Understanding Behavioral Patterns in Contraceptive Use

项目摘要 该项目包括U 54避孕研究中心（PI： Georg）。在美国，意外怀孕的比例-无论是不合时宜的还是不想要的- 高（约45%），但只有一小部分（5%）的意外怀孕是由于避孕 失败相反，绝大多数意外怀孕发生在那些不一致的夫妇身上。 采取避孕措施（41%）或根本不采取避孕措施（54%）。在临床试验中，持续使用有效的 避孕可以将夫妇意外怀孕的风险降低到几乎为零-也就是说，临床上 大多数方法的试验/完美使用失败率极低（例如，避孕套占2%，戒断占4%， 口服避孕药为0.3%）。然而，夫妇的典型使用失败率要高得多（例如，百分之十八 避孕套、戒断和口服避孕药的使用率分别为22%和9%）。我们对这些知之甚少 完美和典型使用失败率之间的差异，主要是由于数据限制。我们建议使用 新的可用的创新数据，克服了以前的障碍，了解这些典型的使用模式。 关系动态和社会生活（RDSL）项目收集了一个人口代表性的数据， 密歇根州一个县的953名年龄在18岁和19岁之间的女性的随机样本。经过50分钟的面对面 密歇根大学调查研究中心的一位专业面试官进行了采访， 年轻女性每周完成在线或电话随访访谈，持续2.5年（130周）。每周 避孕措施的使用和一致性提供了前所未有的机会，了解 研究中包括的2 500对夫妇中典型的避孕药具使用习惯的动态。我们提出 一种创新的数据简化技术--序列分析--用于描述、总结和分类典型用途 模式.由于数据是基于种族/民族、社会经济 特征，以及与怀孕有关的青少年经历，我们还将分析这些模式， 人口分组。此外，因为数据还包括与以下各项的关系特性的度量： 每周的精确度，我们提出了以前不可能的分析，如何夫妇的特点， 每周改变（例如，冲突、性排斥等）影响其每周避孕药具的使用， 一致性，并有助于整个有效（或无效）避孕药具使用的总体模式 他们的关系。因此，拟议中的项目调查了一个长期存在的难题，在理解夫妇 避孕药具使用行为（为什么典型的使用失败率如此之高），通过结合创新的数据集， （RDSL）与最先进的统计分析技术（序列分析，夫妇水平固定效应） 模型）。该项目的成果将有助于开发新的避孕方法， 更有可能被夫妇持续使用，从而提高避孕药具的有效使用率， 意外怀孕

PROJECT SUMMARY This project comprises the behavioral research component of the U54 Contraceptive Research Center (PI: Georg). In the United States, the proportion of pregnancies that is unintended—either mistimed or unwanted— is high (approximately 45%), but only a small fraction (5%) of unintended pregnancies are due to contraceptive failure. Instead, the vast majority of unintended pregnancies occur to couples who were either inconsistently using contraception (41%) or not using contraception at all (54%). In clinical trials, consistent use of effective contraception reduces a couple's risk of an unintended pregnancy to nearly zero – that is, the clinical trial/perfect use failure rate for most methods is extremely low (e.g., 2% for condoms, 4% for withdrawal, and .3% for oral contraceptive pills). However, typical use failure rates for couples are much higher (e.g., 18% for condoms, 22% for withdrawal, and 9% for oral contraceptive pills). We know very little about these differences between perfect and typical use failure rates, largely due to data limitations. We propose to use newly available, innovative data that overcomes the prior barriers to understanding these typical use patterns. The Relationship Dynamics and Social Life (RDSL) project collected data on a population-representative random sample of 953 women ages 18 and 19 in a Michigan county. Following a face-to-face 50-minute interview conducted by a professional interviewer at the University of Michigan's Survey Research Center, the young women completed online or phone follow-up interviews weekly for 2.5 years (130 weeks). Weekly measures of contraceptive use and consistency provide an unprecedented opportunity to understand the dynamics of typical contraceptive use practices among the 2,500 couples included in the study. We propose an innovative data reduction technique – sequence analysis – to describe, summarize, and classify typical use patterns. Because the data are based on a population that is diverse in terms of race/ethnicity, socioeconomic characteristics, and adolescent experiences related to pregnancy, we will also analyze these patterns for population sub-groups. Further, because the data also includes measures of relationship characteristics with weekly precision, we propose previously impossible analyses of how the characteristics of couples that change weekly (e.g., conflict, sexual exclusivity, etc.) influence their weekly contraceptive use and consistency, and contribute to the overall patterns of effective (or ineffective) contraceptive use throughout their relationship. Thus, the proposed project investigates a persistent puzzle in understanding couples' contraceptive use behaviors (why typical use failure rates are so high), by combining an innovative dataset (RDSL) with state-of-the-art statistical analysis techniques (sequence analysis, couple-level fixed effects models). The results of this project will contribute to the development of new contraceptive methods that are more likely to be used consistently by couples, thereby increasing effective contraceptive use and reducing unintended pregnancy.