Distal Determinants of Disparities in Unintended Fertility

意外生育率差异的最终决定因素

• 批准号: 8761122
• 负责人: KAREN B GUZZO
• 金额: $ 32.35万
• 依托单位: BOWLING GREEN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-05 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8761122
• 关键词: Address; Adolescence; Adolescent; Adolescent and Young Adult; Adult; Affect; Attitude; Automobile Driving; Behavior; Birth; Birth Rate; Child; Collaborations; Communities; Contraceptive Agents; Contraceptive Usage; Contraceptive methods; County; Data; Data Analyses; Data Set; Differential Fertility; Distal; Elements; Employment; Enrollment; Ethnic Origin; Event; Factor Analysis; Family; Female; Fertility; Fertility Determinant; Fogs; Gender; Goals; Health; Intervention; Knowledge; Learning; Life; Life Cycle Stages; Link; Literature; Longitudinal Studies; Maternal and Child Health; Measures; Mediating; Michigan; Minority; Modeling; Motivation; Nature; Outcome; Personal Satisfaction; Pregnancy; Pregnancy in Adolescence; Probability; Public Health; Race; Recording of previous events; Reproductive Process; Research; Risk; Sampling; Sex Behavior; Source; Staging; Surveys; Techniques; Testing; Translating; United States; Unmarried; Unplanned pregnancy; Variant; Woman; Work; Youth; advocacy organizations; aged; behavior change; career; child bearing; driving behavior; experience; health disparity; health knowledge; high risk sexual behavior; improved; men; population based; prevent; public health priorities; public health relevance; public health research; reproductive; sex; social; unintended pregnancy; young adult

DESCRIPTION (provided by applicant): Levels of unintended fertility in the United States are high: half of all pregnancies and a third of all births are unintended, with higher levels among young adults and among race-ethnic-nativity minorities. Because unintended births are associated with negative health outcomes, higher rates of unintended fertility among minorities may exacerbate health disparities, and reducing unintended fertility has been a public health goal since the 1980s. Although the proximate determinants of unintended fertility are clear (sex without effective contraceptive use and carrying unintended pregnancies to term), the underlying causes of these behaviors, and of race-ethnic-nativity differences, are not well understood. Drawing on existing frameworks for understanding fertility differentials, this project proposes two key distal determinants - reproductive knowledge and fertility motivation - that may explain differences in unintended fertility across race-ethnic-nativity groups. The project wil test the hypotheses that race-ethnic-nativity minorities have lower reproductive knowledge and motivation to prevent pregnancy; that these differences widen during young adulthood; and that these distal determinants drive differences in the proximate determinants (primarily sex and contraception) and in fertility itself. This project moves beyond prior descriptive work to identif precursors of risky sexual behavior and unintended fertility during young adulthood, a life course stage that is highly variable yet understudied in the fertility literature. We also extend prior wok by incorporating both men and women as well as diverse race- ethnic-nativity groups. Our project will derive robust and consistent measures from three complementary datasets: the Relationship Dynamics and Social Life study ("RDSL"; a population-based sample of women aged 18-19 residing in a Michigan county in 2008/09, followed weekly for 2.5 years), the National Longitudinal Study of Adolescent Health ("Add Health"; youths enrolled in grades 7-12 in 1995 and reinterviewed in 1996, 2001/02, and 2007/08), and the 2009 National Survey of Reproductive and Contraceptive Knowledge ("Fog Zone"; a national sample of unmarried men and women aged 18-29). First, the project will create equivalent measures of the distal determinants across surveys and race-ethnicity-nativity, using factor and latent class analyses guided by integrative data analysis techniques. Second, cross-lag regression models will be used to examine the stability of these constructs as young adults learn and gain new experiences that may affect their reproductive knowledge and fertility motivation. Third, this work will use event history models to identify the elements of fertility motivation and reproductiv health knowledge that are most predictive of risky sexual behavior and unintended births. Findings will guide future research and interventions in targeting those at risk for unintended fertility and highlighting the most crucial domains for intervention. To disseminate our findings t policymakers and practitioners, we will work with a consultant from the National Campaign to Prevent Teen and Unplanned Pregnancy, a nationally respected, politically neutral, private advocacy organization.

描述（由申请人提供）：美国意想不到的生育能力很高：所有怀孕的一半和所有出生的三分之一是意想不到的，年轻人和种族族裔少数群体中的水平较高。由于意外出生与负面的健康结果有关，因此少数族裔之间意外的生育率较高可能会加剧健康差异，并且自1980年代以来，降低意外的生育能力一直是公共卫生目标。尽管意外生育能力的近端决定因素是明显的（性别没有有效的避孕药，并携带意外怀孕的期限），但这些行为的根本原因以及种族族裔差异的差异尚未得到充分了解。该项目利用现有的框架来理解生育差异，提出了两个关键的远端决定因素 - 生殖知识和生育动机 - 可以解释种族族裔纳入群体中意想不到的生育能力的差异。该项目检验了种族族裔少数群体具有较低的生殖知识和预防怀孕动机的假设。这些差异在成年期间扩大了；这些远端决定因素驱动近端决定因素（主要是性别和避孕）以及生育本身的差异。该项目超越了先前的描述性工作，以识别成年后的危险性行为和意外生育能力的前体，这是一个生活阶段，在生育文献中却高度可变却被研究了。我们还通过纳入男性和女性以及多样化的种族纳入群体来扩展先前的锅。 Our project will derive robust and consistent measures from three complementary datasets: the Relationship Dynamics and Social Life study ("RDSL"; a population-based sample of women aged 18-19 residing in a Michigan county in 2008/09, followed weekly for 2.5 years), the National Longitudinal Study of Adolescent Health ("Add Health"; youths enrolled in grades 7-12 in 1995 and reinterviewed in 1996, 2001/02和2007/08），以及2009年的《国家生殖和避孕知识调查》（“雾区”；全国未婚男女样本18-29岁）。首先，该项目将使用以综合数据分析技术为指导的因素和潜在类别分析来创建跨调查和种族纳入远端决定因素的等效度量。其次，随着年轻人学习并获得可能影响其生殖知识和生育动机的新经验，交叉滞后回归模型将用于检查这些结构的稳定性。第三，这项工作将使用事件历史模型来确定最可预测有风险的性行为和意外出生的生育动机和生殖健康知识的要素。调查结果将指导未来的研究和干预措施，以瞄准那些有意外生育能力的风险，并突出最关键的干预领域。为了传播我们的发现，政策制定者和从业人员将与国家运动的顾问合作，以防止青少年和计划外怀孕，这是一个全国受人尊敬的，政治中立的私人倡导组织。