Stress and Unintended Pregnancy in Adolescence and Young Adulthood

 描述(申请人提供)：美国的青少年和年轻成年女性，特别是少数族裔和贫穷的年轻女性，早孕和意外怀孕的比率很高，这与一系列不良后果有关。虽然生育的近端和远端决定因素已经被广泛研究，但很少有研究关注压力在意外怀孕中的作用。压力是导致发病率和死亡率的主要因素。 以及将社会背景和健康差距联系起来的关键机制。应激的生理和心理过程可能会影响意外怀孕的途径，但生殖健康研究尚未解决这一问题。此外，压力的社会决定因素如何影响年轻女性意外怀孕的风险尚不清楚。为了提高我们对意外怀孕复杂的、相互关联的决定因素的认识，并在生物和社会过程(即生物社会)的交叉点推进生殖健康学术，K01指导研究科学家发展奖侧重于压力在青春期和青春期意外怀孕中的重要但未被充分研究的作用。为了在这一领域进行前沿研究，我建议职业发展培训：1)学习研究意外怀孕和压力的社会学理论、概念和方法；2)培养生物人口学研究方法的能力及其在生育研究中的应用；3)对压力和生育能力的生物学理论和研究有更细微的理解；4)精通模拟生命过程所需的高级多层次、纵向和中介统计方法。 压力和意外怀孕之间的关系和途径。相应的K01研究项目将：1)估计压力轨迹与意外怀孕的关系；2)调查 压力的社会决定因素(社会应激源)、压力轨迹和意外怀孕之间的关系；以及3)探索压力在青春期和成年期影响意外怀孕的生物过程(例如，神经内分泌、炎症和免疫)。为了协助K01的培训和研究计划，我组建了一个强大的多学科咨询委员会，成员包括受人尊敬的学者，包括导师詹妮弗·巴伯博士、共同导师凯瑟琳·穆兰·哈里斯博士、科学顾问Ana Diez Roux博士、Timothy Johnson博士和Julia Seng博士，以及统计顾问谢宇博士。密歇根大学妇产科和社会研究所以及北卡罗来纳大学教堂山公共卫生学院和卡罗莱纳人口中心将提供支持这些活动的基础设施。K01将使我成为一名独立的研究员，准备对生育力进行新的生物社会研究，并最终领导创新的跨学科研究努力，以改善结果和减少年轻女性生殖健康方面的差异。

 DESCRIPTION (provided by applicant): Adolescent and young adult women in the U.S., especially racial/ethnic minority and poor young women, have high rates of early and unintended pregnancy, which are associated with a host of adverse outcomes. While proximal and distal determinants of fertility have been widely studied, little research has focused on the role of stress in unintended pregnancy. Stress is a leading contributor to morbidity and mortality and a key mechanism that links social context and health disparities. The biological and psychological processes of stress may affect the pathways to unintended pregnancy, but this has not been addressed in reproductive health research. Moreover, how social determinants of stress shape young women's risk of unintended pregnancy is unknown. To improve our knowledge of the complex, interrelated determinants of unintended pregnancy and to advance reproductive health scholarship at the intersection of biological and social processes (i.e. biosocial), this K01 Mentored Research Scientist Development Award focuses on the important but understudied role of stress in unintended pregnancy during adolescence and young adulthood. So that I may conduct cutting-edge research in this area, I propose career development training to: 1) learn sociological theories, concepts, and methods for studying unintended pregnancy and stress; 2) build competency in bio demographic research methods and their application to fertility research; 3) attain a more nuanced understanding of the theory and research on the biology of stress and fecund ability; and 4) become proficient in advanced multilevel, longitudinal, and mediational statistical methods required for modeling the life course of and pathways between stress and unintended pregnancy. The corresponding K01 research project will: 1) estimate how trajectories of stress relate to unintended pregnancy; 2) investigate relationships between social determinants of stress (social stressors), stress trajectories, and unintended pregnancy; and 3) explore the biological processes (e.g., neuroendocrine, inflammatory, and immune) through which stress influences unintended pregnancy, during adolescence and young adulthood. To assist with the K01 training and research plans, I have assembled a strong multidisciplinary advisory board comprised of esteemed scholars, including mentor Jennifer Barber PhD, co-mentor Kathleen Mullan Harris PhD, scientific advisors Ana Diez Roux MD PhD, Timothy Johnson MD, and Julia Seng PhD MSN, and statistical consultant Yu Xie PhD. The University of Michigan Department of Obstetrics and Gynecology and Institute for Social Research and The University of North Carolina at Chapel Hill School of Public Health and Carolina Population Center will provide the infrastructures to support these activities. This K01 will establish me as an independent investigator poised to conduct new biosocial studies of fertility and ultimately lead innovative, interdisciplinary research efforts to improve outcomes an reduce disparities in young women's reproductive health.