Young Women's Relationships, Contraception, and Unintended Pregnancy

描述（由申请人提供）：我们提出了一项新的研究来调查意外怀孕及其社会背景。我们的方法将提供对意外怀孕流行率的新估计，对产生意外怀孕的社会背景的新见解，以及可用于意外怀孕和相关主题的主要国家研究的新测量策略。为了加深我们对导致年轻女性意外怀孕的过程的理解，该项目有四个目标：(1)收集新的详细的、动态的意外怀孕指标；(2)收集新的详细的、动态的行为、态度和社区环境方面的措施，包括关系、避孕药具的使用、怀孕和与生育竞争的活动；(3)根据新的前瞻性测量策略提供意外怀孕发生率的替代估计，并直接将这些新的发生率估计与基于国家研究的估计进行比较；(4)确定哪些行为、态度和环境方面的关系、避孕措施的使用和与生育竞争的活动会增加成年过渡期间的意外怀孕率。为了实现这些目标，我们提出了一项为期五年的研究，从民族志、认知访谈和试点研究开始，所有这些都与国家数据收集领导的咨询小组协调，最终确定我们将使用的数据收集工具。接下来，我们将在密歇根州的一个县对1250名18岁和19岁的女性进行面对面的访谈，并进行为期30个月的期刊随访研究。在30个月的时间里，这些妇女将每周通过互联网和交互式语音应答（电话）技术提供有关其关系、避孕药事使用、怀孕和竞争活动的行为和态度方面的最新信息。我们还将对大约10%的怀孕妇女和一组没有怀孕的年轻妇女进行半结构化的随访访谈。在期刊随访期结束时，参与研究的女性将完成用于全国家庭成长调查（NSFG）第7周期的个人访谈。调整潜在的测试-反应的相互作用，nsfg风格的测量将提供每周基于期刊的估计和国家估计的意外怀孕和相关因素之间的比较。我们对期刊测量的分析将采用最先进的动态事件历史模型，使用完全详细的时间信息来记录关系、避孕措施的使用、与生育竞争的活动和意外怀孕的行为、态度和上下文方面之间的相互联系。研究结果将对围绕这一高度优先的公共卫生和公共政策问题的进程产生重要的新见解。

DESCRIPTION (provided by applicant): We propose new research to investigate unintended pregnancies and their social context. Our approach will provide new estimates of the prevalence of unintended pregnancy, new insights into the social context producing unintended pregnancies, and new measurement strategies that can be adapted by major national studies of unintended pregnancy and related topics. To advance our understanding of the processes leading to unintended pregnancy among young women, this project has four aims: (1) Collect new detailed, dynamic measures of unintended pregnancy; (2) Collect new detailed, dynamic measures of behavioral, attitudinal, and community context aspects of relationships, contraceptive use, pregnancy, and activities that compete with childbearing; (3) Provide alternative estimates of the prevalence of unintended pregnancy based on new, prospective measurement strategies and directly compare these new prevalence estimates to those based on national studies; and (4) Determine which behavioral, attitudinal, and contextual aspects of relationships, contraceptive use, and activities that compete with childbearing increase unintended pregnancy rates during the transition to adulthood. To meet these aims, we propose a five-year study that begins with ethnography, cognitive interviewing, and a pilot study - all coordinated with an advisory group of national data collection leaders - to finalize the data collection instruments we will use. Next we will conduct face-to-face interviews with 1250 18 and 19-year-old women in one county in Michigan, along with a thirty month journal follow-up study. Over the thirty month period, these women will provide weekly updates about behavioral and attitudinal aspects of their relationships, contraceptive use, pregnancies, and competing activities via Internet and Interactive Voice Response (telephone) technologies. We will also conduct semi-structured follow-up interviews with approximately 10 percent of the women who experience pregnancies and a control group of young women who do not become pregnant. At the conclusion of the journal follow-up period, women in the study will complete the individual interview used for Cycle 7 of the National Survey of Family Growth (NSFG). Adjusting for potential testing-response interactions, the NSFG-style measurement will provide a comparison between the weekly journal-based estimates and the national estimates of unintended pregnancy and related factors. Our analyses of the journal measures will feature state-of-the-art dynamic event history models using the fully detailed timing information to document the interconnections among behavioral, attitudinal, and contextual aspects of relationships, contraceptive use, activities that compete with childbearing, and unintended pregnancy. The results will produce essential new insights into the processes surrounding this high priority public health and public policy concern.