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

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Unplanned births in Italy have significantly declined over the past 30 years, distinguishing Italy from other Western countries. Italy's success may be attributed to condom vending machines (CVMs), which contribute to minimizing embarrassment in contraceptive purchases. This study examined consumer perceptions toward CVMs and their impact on condom purchasing attitudes and behaviors among Italian women. Semi‐structured interviews were conducted among participants living in Florence, Italy, a popular region for these machines. Grounded theory and a constant comparative method were used for qualitative theme development. Data suggest participants feel positively toward machines, considering them a convenient purchase outlet. Participants noted barriers and facilitators to machine use, offering improvement opportunities for consumer behavior researchers, marketers, and machine retailers (i.e., alternate CVM placement, diversified product offerings, product quality guarantees), potentially contributing to their efficacy as viable condom purchasing alternatives. Findings expand consumer behavior and embarrassment literature and offer insight for future CVM implementation.

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