Understanding unintended pregnancy among New Latinas: A mixed method approach.

了解新拉丁裔的意外怀孕：混合方法。

• 批准号: 7673250
• 负责人: Anna Lynn Christensen
• 金额: $ 3.48万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-01 至 2009-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7673250
• 关键词: Understanding; unintended; pregnancy; among; New

DESCRIPTION (provided by the investigator): Unintended pregnancy occurs frequently in the U.S. and has many social and economic costs. The 2001 National Survey of Family Growth (NSFG) estimated that 49% (3.1 million) of all U.S. pregnancies were unintended (Finer & Henshaw, 2006). A Healthy People 2010 objective is to reduce this figure to 30% (objective 9-1). Hispanic women have higher than average fertility rates and unintended pregnancy rates and also terminate a smaller percentage of unintended pregnancies than the national average. These factors combined give Hispanic women an unintended birth rate of almost twice the national average (Finer & Henshaw, 2006). To design effective and culturally competent programs to help Hispanic women prevent these unintended births, it is important to understand the correlates, cultural context, and women's perceptions of unintended pregnancy in Hispanic communities. As such, specific aims of this mixed-method dissertation are: to determine the sociodemographic correlates of pregnancy intention in a sample of predominantly low-income Latina women using previously-collected quantitative data, to explore the cultural relevance of the construct of pregnancy intendedness among Latina women though qualitative interviews, and to use cognitive interviewing techniques to explore women's perceptions of commonly-used measures of pregnancy intendedness and provide data on women's cognitive processing of the given measures. A second component of this dissertation is to test the adverse effects of unintended births on perinatal depression in this population. Postpartum depression is common (prevalence 13%; O'Hara & Swain, 1996) and Hispanic women exhibit a risk of depressive symptoms twice as high as White, non-Hispanic women (Howell, Mora, Horowitz, & Leventhal, 2005; Huang, Wong, Ronzio, & Yu, 2007; Rich-Edwards et al., 2006). There is limited research on pregnancy intention and maternal mental health outcomes (Gipson, Koenig, & Hindin, 2008). The few studies that have been conducted suggest an association between unintended pregnancy and poor maternal mental health (Barber, Axinn, & Thornton, 1999; Lau & Keung, 2007; Najman, Morrison, Williams, Andersen, & Keeping, 1991; Nakku, Nakasi, & Mirembe, 2006; Orr & Miller, 1997; Sayil, Gure, & Ucanok, 2006). However, many of these studies have methodological limitations, including cross-sectional study design, bivariate statistical analyses that do not control for confounding variables, and uncommon or unvalidated measures of depression and/or pregnancy intention. To fill this gap in research on the outcomes of unintended pregnancy, the final specific aim of this dissertation is to use longitudinal linear regression models to determine if there is an adjusted association between unintended pregnancy and perinatal depressive symptoms using previously-collected longitudinal data on mental health among Latinas.

描述（由研究者提供）：意外怀孕在美国经常发生，并造成许多社会和经济成本。 2001 年全国家庭成长调查 (NSFG) 估计，美国 49%（310 万）的怀孕是意外怀孕（Finer & Henshaw，2006）。 《健康人类 2010》的目标是将这一数字减少到 30%（目标 9-1）。西班牙裔妇女的生育率和意外怀孕率高于平均水平，终止意外怀孕的比例也低于全国平均水平。这些因素综合起来导致西班牙裔妇女的意外生育率几乎是全国平均水平的两倍（Finer & Henshaw，2006）。为了设计有效且符合文化的计划来帮助西班牙裔妇女预防这些意外怀孕，了解西班牙裔社区中意外怀孕的相关性、文化背景和妇女的看法非常重要。因此，这篇混合方法论文的具体目标是：使用先前收集的定量数据，确定主要是低收入拉丁裔女性样本中怀孕意向的社会人口统计学相关性，通过定性访谈探讨拉丁裔女性怀孕意向结构的文化相关性，并使用认知访谈技术探讨女性对常用怀孕意向衡量标准的看法，以及 提供有关女性对给定措施的认知处理的数据。本论文的第二个组成部分是测试意外分娩对该人群围产期抑郁症的不利影响。产后抑郁症很常见（患病率 13%；O'Hara & Swain，1996），西班牙裔女性出现抑郁症状的风险是非西班牙裔白人女性的两倍（Howell, Mora, Horowitz, & Leventhal, 2005；Huang, Wong, Ronzio, & Yu，2007；Rich-Edwards et al., 2006）。关于怀孕意愿和孕产妇心理健康结果的研究有限（Gipson、Koenig 和 Hindin，2008）。已经进行的少数研究表明，意外怀孕与孕产妇心理健康状况不佳之间存在关联（Barber、Axinn 和 Thornton，1999 年；Lau 和 Keung，2007 年；Najman、Morrison、Williams、Andersen 和 Keeping，1991 年；Nakku、Nakasi 和 Mirembe，2006 年；Orr 和 Miller，1997 年；Sayil、Gure 和 Ucanok， 2006）。然而，其中许多研究存在方法学局限性，包括横断面研究设计、不控制混杂变量的双变量统计分析，以及不常见或未经验证的抑郁和/或怀孕意向测量。为了填补意外怀孕结果研究的这一空白，本论文的最终具体目标是利用纵向线性回归模型，利用之前收集的拉丁裔心理健康纵向数据来确定意外怀孕与围产期抑郁症状之间是否存在调整后的关联。