Measuring and Explaining Unintended Pregnancy in the United States, 1987-2009

1987-2009 年美国意外怀孕的测量和解释

• 批准号: 7874538
• 负责人: Lawrence B Finer
• 金额: $ 27.05万
• 依托单位: GUTTMACHER INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7874538
• 关键词: Abortion Rates; Accounting; Address; Adolescent; Adult; Automobile Driving; Behavior; Birth; Censuses; Characteristics; Child; Contraceptive Agents; Contraceptive Usage; Counseling; Couples; Data; Data Collection; Data Files; Data Sources; Decision Making; Education; Ethnic Origin; Ever Married; Exposure to; Failure; Family; Fertility; Funding; Goals; Growth; Health; Health Personnel; Healthy People 2010; Immigration; Incidence; Individual; Induced Abortion; Institutes; Intention; Interview; Link; Marriage Ages; Measurement; Measures; Methodology; Methods; Monitor; Multivariate Analysis; Patients; Play; Policies; Policy Making; Population; Population Group; Poverty; Pregnancy; Pregnancy Rate; Process; Provider; Proxy; Public Health; Publishing; Race; Relative (related person); Religion and Spirituality; Reporting; Research; Research Personnel; Risk; Role; Sampling; Sex Behavior; Standardization; Subgroup; Surveys; Techniques; Time; United States; Unmarried; Unwanted Birth; Update; Use Effectiveness; Variant; Vital Statistics; Woman; Work; abortion; base; child bearing; comparative; fetal; improved; indexing; innovation; parity; pregnant; prevent; programs; public health relevance; response; sexually active; social; tool; trend; unintended pregnancy

DESCRIPTION (provided by applicant): Efforts by individuals, couples, health care providers and policymakers to achieve the Healthy People 2010 goal of reducing the nation's rate of unintended pregnancy are hampered by incomplete information about its incidence, by inadequate understanding of the factors driving unintended pregnancy rate trends and differences across sociodemographic groups, and by lack of easy-to-use tools for regular monitoring of these trends and differences. In response to these deficits, this project would: 1. Estimate up-to-date levels of total and unintended pregnancy (the first since 2001) for the United States and key sociodemographic subgroups, including age, marriage and union status, poverty status race/ethnicity, education, parity, religious affiliation, and (for the most recent period) immigration status. National data on pregnancy intendedness are collected by the National Survey of Family Growth (NSFG), but these data are substantially incomplete with regard to the one-fifth of pregnancies that end in abortion. We would fill this gap with data collected (with independent funding) from a national census of abortion providers and a nationally representative sample of women having abortions, and using estimation methodologies developed by Guttmacher researchers. 2. Analyze the relative contributions of key intermediate factors to differences in unintended pregnancy rates over time and across sociodemographic subgroups. We would ascertain the role of these factors - population composition, sexual activity, fecundity, desire for childbearing, contraceptive use and effectiveness) - in accounting for time trends 1987-2009 and for differences across population groups. In the process of doing so, we will use multiple approaches to measurement (measures based on one point in time vs. across a longer period of exposure) and to analysis (descriptive comparative analysis, decomposition and standardization techniques and multivariate analyses) in order to identify the most stable results. 3. Estimate up-to-date contraceptive use-failure rates corrected for underreporting of induced abortion, in order to inform and counsel sexually active couples who want to avoid becoming pregnant and to determine the possible impact of changes in method use-effectiveness on unintended pregnancy rate trends and differences. 4. Develop a tool based on NSFG survey data alone for monitoring population trends in unintended pregnancy risk and protection that can be used as a proxy for unintended pregnancy rates themselves, but can be implemented more frequently and less expensively and thus supplement the calculation of actual rates, which remain necessary but which can only be done at periodic intervals of five or more years. PUBLIC HEALTH RELEVANCE: Public health efforts to reach the Healthy People 2010 goal to reduce unintended pregnancy from its current proportion of roughly half to 30 percent of all pregnancies, to monitor progress in addressing the negative health and social consequences of mistimed or unwanted births, and to reduce the need for induced abortion are hindered by the lack of accurate and regular measures of unintended pregnancy that adjust for abortion underreporting in the primary monitoring tool (the National Survey of Family Growth). Accurate, ongoing and frequent measures are now especially needed to monitor and understand unintended pregnancy trends and subgroup differences, since recently published data indicate possible changes in birth and abortion rate trends. Such measures are also needed for policy and programs to appropriately respond to the growing recognition that unintended pregnancy and its sequelae are issues not only for adolescents and unmarried women, but also for adult and for ever-married women, who now account for a substantial proportion of unintended pregnancies and abortions.

描述（由申请人提供）：个人，夫妻，卫生保健提供者和决策者的努力，以实现健康的人，2010年，降低全国意外怀孕率的目标，这是由于对其发病率的不完全了解，通过对驱动无意外怀孕率和差异的趋势和差异的趋势和差异而缺乏这些因素和差异来实现这些因素的不足和差异，从而妨碍了其发病率的不足，并且缺乏这些工具的差异。为了应对这些赤字，该项目将：1。估计美国的总和意外怀孕（自2001年以来的首次）和关键的社会人口统计学亚组，包括年龄，婚姻和工会状况，贫困状况，贫困状况，贫困状况，教育，教育，宗教信仰，宗教信仰，宗教信仰，以及最新时期）的移民地位。国家关于家庭增长的调查（NSFG）收集了有关妊娠预期性的国家数据，但是这些数据在堕胎结束的五分之一的怀孕方面基本上是不完整的。我们将通过全国性堕胎提供者人口普查和全国代表性的妇女样本收集的数据（独立资助）来填补这一空白，并使用Guttmacher研究人员开发的估算方法。 2。分析关键中级因素对随着时间的推移以及整个社会人口统计学亚组的差异的相对贡献。我们将确定这些因素的作用 - 人口组成，性活动，生育，对生育的渴望，避孕药使用和有效性）在这样做的过程中，我们将使用多种方法进行测量（基于一个时间点与在更长的暴露期间的测量值）和分析（描述性比较分析，分解和标准化技术以及多变量分析），以识别最稳定的结果。 3。估计纠正措施避孕避孕失败率，以告知诱发流产的频率，以告知和咨询性活跃的夫妻，他们希望避免怀孕，并确定方法使用效应对未意外怀孕率趋势和差异的可能变化的可能影响。 4.仅根据NSFG调查数据开发一种工具，以监测意外怀孕风险和保护中的人口趋势，该工具可以用作意外怀孕率本身的代理，但可以更频繁地实施，因此可以更频繁地实施，从而补充实际费率的计算，但只能以五年或更多年的时间间隔进行必要的时间。 公共卫生相关性：公共卫生为达到健康人的2010年目标的努力，以减少意外怀孕的比例的比例的大约一半到所有怀孕的一半，以监控解决误入或不必要的出生的负面健康和社会后果的进展，并减少对未经主导的临时锻炼的不足和定期监测的诱因的需求，以使其对造成的临时造成不断的措施，从而使劳动量不佳。现在特别需要进行准确，持续和频繁的措施来监视和了解意外怀孕趋势和亚组差异，因为最近发布的数据表明出生和堕胎率趋势的可能变化。政策和计划还需要采取此类措施，以适当地应对日益认识到意外怀孕及其后遗症的人们不仅是青少年和未婚妇女的问题，而且对于成年妇女而言也是妇女，这些妇女现在占意外怀孕和失败的很大一部分。