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

描述（由研究者提供）：意外怀孕在美国经常发生，并产生许多社会和经济成本。2001年全国家庭增长调查（NSFG）估计，49%（310万）的美国怀孕是意外的（Finer & Henshaw，2006）。“2010年健康人”的目标是将这一数字降至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。这些因素加在一起使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）。要设计有效的和文化上有能力的方案，以帮助西班牙裔妇女防止这些意外出生，重要的是要了解的相关因素，文化背景，以及妇女的看法，在西班牙裔社区的意外怀孕。因此，本混合方法论文的具体目标是：使用先前收集的定量数据，确定以低收入拉丁裔妇女为主的样本中怀孕意愿的社会人口学相关性，通过定性访谈探索拉丁裔妇女怀孕意愿结构的文化相关性，采用认知访谈技术，探讨妇女对常用的怀孕意向测量的看法，并提供妇女对给定测量的认知加工数据。本论文的第二个组成部分是测试意外出生对围产期抑郁症在这一人群的不利影响。产后抑郁症是常见的（患病率13%; O 'Hara & Swain，1996），西班牙裔妇女表现出抑郁症状的风险是白色，非西班牙裔妇女的两倍（豪厄尔，莫拉，霍洛维茨，Leventhal，2005;黄，黄，Ronzio，和Yu，2007;里奇-爱德华兹等人，2006年）。关于怀孕意愿和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，意外怀孕和产妇心理健康状况不佳之间存在关联（Barber，Axinn，& Thornton，1999; Lau & Keung，2007; Najman，莫里森，威廉姆斯，安德森，& Keeping，1991; Nakku，Nakasi，& Mirembe，2006; Orr &米勒，1997; Sayil，Gure，& Ucanok，2006）。然而，这些研究中有许多存在方法学上的局限性，包括横断面研究设计、不控制混杂变量的双变量统计分析、以及抑郁和/或怀孕意愿的不常见或未经验证的测量。为了填补这一空白，在意外怀孕的结果研究，本论文的最终具体目标是使用纵向线性回归模型，以确定是否有调整的关联意外怀孕和围产期抑郁症状使用以前收集的纵向数据之间的拉丁美洲人的心理健康。

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.