Measuring pregnancy preferences among women and men in a resource-limited, high-fertility setting

项目概要/摘要 我们的目标是改善对女性和男性预期怀孕偏好的测量 在撒哈拉以南非洲低资源、高生育率环境下， 和适应性的愿望，以避免怀孕（DAP）规模（目的1），并评估可靠性 通过在乌干达的妇女和男子中进行测试，对经过调整的DAP量表进行评估和有效性评估（目标2）。 我们的定性方法、量表开发和调查研究专家团队来自 美国和乌干达将进行一项连续的混合方法研究， 在乌干达妇女和男子之间转让DAP领域，调整和开发项目， 反映他们的观点，试点测试和心理测量评估项目。具体目标是： 1.目标1：制定针对不同性别的“避免怀孕的愿望”（DAP） 在女性和男性中分别具有结构效度的量表， 乌干达的情况。我们将把DAP量表项目翻译成当地语言， 定性方法，包括认知和深入访谈，在30名妇女年龄 15-49和30名18岁以上的男性，以探索DAP的项目理解和显著性 域.我们将使用演绎，主题分析，以检查收敛和 女性和男性的怀孕偏好的差异，分别与每个DAP 域和调整DAP项目，以捕捉在乌干达的情况下怀孕的偏好。 2.目的2：评估乌干达DAP量表的信度和效度。我们将 有目的地抽样400名15-49岁的女性和400名18岁以上的男性， 农村和一个城市地区进行适应性DAP的表面有效性和试点测试 鳞片我们将分析DAP量表的心理测量学特性，包括 维度、内部一致性信度和结构效度，分别为男性 和妇女，使用基于项目反应理论的方法。 开发和验证经调整的DAP量表将提高 低资源、高生育率环境下的健康计划，以（i）确定具有较强生育能力的个人 避免怀孕的愿望，（二）定制以人为本的生殖服务，以满足他们的需求， (iii)加强对夫妇怀孕偏好动态的了解，以及（四） 提高怀孕偏好措施在预测和解决 生育率、孕产妇和儿童健康成果，以促进终身健康和福祉。

PROJECT SUMMARY/ABSTRACT Our goal is to improve measurement of women’s and men’s prospective pregnancy preferences in low-resource, high-fertility settings in sub-Saharan Africa through gender-specific evaluation and adaptation of the Desire to Avoid Pregnancy (DAP) scale (Aim 1) and assess the reliability and validity of adapted DAP scales through testing among women and men in Uganda (Aim 2). Our team of experts in qualitative methods, scale development, and survey research from the United States and Uganda will conduct a sequential mixed-methods study to understand transferability of DAP domains among Ugandan women and men, adapt and develop items that reflect their perspectives, and pilot test and psychometrically evaluate items. Specific aims are to: 1. Aim 1: Develop gender-specific versions of the Desire to Avoid Pregnancy (DAP) scale that have construct validity among women and men, respectively, in the Ugandan context. We will translate the DAP scale items into local languages and use qualitative methods, including cognitive and in-depth interviews, among 30 women aged 15-49 and 30 men aged 18+ years to explore item comprehension and salience of DAP domains. We will use deductive, thematic analysis to examine convergence and divergence of women’s and men’s pregnancy preferences, respectively, with each DAP domain and adapt DAP items to capture pregnancy preferences in the Ugandan context. 2. Aim 2: Evaluate the reliability and validity of the Ugandan DAP scales. We will purposively sample 400 women aged 15-49 years and 400 men aged 18+ years in one rural and one urban district to conduct face validity and pilot testing of the adapted DAP scales. We will analyze the psychometric properties of the DAP scales, including dimensionality, internal consistency reliability, and structure validity, separately for men and women, using methodologies grounded in Item Response Theory. The development and validation of the adapted DAP scales will improve the capacity of health programs in low-resource, high-fertility contexts to (i) identify individuals with strong desires to avoid pregnancy, (ii) tailor person-centered reproductive services to meet their needs, (iii) strengthen understanding of the dynamics of pregnancy preferences within couples, and (iv) enhance the utility that measures of pregnancy preferences offer for predicting and addressing fertility, maternal, and child health outcomes to promote lifelong health and well-being.