Young Women's Relationships, Contraception, and Unintended Pregnancy

描述(由申请人提供)：我们建议进行新的研究，以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，以及可以被意外怀孕和相关主题的主要国家研究采用的新的测量策略。为了促进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)收集关于意外怀孕的新的详细、动态的测量；(2)收集关于关系、避孕措施的使用、怀孕和与生育竞争的活动的行为、态度和社区背景方面的新的详细、动态的测量；(3)基于新的前瞻性测量策略提供意外怀孕流行率的替代估计，并直接将这些新的流行率估计与基于国家研究的估计进行比较；以及(4)确定关系中的哪些行为、态度和背景方面、避孕措施的使用以及与生育竞争的活动在向成年过渡期间会增加意外怀孕率。为了实现这些目标，我们提议进行一项为期五年的研究，从人种学、认知访谈和试点研究开始--所有这些都与一个由国家数据收集负责人组成的咨询小组协调--以最终确定我们将使用的数据收集工具。接下来，我们将对密歇根州一个县的1250名18岁和19岁的女性进行面对面的采访，同时进行一项为期30个月的期刊跟踪研究。在30个月的时间里，这些女性将通过互联网和互动语音应答(电话)技术，每周提供关于她们关系的行为和态度方面的最新情况，避孕措施的使用，怀孕，以及竞争活动。我们还将对大约10%经历过怀孕的女性和一组未怀孕的年轻女性进行半结构化的后续采访。在期刊跟踪期结束时，研究中的女性将完成全国家庭成长调查(NSFG)第七周期的个人访谈。对潜在的测试-反应交互作用进行调整后，NSFG式的测量将提供每周基于期刊的估计与国家对意外怀孕和相关因素的估计之间的比较。我们对期刊措施的分析将以最先进的动态事件历史模型为特色，使用完全详细的时间信息来记录关系的行为、态度和背景方面、避孕使用、与生育竞争的活动和意外怀孕之间的相互联系。这些结果将对围绕这一高度优先的公共卫生和公共政策关切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.