tian M, Xu L. Reliability and validity of the Chinese version of the contraceptive knowledge assessment scale in college students. BMC Public Health. 2024;24:2810.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBentler P, Chou C-P. Practical Issues in Structural Equation Modeling. Sociol Methods Res. 1987;16:78\u0026ndash;117.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCohen R, Sheeder J, Kane M, Teal SB. Factors Associated With Contraceptive Method Choice and Initiation in Adolescents and Young Women. J Adolesc Health. 2017;61:454\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBalkan E, Gen\u0026ccedil; Koyucu R. The knowledge levels of midwifery students on contraceptive methods: A cross-sectional study. Nurse Educ Today. 2022;119:105605.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMahande MJ, Shayo E, Amour C, Mshana G, Msuya S. Factors associated with modern contraceptives use among postpartum women in Bukombe district, Geita region, Tanzania. PLoS ONE. 2020;15:e0239903.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCurry CG, Hensel DJ, Imburgia TM, Ott MA. Targeting Rural Adolescent Pregnancy: Modifiable Protective Factors and Contraceptive Use. J Adolesc Health. 2024;75:947\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZeal C, Paul R, Dorsey M, Politi MC, Madden T. Young women\u0026rsquo;s preferences for contraceptive education \u0026amp; development of an online educational resource. PEC Innov. 2022;1:100046.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChurch S, Ejder Apay S, Gurol A, Slaveva Y, Mills R. Student midwives\u0026rsquo; perspectives of women\u0026rsquo;s sexual and reproductive health literacy in Turkey. Sex Reprod Healthc. 2023;37:100864.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSantos Mj, Ferreira E, Duarte J, Ferreira M. Risk factors that influence sexual and reproductive health in Portuguese university students. Int Nurs Rev. 2018;65:225\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMiller KK, Saftner MA, McNamara M, McMorris B, Olupot-Olupot P. Provision of adolescent health care in Resource-Limited Settings: Perceptions, practices and training needs of Ugandan health care workers. Child Youth Serv Rev. 2022;132:106310.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGichangi P, Gonsalves L, Mwaisaka J, Thiongo M, Habib N, Waithaka M, et al. Busting contraception myths and misconceptions among youth in Kwale County, Kenya: results of a digital health randomised control trial. BMJ Open. 2022;12:e047426.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee ASD, Burke AE. Integration of a Comprehensive Contraception Education Program Into Clinical Practice in a Family Planning Clinic. Nurs Women\u0026rsquo;s Health. 2019;23:414\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSingh S, Shekhar C, Bankole A, Acharya R, Audam S, Akinade T. Key drivers of fertility levels and differentials in India, at the national, state and population subgroup levels, 2015\u0026ndash;2016: An application of Bongaarts\u0026rsquo; proximate determinants model. PLoS ONE. 2022;17:e0263532.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"contraception, reproductive health, sexual health, contraceptive knowledge assessment, university students","lastPublishedDoi":"10.21203/rs.3.rs-6394972/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6394972/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eObjectives: This study aimed to assess the contraceptive knowledge of university students and to identify the key factors influencing this knowledge.\u003c/p\u003e\n\u003cp\u003eMethods: A cross-sectional survey was conducted with 388 university students in Shanghai using consecutive sampling. Data were collected through an online survey that included demographic information, sexual behavior, and the Chinese version of the CKA Scale. The Chinese CKA scale, which was cross-culturally adapted and validated by the research team, consists of 22 items and demonstrates good internal consistency (Cronbach’s α = 0.793). Descriptive statistics, Chi-square tests, t-tests, and multivariate regression were used to identify predictors of adequate contraceptive knowledge, with statistical significance set at P \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003eResults: Among the 388 respondents (68.30% female, 31.70% male), 95.88% were undergraduates, and 45.10% were from medical-related majors. The average CKA score was 6.5 (SD = 3.36), indicating a low level of contraceptive knowledge. The highest levels of contraceptive knowledge were observed for condoms, emergency contraception, and oral contraceptives. However, misconceptions were prevalent, with 5.93% believing vaginal douching was a contraceptive method, and 8.76% unaware that unprotected sex can lead to pregnancy. Online platforms were the primary source of contraceptive information, while many students reported receiving insufficient information from schools or families. CKA scores were positively correlated with high self-perceived knowledge and correct knowledge of contraceptive methods.\u003c/p\u003e\n\u003cp\u003eConclusion: University students exhibit limited contraceptive knowledge, with notable misconceptions remaining. This highlights the need for comprehensive sexual education initiatives that involve collaboration between schools, families, communities, healthcare institutions, and society.\u003c/p\u003e","manuscriptTitle":"Contraceptive Knowledge and Influencing Factors Among University Students in Shanghai, China: A Cross-sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-30 10:40:27","doi":"10.21203/rs.3.rs-6394972/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"005d9fb3-e8ff-459b-bacb-757deef4bf10","owner":[],"postedDate":"May 30th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-03T08:25:12+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-30 10:40:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6394972","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6394972","identity":"rs-6394972","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}