Rains’s model
This model was developed by Rains (1971) and again places contraception use within
the context of sexuality and self-concept. It suggests that contraception use is more likely
to occur at a stage when the individual believes that sexual activity is ‘right for them’.
This process involves the following four stages:1 Falling in love: this provides a rationale for sex.
2 Having an exclusive, long-term relationship.
3 Sexual intercourse becomes an acceptable behaviour.
4 Individuals accept themselves as sexual and plan sex for the future.According to this model, reaching stage 4 predicts reliable contraception use.Decision-making models
Decision-making models examine the psychological factors that predict and are the
precursors to contraception use. There are several different decision-making models and
they vary in their emphasis on individual cognitions (e.g. costs and benefits of contra-
ception use) and the extent to which they place these cognitions within the specific
context of the relationship (e.g. the interaction, seriousness of relationship, frequency
of sexual intercourse in the relationship) and the broader social context (e.g. peer norms,
social attitudes).Subjective expected utility theory
Most decision-making models of behaviour are based on the subjective expected utility
theory (SEU) (Edwards 1954). The SEU predicts that individuals make subjective
estimates of the possible costs and benefits of any particular behaviour and, based on
this assessment, make a decision as to which behaviour results in the least costs and the
most benefits (material, social and psychological). It therefore characterizes behaviour
as rational. Luker (1975) examined the SEU in the context of contraceptive use and
argued that individuals weigh up the costs and benefits of pregnancy against the costs
and benefits of contraception. Sheeran et al. (1991) argued that this approach was
important as it undermined the belief that contraception has no costs for women and
pregnancy had no benefits. The SEU is predominantly individualistic and the role of both
the relationship and social context is minimal.The five-component model
This model was developed by Reiss et al. (1975) and, although it still regards contra-
ceptive use as resulting from a rational appraisal of the situation, it includes measures
of more general attitudes. The components of the model are: (1) endorsement of sexual
choices (e.g. permissiveness, religiosity); (2) self-assurance; (3) early information on
sex and contraception; and (4) congruity between premarital sexual standards and190 HEALTH PSYCHOLOGY