Social support and pregnancy outcomes in early adulthood

 描述(申请人提供)：在美国，一半的女性将在45岁之前经历意外怀孕。1、2在年轻女性中，到20岁时，超过30%的人将经历怀孕，并且超过80%的怀孕将是意外的。1意外分娩对妇女和她的孩子都有负面的身体、社会和经济后果。3-5确保女性能够在是否怀孕到足月的问题上做出正确的选择，这对她的健康和幸福是至关重要的。关于意外怀孕的决定会影响到女性的教育、职业和个人抱负，以及她现在和未来的家庭生活。6、7社会支持--来自伴侣、父母和朋友--对妇女决定意外怀孕至足月的重要性已在以前的工作中得到确认，8-11但这种支持的动态性质及其可能采取的各种形式尚未得到充分研究。特别是，很少有研究考察亲密的性关系对怀孕决定的影响。这项拟议的研究旨在1)确定亲密的性关系动态，预测女性是否会在成年早期(18-22岁)选择意外怀孕到足月，以及在决定过程中的任何延误；2)描述面临意外怀孕的年轻女性对决策支持的需求。这两个目标结合在一起，将使人们深入了解社会支持对年轻女性怀孕决策的总体影响，最终目标是帮助卫生专业人员在咨询期间解决这些影响--包括如何增强妇女获得她们需要的社会支持的能力，以及确保她们的信息需求得到满足。这种加强的支持应该会减少怀孕决策(财务和医疗)方面代价高昂的延误，并提高妇女对自己的选择的满意度。对于目标1，数据将来自对196名年龄在18-22岁之间的年轻女性进行的为期两年半的每周广泛调查采访，她们在NICHD资助的关系动态和社交生活(RDSL)研究期间经历了233次意外怀孕。运用Logistic回归和边际结构模型，探讨关系动态对妊娠解决的影响。对于目标2，首席调查员将从从196名RDSL参与者的原始样本中抽取的25名妇女的深入访谈中收集新的定性数据。定性的方法将被用来分析访谈数据，将定量分析的结果与背景联系起来，并为未来的博士后研究产生假设。我在这份申请中提出的培训计划将使我不仅能够发展定量和定性的方法论技能来进行论文研究，而且还将帮助我获得作为一名独立的学术研究人员的积极职业生涯所需的必要专业技能。

 DESCRIPTION (provided by applicant): In the United States, half of all women will experience an unintended pregnancy by age 45. 1, 2 among younger women, by the age of 20, more than 30% will experience a pregnancy, and over 80% of these pregnancies will be unintended. 1 Unwanted births are associated with negative physical, social and economic consequences for both the woman and her child. 3-5 Ensuring that a woman is able to make the right choice for herself about whether to carry an unintended pregnancy to term is fundamental to her health and wellbeing. Decisions regarding unintended pregnancy have ramifications that affect a woman's educational, professional and personal aspirations, as well as her current and future family life. 6, 7 the importance of social support - from partners, parents and friends - for a woman's decision to carry an unintended pregnancy to term has been identified in previous work, 8-11 but the dynamic nature of this support and the various forms it can take have been under-studied. Particularly, few studies have examined the influence of intimate, sexual relationships on the pregnancy resolution decision. This proposed study aims to 1) identify dynamics of intimate, sexual relationships that predict whether a woman will choose to carry an unintended pregnancy to term during her early adulthood (ages 18-22 years), and any delays in that decision; and 2) describe the needs for decision- making support perceived by young women faced with an unintended pregnancy. Combined, these two aims will provide insight into the overall influence of social support on pregnancy decision-making in young women, with the ultimate goal of helping health professionals address these influences during their counseling - including how to empower women to access the social support that they need, as well as ensuring that their informational needs are met. This enhanced support should reduce costly delays in pregnancy decision- making (financial and medical), and improve women's satisfaction with their choice. For Aim 1, the data will be derived from two and a half years of extensive weekly survey interviews with 196 young women ages 18-22 years who experienced 233 unintended pregnancies during their enrollment in the NICHD-funded Relationship Dynamics and Social Life (RDSL) Study. Logistic regression and marginal structural modeling will be used to explore the influence of relationship dynamics on pregnancy resolution. For Aim 2, the Principal Investigator will collect new qualitative data from in-depth interviews conducted among 25 women drawn from the original sample of 196 RDSL participants. Qualitative methods will be used to analyze interview data to contextualize results from quantitative analyses and to generate hypotheses for future post-doctoral research. The training program that I propose in this application will allow me to not only develop the quantitative and qualitative methodological skills to carry out my dissertation research, but will also help me to obtain the necessary professional skills that I will need for an active career as an independent, academic researcher.