Sociocultural context and mental health around an unintended pregnancy

项目摘要 该项目检查选择性终止妊娠前后的心理健康状况，以及是否和 社会文化背景如何与选择性终止前后的心理健康相关。这项研究是 对于有效和高效地促进妇女及其家庭的心理健康以及 子孙后代的。只有一项30年前进行的美国研究检查了抑郁症状 从选择性终止之前到之后，没有研究直接检查是否或如何 社会文化背景影响选择性终止前后的心理健康。在过去的30年里，许多事情都发生了变化 关于社会文化背景和谁有选择性终止妊娠的问题。有选择权的患者 堕胎的种族和民族更多样化，更有可能是低收入，更有可能是 已经是母亲了。关于社会文化背景，总体上增加了 颁布了关于选择性终止的政策(2021年是自1973年以来最多的)，减少了 提供选择性终止手术的诊所数量，以及美国成年人认为 选择性终止在所有或大多数情况下都应该是合法的。此外，在美国国内，这些社会文化 指标因地理位置而异。这项研究的长期目标是了解是否以及如何 社会文化背景影响选择性终止前后的心理健康，因此简单的干预措施 在有选择性终止妊娠的人中促进心理健康可能是最有效的实施和 效率很高。这项建议的主要目标是测试一种新方法的可行性，该方法 评估心理健康(包括抑郁、焦虑、压力和创伤后应激症状，以及 自杀意念)从选择性终止之前到结束后，考察了社会文化是否以及如何 背景会影响选择性终止前后的心理健康。为了做到这一点，我们建议招募和跟踪 每年有560名妇女在两种截然不同的社会文化背景下进行选择性堕胎(每种情况下有280人 上下文)。根据压力和应对理论、实证研究和我们最近进行的试点队列 研究，我们有以下目标：1)详细说明从治疗前1周到治疗1年后的心理健康变化 选择性终止，2)检查社会文化背景对心理健康的影响程度 围绕选择性终止，3)调查污名、后勤经历、认知评估 应对期望在社会文化背景和心理健康之间起中介作用 选择性终止，以及4)探索社会支持是否缓冲了负面社会文化的影响 关于选择性终止的精神健康的背景。从拟议的研究中获得的知识将 指导下一步的研究，并提供简短的干预措施和临床实践，旨在促进心理健康 关于选择性终止的健康。

Project Summary This project examines mental health from before to after an elective termination of pregnancy and whether and how the sociocultural context is associated with mental health around an elective termination. This research is important for effectively and efficiently promoting mental health in women and their families and for the well- being of future generations. Only one U.S. study conducted 30 years ago has examined depressive symptoms from before to after an elective termination, and no research has directly examined whether or how the sociocultural context influences mental health around an elective termination. Much has changed in the past 30 years regarding the sociocultural context and who has elective terminations. Patients who have elective terminations are more racially and ethnically diverse, more likely to be low income, and more likely to be mothers already. With respect to the sociocultural context, there has been an overall increase in the volume of enacted policies around elective terminations (with 2021 having the most since 1973), a decrease in the number of clinics providing elective terminations, and an increase in the percentage of U.S. adults believing elective terminations should be legal in all or most cases. Furthermore, within the U.S. these sociocultural indicators vary by geographical location. The long-term goal of this research is to understand whether and how the sociocultural context influences mental health around an elective termination so that brief interventions to promote mental health among those having elective terminations may be implemented most effectively and efficiently. The primary objectives of this proposal are to test the feasibility of a novel methodology that assesses mental health (including depressive, anxiety, stress, and post-traumatic stress symptoms, and suicidal ideation) from before to after an elective termination and examines whether and how the sociocultural context influences mental health around an elective termination. To do this, we propose to recruit and follow for a year 560 women having elective terminations in two very different sociocultural contexts (280 in each context). Informed by stress and coping theory, empirical research, and our recently conducted pilot cohort study, we have the following aims: 1) To detail mental health changes from 1 week before to 1 year after an elective termination, 2) To examine the extent to which the sociocultural context influences mental health around an elective termination, 3) To investigate whether stigma, logistical experiences, cognitive appraisals and coping expectations mediate the association between sociocultural context and mental health around an elective termination, and 4) To explore whether social support buffers the effects of a negative sociocultural context on mental health around an elective termination. Knowledge gained from the proposed research will guide next steps in research and inform brief interventions and clinical practice aimed at promoting mental health around an elective termination.