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Chofakian CBDN, Borges ALV. Contraceptive switch and abandonment among women using the pill, condoms and injectables in Brazil. EUR J CONTRACEP REPR 2024; 29:15-23. [PMID: 38108084 DOI: 10.1080/13625187.2023.2289831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE The aim of our study was to assess the covariates of contraceptive switching and abandonment among Brazilian women stratified by oral pills, condoms and injectables. MATERIALS AND METHODS Women attending primary health care services in three Brazilian mid- to large-sized cities were interviewed face-to-face about their contraceptive practices (n = 2,051). Data were collected using a contraceptive calendar. Analysis included estimates using Kaplan-Meier multiple-decrement life-table probabilities and discrete-time hazards modelling of switching from a method to another or to no method. RESULTS Among 3,280 segments of contraceptive use, we observed that five-year contraceptive switching rates ranged from 34.9% among injectable users to 56.1% among pill users. Of particular concern were the high discontinuation rates of abandonment, which ranged from 50.9% among injectable users to 77.4% among pill users. Covariates of method switching and abandonment varied by type of method, but age, race/ethnicity, religion and relationship status must be highlighted as key elements of discontinuation. CONCLUSION Contraceptive method switching and abandoning are frequent outcomes of contraceptive use. Understanding the factors that shape women's decisions to continue or discontinue the use of a contraceptive method can help tailoring comprehensive contraceptive counselling that meet their expectations and reproductive needs when starting using a method.
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Affiliation(s)
| | - Ana Luiza Vilela Borges
- Department of Public Health Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil
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2
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Derrigo K, LaFata EM. Examining the proportions of food addiction among women with and without polycystic ovarian syndrome who do and do not take hormonal birth control. Eat Behav 2023; 51:101824. [PMID: 37950975 DOI: 10.1016/j.eatbeh.2023.101824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/13/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is a reproductive disorder driven by insulin resistance. Insulin resistance may increase weight gain and increase the rewarding intake of ultra-processed foods (UPFs). Individuals with PCOS may be more susceptible to the reinforcing properties of UPFs, increasing the risk to consume UPFs in addictive-like ways, operationalized by food addiction (FA). Additionally, hormonal birth control, commonly prescribed to women with PCOS, are found to increase food cravings and overeating. This study examined the relationships between PCOS status, FA, and hormonal birth control use. The study sample (N = 365, assigned female at birth) was drawn from Amazon Mechanical Turk, with half of the sample (n = 181) reporting having PCOS and the other half not (n = 184). Participants answered questions about women's reproductive health (i.e., PCOS, hormonal birth control use) and completed the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0). A chi-square test found that 51.9 % of participants with PCOS (M = 6.23, SD = 3.82) met diagnostic criteria for FA (assessed by the mYFAS 2.0) compared to 16.8 % of participants without PCOS (M = 2.47, SD = 3.39). A hierarchical linear regression found independent main effects of PCOS status (β = 0.40, t(352) = 8.61, p < .001) and hormonal birth control use (β = 0.16, t(351) = 3.59, p < .001), to be associated with higher mYFAS symptom count scores. No differences were found between the types of hormonal birth control participants reported taking. The finding suggests that FA is an overlooked, understudied psychological condition impacting these individuals in weight loss treatments. Future studies are needed to understand the relationship between FA and PCOS in clinical samples.
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Affiliation(s)
- Karly Derrigo
- Department of Psychology, Drexel University, Philadelphia, PA, United States.
| | - Erica M LaFata
- Department of Psychology, Drexel University, Philadelphia, PA, United States.
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3
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Rowley S, Broomfield C, Min J, Quinn S, Campbell K, Wood S. Racial Inequities in Adolescent Contraceptive Care Delivery: A Reproductive Justice Issue. J Pediatr Adolesc Gynecol 2023; 36:298-303. [PMID: 36423806 PMCID: PMC10149577 DOI: 10.1016/j.jpag.2022.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 11/03/2022] [Accepted: 11/10/2022] [Indexed: 11/23/2022]
Abstract
STUDY OBJECTIVE The objective of this study was to examine racial/ethnic disparities in contraceptive delivery for adolescent patients within an adolescent medicine subspecialty clinical system before and during the COVID-19 pandemic. Secondarily, we aimed to assess the relationship between race and contraceptive delivery by telehealth. DESIGN Retrospective cohort study using electronic health record data SETTING: Three adolescent medicine subspecialty clinics in a large academic hospital system, including an urban location and 2 suburban locations PARTICIPANTS: Patients assigned female sex at birth prescribed hormonal contraception between January 1st, 2018, and May 31st, 2021. MAIN OUTCOME MEASURES Method and type of contraceptive prescribed (short-acting, medium-acting, long-acting reversible contraception [LARC]) RESULTS: There were 2453 patients in the study; 47.5% were White, 36.0% were Black, and 8.1% identified as Hispanic. After controlling for insurance and age, Black patients, compared with non-Black patients, had twofold higher odds of receiving LARC compared with a short-acting method across the study period (aOR = 2.0; 95% CI, 1.52-2.62). We identified effect modification with significant interaction between Black race and the pandemic period, with evidence of a higher marginal probability of Black patients receiving LARCs during the pandemic. Additionally, during the pandemic, patients receiving new contraceptive prescriptions via telehealth were less likely to be Black (aOR = 0.63; 95% CI, 0.41-0.94) or publicly insured (aOR = 0.56; 95% CI, 0.38-0.81). CONCLUSION Our data show significantly higher prescribing of LARCs to Black adolescents by clinicians, which could suggest differences in physician contraceptive counseling with a bias toward preferentially counseling Black patients toward LARCs. Our data also show that Black and publicly insured patients had decreased utilization of contraceptive care by telehealth during the pandemic.
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Affiliation(s)
- Sarah Rowley
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
| | | | - Jungwon Min
- Department of Biomedical and Health Informatics, Children...s Hospital of Philadelphia
| | - Sheila Quinn
- Craig-Dalsimer Division of Adolescent Medicine, Children...s Hospital of Philadelphia; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania
| | - Kenisha Campbell
- Policy Lab, Children...s Hospital of Philadelphia; Craig-Dalsimer Division of Adolescent Medicine, Children...s Hospital of Philadelphia; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania
| | - Sarah Wood
- Policy Lab, Children...s Hospital of Philadelphia; Craig-Dalsimer Division of Adolescent Medicine, Children...s Hospital of Philadelphia; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania
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Lieberman AG, Stock ML, AuBuchon KE, Beekman JB, Lambert SF. Intersectional discrimination from black women, white women, black men, or white men impacts young adult black women's affective states and risky health cognitions. Psychol Health 2023; 38:1-17. [PMID: 34180327 DOI: 10.1080/08870446.2021.1941962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Black women experience pronounced inequalities in alcohol use and sexual risk outcomes. Racial discrimination is a known contributor to health inequalities. However, Black women face unique and intersectional forms of discrimination beyond racial discrimination. The current study investigates how exclusion from four distinct social groups effects Black women's negative affect and risky health cognitions. DESIGN Black women (N = 124; ages 18-29) were randomly assigned to be excluded in Cyberball by Black women, Black men, White women, or White men. MAIN OUTCOME MEASURES Participants responded to measures of internalising (depressive, anxious) and externalising (anger) affect, heavy alcohol use willingness, and risky sex expectations. RESULTS Participants primarily attributed exclusion from White women to racial discrimination, exclusion from Black men to gender discrimination, and exclusion from White men to both gender and racial discrimination. When excluded by White women, participants reported the highest levels of anger, depressive affect, and anxiety. Exclusion by White men predicted the greatest heavy drinking willingness, though exclusion by Black men predicted the greatest risky sex expectations. CONCLUSION This study is the first to demonstrate that exclusion from different social groups leads to differing patterns of negative affect and risky health cognitions in young adult Black women.
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Affiliation(s)
- Abby G Lieberman
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Michelle L Stock
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Katarina E AuBuchon
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Janine B Beekman
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Sharon F Lambert
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
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Wilkinson TA, Hawryluk B, Moore C, Peipert JF, Carroll AE, Wiehe S, Fortenberry JD. A human-centered designed outreach strategy for a youth contraception navigator program. PEC INNOVATION 2022; 1:100093. [PMID: 36540664 PMCID: PMC9762731 DOI: 10.1016/j.pecinn.2022.100093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/17/2022] [Accepted: 10/17/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To identify key elements of an outreach strategy for a youth contraception navigator program designed to help young people overcome barriers to contraception access. METHODS A human-centered design approach was used to engage adolescents aged 15-17 in co-design sessions. Human-centered design techniques, such as affinity diagramming and model building were used to inform key elements of the communication model and the final outreach strategy messages. RESULTS Messages focused on the individual, normalizing talking about birth control, acknowledging the challenges to obtaining birth control, explaining how the navigator program works resonate with young people. Having images of diverse participants, offering information about birth control, and showing images of reputable sources will enhance trust. CONCLUSIONS A name (IN Control) and key elements of an outreach strategy were determined for the navigator program. It is important to work with key stakeholders and co-design the optimal strategy and messages to assure that the intended audience is reached, and the desired behavior change is achieved. INNOVATION Human-centered design techniques can be used to provide insight into programmatic outreach strategies for a contraception navigator program to increase their impact and ultimate success.
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Affiliation(s)
- Tracey A. Wilkinson
- Indiana University School of Medicine, Department of Pediatrics/Children's Health Services Research, 410 West 10 Street, HS 2000, Indianapolis, IN 46202, United States of America
| | - Bridget Hawryluk
- Indiana Clinical Translational Institute, Research Jam, 410 West 10 Street, HS 2000, Indianapolis, IN 46202, United States of America
| | - Courtney Moore
- Indiana Clinical Translational Institute, Research Jam, 410 West 10 Street, HS 2000, Indianapolis, IN 46202, United States of America
| | - Jeffrey F. Peipert
- Indiana University School of Medicine, Department of Obstetrics and Gynecology, UH 2440, Indianapolis, IN 46202, United States of America
| | - Aaron E. Carroll
- Indiana University School of Medicine, Department of Pediatrics/Center for Pediatric and Adolescent Comparative and Effective Research, 410 West 10 Street, HS 2000A, Indianapolis, IN 46202, United States of America
| | - Sarah Wiehe
- Indiana University School of Medicine, Department of Pediatrics/Children's Health Services Research, 410 West 10 Street, HS 2000, Indianapolis, IN 46202, United States of America
- Indiana Clinical Translational Institute, Research Jam, 410 West 10 Street, HS 2000, Indianapolis, IN 46202, United States of America
| | - J. Dennis Fortenberry
- Indiana University School of Medicine, Department of Pediatrics, Division of Adolescent Medicine, 410 West 10 Street, HS 1000, Indianapolis, IN 46202, United States of America
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6
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Clark AC, Kusunoki Y, Barber JS. Mechanisms Linking High Residential Mobility to Decreased Contraceptive Use: The Importance of Method Availability. SOCIAL PROBLEMS 2022; 69:1068-1091. [PMID: 36249958 PMCID: PMC9557177 DOI: 10.1093/socpro/spab009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
While research has demonstrated that high residential mobility has negative consequences for an array of outcomes, particularly among women and young adults, the mechanisms underlying these associations are unclear. The consequences of high residential mobility may be comprised solely of a series of short-term disruptions surrounding individual moves, or there may also be long-term, cumulative effects from repeated moves. High residential mobility may diminish access to resources as individuals move to different neighborhoods, impose a cognitive burden that impairs their ability to plan ahead, or decrease the relative power they have in their relationships to limit exposure to risk behaviors. We adjudicate between these possibilities by predicting the effects of high residential mobility on sexual intercourse and contraceptive use, the proximate determinants of pregnancy, during women's transition to adulthood. Using 2.5 years of monthly address data for 882 respondents in the Relationship Dynamics and Social Life study-a random sample of young women in Genesee County, Michigan-we find that high residential mobility is associated with long-term decreases in contraceptive use. These long-term consequences are independent of the short-term effects of individual moves and attributable to diminished contraceptive access. We disentangle the effects of home-leaving, which is distinct from subsequent moves.
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7
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Zang E, Sariego C, Krishnan A. The interplay of race/ethnicity and education in fertility patterns. POPULATION STUDIES 2022; 76:363-385. [PMID: 36256449 PMCID: PMC9613612 DOI: 10.1080/00324728.2022.2130965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 06/17/2022] [Indexed: 12/25/2022]
Abstract
This study examines the interplay between race/ethnicity and educational attainment in shaping completed fertility in the United States for women born 1961-80. Using data from the National Survey of Family Growth, 2006-17, we apply multilevel, multiprocess hazard models to account for unobserved heterogeneity and to estimate (1) cohort total fertility rates, (2) parity progression ratios, and (3) parity-specific fertility timing, for non-Hispanic white, non-Hispanic Black, and Hispanic women by educational attainment. We find that compared with their white counterparts, fertility was higher among Black and Hispanic women with less than high school education. However, among college-educated women, fertility levels were lowest among Black women and highest among Hispanic women. The difference in fertility between college-educated Black and white women is driven mainly by the smaller proportion of Black mothers having second births. We find little evidence that the observed racial/ethnic disparities in fertility levels by educational attainment are driven by differences in fertility timing.
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Affiliation(s)
- Emma Zang
- Department of Sociology, Yale University
- Department of Biostatistics, Yale University
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8
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Variants of Second Demographic Transition: Empirical Evidence from Young Women’s Attitudes About Childbearing. POPULATION RESEARCH AND POLICY REVIEW 2022. [DOI: 10.1007/s11113-022-09738-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Saucier CJ, Suresh S, Brooks JJ, Walter N, Plant A, Montoya JA. The Effect of an Entertainment-Education Intervention on Reproductive Health of Young Women of Color. HEALTH COMMUNICATION 2022; 37:1093-1103. [PMID: 33784898 DOI: 10.1080/10410236.2021.1903741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
While teen pregnancy rates in the United States have been declining for decades, they remain the highest of all western countries. Within the U.S., Black and Latina teens experience disproportionate rates of unplanned pregnancy. Plan A is an entertainment-education video intervention that was developed to help address these disparities, in part by emphasizing the ability of young cisgender women to control when they become pregnant by using an effective contraception method. The intervention was developed in close collaboration with the target audience (Black and Latina women aged 18-19) to ensure that it was relevant, engaging, and motivational. We conducted an online study to: (a) investigate the effects of Plan A on attitudes toward the contraception methods covered in the video; (b) whether these effects varied by race/ethnicity or age, and; (c) if identification with characters in the video mediated these effects. The study used a posttest-only design where participants were randomly assigned to watch Plan A or to a neutral control condition. The sample included Black, Latina, and non-Latina White women aged 16 to 19 (N= 242), with younger and White women included for comparison purposes. Results indicated that exposure to Plan A significantly improved attitudes toward long-acting reversible contraceptives (LARCs) among all age groups and among young Black and Latina women, but not White women. These findings may be explained by participant's identification with the Black and Latina lead characters - both of whom model positive reproductive health behaviors.
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Affiliation(s)
| | - Sapna Suresh
- School of Communication, Northwestern University
| | | | | | - Aaron Plant
- Department of Communication Studies, Sentient Research
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10
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Ayinmoro AD, Fayehun OA. Differentials in Contraceptive Use Among Selected Minority Ethnic Groups in Nigeria. Front Glob Womens Health 2022; 3:878779. [PMID: 35720812 PMCID: PMC9204047 DOI: 10.3389/fgwh.2022.878779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
Ethnicity is one of the critical factors that shape contraceptive use in Nigeria. While there are growing disparities in contraceptive uptake among women of reproductive age in the three major ethnic groups (Hausa, Igbo and Yoruba), not much is known about differentials in contraceptive use among the minority ethnic groups. This study examined differentials in contraceptive use among a sample of 1,072 respondents comprising the Ebira (352), Igala (358) and Okun (361) ethnic groups in Nigeria. Questionnaire was administered to respondents proportionately in the selected minority ethnic groups with six key informant interviews and 12 focus group discussions to generate quantitative and qualitative data among ever-married women. Quantitative data were analyzed at bivariable and multivariable levels. The qualitative data were content-analyzed. Differentials in contraception are shaped by ethnic affiliations and socio-demographic characteristics of couples. The use of modern contraceptives was low among the Ebira (25.7%) and Igala (24.1%) ethnic groups, but high among Okun (67%) women of reproductive age. The odd of using a modern contraceptive is significantly higher among the Okun women (UOR = 5.618, 95% CI 4.068–7.759) than the Ebira and Igala. There is no significant difference between the Ebira and Igala minority ethnic groups on modern contraceptive use. Ethnicity as a factor is not a stand-alone predictor of the use of modern contraception among the study groups, other socio-economic variables such as residence, religion, income and marital status were significant predictors of modern contraceptive use among minority ethnic groups. We suggest introducing reproductive health intervention programmes targeted at sensitizing the minority ethnic groups on effective modern contraceptive use while addressing their specific modern contraceptive need in Nigeria.
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Ramos-Ortiz J, King H, DeMaria AL. Hormonal Male Contraception: Formative Research to Develop and Test Communication Messaging. Am J Mens Health 2022; 16:15579883221094702. [PMID: 35748372 PMCID: PMC9240595 DOI: 10.1177/15579883221094702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Male-controlled contraception is limited, yet a promising hormonal male
contraceptive (HMC) development in may increase options for men to share in the
work of pregnancy prevention. This study examined college-aged (18–26 years)
men’s and women’s perceptions of influential marketing strategy for an
experimental novel HMC method, a transdermal gel. Six focus groups
(n = 29) were conducted to glean insights for ad prototype
creation. Ad prototypes were designed and then tested in semi-structured
interviews (n = 20) to understand whether the messages were
adequately representing the attributes intended while also allowing participants
to contribute insights on improving appeal. A constant comparative approach was
used for data contextualization and theme identification. Results provided a
foundation for the creation of HMC message prototypes, aimed at increasing
knowledge and uptake of a novel family planning method for men. Representation
of a relatable character, or drawing on authentic experiences, aligned best with
participant values. Focus groups illuminated salient concepts for HMC marketing,
including humor, destigmatization, information, and credibility. Interview
message testing yielded an understanding of elements participants responded most
strongly to, including (1) ad sentiment and (2) trustworthiness. Findings
provide a basis for understanding the placement of a potential marketing
campaign to effectively frame HMC uptake as easy to use, safe, and popular while
building on peer norms and group acceptability among a college-aged demographic.
Healthcare providers and other practitioners can utilize these findings while
engaging in family planning conversations, interventions, and message
development.
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Affiliation(s)
- Jaziel Ramos-Ortiz
- Division of Consumer Science, Purdue University, West Lafayette, IN, USA
| | - Hannah King
- Department of Public Health, Purdue University, West Lafayette, IN, USA
| | - Andrea L DeMaria
- Department of Public Health, Purdue University, West Lafayette, IN, USA
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Masten M, Vega S, Hailemariam M, Kagotho N, Key K, Jefferson B, Muhammad J, Summers M, Spencer B, Sadler S, Robinson D, Richie F, Miller R, McCoy JW, Greer D, Johnson JE. The Flint women's study: community perspectives on contraception and family planning, sexuality education and barriers to reproductive health. CULTURE, HEALTH & SEXUALITY 2021; 23:961-975. [PMID: 32484423 DOI: 10.1080/13691058.2020.1746401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 03/19/2020] [Indexed: 06/11/2023]
Abstract
Teenage pregnancy can have adverse social and health outcomes, and rates are high in Flint, Michigan as compared to the rest of the state and the USA. It is important to understand contributing factors to adolescent pregnancy to be able to better address this issue. This study examined qualitative data from interviews with 100 community members who participated in the Flint Women's Study, a study designed to better understand the hopes, dreams and needs of women in Flint, and their suggestions for how to address identified needs. Using a Community Based Participatory Approach, data were collected and analysed by a team of community members and academic researchers. The paper focuses on the theme of family planning among young women which included attitudes about contraception, sexuality education and bio-medical and structural barriers to accessing reproductive health. Community members emphasised the need for increased access to comprehensive contraception options, improved sexuality education in schools and from health care providers, and ultimately valuing young women.
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Affiliation(s)
- Megan Masten
- College of Human Medicine, Michigan State University, Flint, MI, USA
- Department of Obstetrics and Gynecology, University of Colorado, Aurora, CO, USA
| | - Shayna Vega
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Maji Hailemariam
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Njeri Kagotho
- College of Social Work, Ohio State University, Columbus, OH, USA
| | - Kent Key
- College of Human Medicine, Michigan State University, Flint, MI, USA
- Flint Community, Flint, MI, USA
| | | | | | - Monicia Summers
- College of Human Medicine, Michigan State University, Flint, MI, USA
- Flint Community, Flint, MI, USA
| | | | | | | | - Fallon Richie
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Raven Miller
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Jonne White McCoy
- College of Human Medicine, Michigan State University, Flint, MI, USA
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Garnett C, Pollack L, Rodriguez F, Renteria R, Puffer M, Tebb KP. The Association Between Nonbarrier Contraceptive Use and Condom Use Among Sexually Active Latina Adolescents. J Adolesc Health 2021; 68:985-990. [PMID: 32933838 DOI: 10.1016/j.jadohealth.2020.07.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study aimed to determine the association between use of highly effective methods of nonbarrier contraception and condom use in a sample of Latina adolescents and whether the change to a more effective method of nonbarrier contraception is associated with a change in condom use. METHODS As part of a larger study, 442 sexually active Latina adolescents aged 14-18 years were surveyed immediately before an appointment with a medical care provider at a school-based health center and 3 months later. Ordinal logistic and linear regression were used in the analysis of cross-sectional and longitudinal data to assess the relationship between patterns of nonbarrier contraception and condom use. RESULTS The use of all types of nonbarrier methods of contraception was significantly associated with decreased condom use. Change over time from a less effective to a more effective nonbarrier method of contraception was also associated with a decrease in condom use. Greater number of sexual encounters was associated with lower the frequency of condom use. CONCLUSIONS The use of highly effective methods of nonbarrier contraception was associated with reduced frequency of condom use. This highlights the need to promote condom use concurrently with nonbarrier methods of contraception to improve protection against both pregnancy and STIs.
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Affiliation(s)
- Chelsea Garnett
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California.
| | - Lance Pollack
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Felicia Rodriguez
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Robert Renteria
- The Los Angeles Trust for Children's Health, Los Angeles, California
| | - Maryjane Puffer
- The Los Angeles Trust for Children's Health, Los Angeles, California
| | - Kathleen P Tebb
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California
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14
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The social context of retrospective-prospective changes in pregnancy desire during the transition to adulthood: The role of fathers and intimate relationships. DEMOGRAPHIC RESEARCH 2021. [DOI: 10.4054/demres.2021.44.38] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Krull LM, Pearce LD, Jennings EA. How Religion, Social Class, and Race Intersect in the Shaping of Young Women's Understandings of Sex, Reproduction, and Contraception. RELIGIONS 2021; 12:5. [PMID: 34422390 PMCID: PMC8378803 DOI: 10.3390/rel12010005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Using a complex religion framework, this study examines how and why three dimensions of religiosity-biblical literalism, personal religiosity, and religious service attendance-are related to young women's reproductive and contraceptive knowledge differently by social class and race. We triangulate the analysis of survey data from the Relationship Dynamics and Social Life study (RDSL) and semi-structured interview data from the National Study of Youth and Religion (NSYR) to identify and explain patterns. From the quantitative data, we find that all three dimensions of religiosity link to young women's understandings of sex, reproduction, and contraception in unique ways according to parental education and racial identity. There is a lack of knowledge about female reproductive biology for young women of higher SES with conservative Christian beliefs (regardless of race), but personal religiosity and religious service attendance are related to increased contraceptive knowledge for young black women and decreased knowledge for young white women. From the qualitative data, we find that class and race differences in the meaning of religion and how it informs sexual behavior help explain results from the quantitative data. Our results demonstrate the importance of taking a complex religion approach to studying religion and sex-related outcomes.
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Affiliation(s)
- Laura M. Krull
- Department of Sociology, St. Norbert College, De Pere, WI 54115, USA
| | - Lisa D. Pearce
- Department of Sociology, University of North Carolina—Chapel Hill, Chapel Hill, NC 27599, USA
| | - Elyse A. Jennings
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Wright KQ. Contraceptive selection and practice: Associations with self-identified race and socioeconomic disadvantage. Soc Sci Med 2020; 266:113366. [PMID: 33068869 PMCID: PMC7669550 DOI: 10.1016/j.socscimed.2020.113366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 01/27/2023]
Abstract
Many researchers and policymakers have linked contraceptive programs to improvements in women's and children's socioeconomic outcomes. However, these studies have overlooked how socioeconomic status may be an initial driver of contraceptive choice and behavior. Here, I examine the relationship between a comprehensive measure of socioeconomic disadvantage, self-identified race, and contraceptive method selection at enrollment in a unique longitudinal study of contraceptive clients who received a new type of method at no cost. I then examine whether socioeconomic disadvantage has an association with contraceptive switching or discontinuation. I demonstrate that socioeconomic disadvantage decreases the chance of selecting any IUD, while Black racial membership increases the chance of selecting the 3-month injectable and Multiracial membership increases the chance of selecting the Vaginal Ring. I then demonstrate that socioeconomic disadvantage and self-identified race have intersectional and variable associations with switching, and, to a lesser extent, discontinuing methods. These findings offer an important insight for implementation in contraceptive programs: eliminating financial barriers to access contraceptive services does not eliminate the socioeconomic contexts that influence method selection and use that occur as part of everyday lived experiences. Taken cumulatively, these results suggest that contraceptive services should be offered to women in ways that ensure access to reproductive justice without obscuring the need for social changes in the institutions that create disadvantage and shape contraceptive use itself.
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Affiliation(s)
- Kelsey Q Wright
- University of Wisconsin, Sewell Social Sciences, 1180 Observatory Drive Madison, Madison 4471, WI, 53706, USA.
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17
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Kusunoki Y, Barber JS. The Dynamics of Intimate Relationships and Contraceptive Use During Early Emerging Adulthood. Demography 2020; 57:2003-2034. [PMID: 32901407 PMCID: PMC8112453 DOI: 10.1007/s13524-020-00916-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We investigate the immediate social context of contraceptive behaviors: specifically, the intimate relationship. We use the Relationship Dynamics and Social Life (RDSL) study (2008-2012), based on a random sample of 1,003 women ages 18-19 residing in a Michigan county. Women were interviewed weekly for 2.5 years, resulting in an age range of 18-22. We test three sets of hypotheses about change over time within a relationship, using relationship-level within-between models, which compare a couple's contraceptive behaviors across different times in the relationship. First, we find that a couple is less likely to use contraception when the relationship is more intimate and/or committed and that a couple becomes less likely to use contraception over time, regardless of intimacy and commitment. Second, we find that a couple using contraception becomes increasingly likely to choose hormonal over coital methods, but this change occurs as a relationship endures and is unrelated to intimacy and/or commitment. Third, we find that a condom-using couple's consistency does not decline when there is conflict; rather, consistency of condom use declines over time regardless of the relationship's characteristics. We also demonstrate that conflict and power imbalance increase reliance on hormonal methods among those using contraception; conflict decreases consistency among withdrawal (but not condom) users; and nonmonogamy increases reliance on condoms and decreases withdrawal consistency. The strong and consistent link between duration and contraceptive behaviors-regardless of intimacy, commitment, conflict, or power imbalance-suggests that the continual vigilance required for long-term contraceptive use is difficult during early emerging adulthood.
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Affiliation(s)
- Yasamin Kusunoki
- School of Nursing, Department of Systems, Populations and Leadership, and Population Studies Center and Survey Research Center at the Institute for Social Research, University of Michigan, 400 North Ingalls Street, Room 4156, Ann Arbor, MI, 48109-4582, USA.
| | - Jennifer S Barber
- Department of Sociology and Kinsey Institute, Indiana University, Bloomington, IN, 47405-7103, USA
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18
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Abstract
Decades of research have attempted to understand the paradox of stubbornly high unintended pregnancy rates despite widespread use of contraception. Much of this research has focused on socioeconomic disparities in rates of unintended pregnancy, finding that economically disadvantaged women tend to use less effective contraceptive methods and use them less consistently. Building on this research, this study examines how material hardship is associated with less consistent contraceptive use among women who do not desire to become pregnant. Using the Relationship Dynamics and Social Life (RDSL) Study, a weekly longitudinal survey, I find lower levels of contraceptive use and less consistent use of contraception among women experiencing material hardship, relative to those without hardship experiences. I also investigate the extent to which this association is explained by access barriers and lower contraceptive efficacy among women experiencing hardship. Using structural equation modeling, I find that these mediators significantly explain the relationship between hardship and risky contraceptive behaviors, suggesting that hardship creates mental and resource constraints that impede successful implementation of contraception. However, net of these mediators, material hardship remains associated with riskier contraceptive behaviors among young women, calling for further research on how hardship exposes women to greater risk of unintended pregnancies.
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Affiliation(s)
- Elly Field
- Department of Sociology and Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Room 2267, Ann Arbor, MI, 48106-1248, USA.
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19
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Dumas SA, Chu S, Horswell R. Analysis of Pregnancy and Birth Rates Among Black and White Medicaid-Enrolled Teens. J Adolesc Health 2020; 67:409-415. [PMID: 32576486 PMCID: PMC7483952 DOI: 10.1016/j.jadohealth.2020.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/03/2020] [Accepted: 04/22/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE In the United States, black teens overall have higher pregnancy and birth rates than whites, and it is commonly believed that minority race and low income account for this disparity. We examined racial differences in pregnancy and birth rates among teens from low-income households using Medicaid-enrollment as a proxy for low income. METHODS This was a retrospective study of Louisiana Medicaid claims data for female teens aged 15-17 years in 2014 (n = 66,069). Pregnancy and pregnancy outcome codes were identified (n = 2,276) and analyzed for differences by black and white race. We conducted validity analyses with different rate definitions and teens' claims status. RESULTS The cohort was 36% white and 54% black. More black teens than whites lacked any claims data (15.6% vs. 12.6%; p < .001). Rates calculated as events per 1,000 person-years of Medicaid coverage showed no difference in live birth rates between white and black teens (24.6 vs. 25.8; relative incidence ratio, 1.05; 95% confidence interval, .93-1.18; p = .43); however, pregnancy rates for whites were higher than those for blacks (42.7 vs. 36.1; relative incidence ratio, .85; 95% confidence interval, .77-.93; p < .001). CONCLUSION In contrast to national trends, which include teens from diverse racial and socioeconomic backgrounds, Louisiana Medicaid-enrolled teens aged 15-17 years had equal birth rates regardless of black or white race, and whites had higher pregnancy rates. Decreased racial disparities in pregnancy and birth rates among these adolescents highlights socioeconomic influences in sexual health behavior and a need to examine the interplay of risk factors contributing to racial disparities seen among adolescents nationally.
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Affiliation(s)
- S. Amanda Dumas
- Louisiana State University Health Sciences Center, Department of Pediatrics, 200 Henry Clay Avenue, State Street Campus, New Orleans, Louisiana 70118 USA
| | - San Chu
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, Louisiana 70808 USA
| | - Ronald Horswell
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, Louisiana 70808 USA
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20
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Guzzo KB, Hayford SR. Pathways to Parenthood in Social and Family Context: Decade in Review, 2020. JOURNAL OF MARRIAGE AND THE FAMILY 2020; 82:117-144. [PMID: 34012172 PMCID: PMC8130890 DOI: 10.1111/jomf.12618] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 07/29/2019] [Indexed: 05/12/2023]
Abstract
OBJECTIVE This article reviews research from the past decade on patterns, trends, and differentials in the pathway to parenthood. BACKGROUND Whether, and under what circumstances, people become parents has implications for individual identity, family relationships, the well-being of adults and children, and population growth and age structure. Understanding the factors that influence pathways to parenthood is central to the study of families and can inform policies aimed at changing childbearing behaviors. METHOD This review summarizes recent trends in fertility as well as research on the predictors and correlates of childbearing, with a focus on the United States and on research most relevant to family scholars. We document fertility differentials and prevailing explanations for variation across sub-groups and discuss alternative pathways to parenthood, such as adoption. The article suggests avenues for future research, outlines emerging theoretical developments, and concludes with a discussion of fertility policy. RESULTS U.S. fertility has declined in recent years; whether fertility rates will increase is unclear. Elements of the broader social context such as the Great Recession and increasing economic inequality have impacted pathways to parenthood, and there is growing divergence in behaviors across social class. Scholars of childbearing have developed theories to better understand how childbearing is shaped by life course processes and social context. CONCLUSION Future research on the pathways to parenthood should continue to study group differentials, refine measurement and theories, and better integrate men and couples. Childbearing research is relevant for social policy, but ideological factors impact the application of research to policy.
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Affiliation(s)
- Karen Benjamin Guzzo
- Department of Sociology, Bowling Green State University, Bowling Green, OH 43403-0222
| | - Sarah R Hayford
- Department of Sociology, The Ohio State University 1885 Neil Avenue Mall Columbus, OH, 43210
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21
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Brew B, Weitzman A, Musick K, Kusunoki Y. Young women's joint relationship, sex, and contraceptive trajectories: Evidence from the United States. DEMOGRAPHIC RESEARCH 2020; 42:933-984. [PMID: 38249422 PMCID: PMC10798792 DOI: 10.4054/demres.2020.42.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE We identify common patterns of joint relationship, sex, and contraceptive trajectories in young adulthood and assess how selection into these trajectories differs across socioeconomic and demographic groups and varies with earlier sexual and reproductive experiences and attitudes. METHODS We draw on a weekly panel of 581 young adult women in the United States that includes granular data on sexual and contraceptive behaviors. We use sequence analysis to describe joint relationship, sex, and contraceptive trajectories over the course of a year and multinomial logistic regression to examine how these trajectories are associated with socioeconomic disadvantage and minority racial status. RESULTS We identify six trajectories characterized by differences in relationship stability, sexual regularity, and contraceptive efficacy. Many women report no romantic relationships over the year. Among those who do, instability in relationships, sex, and contraception is common. Less advantaged women are more likely to be on trajectories marked by frequent relationship transitions, coresidence, and less effective contraception. These socioeconomic differences are largely explained by earlier experiences and attitudes. Black women are the most likely to be on a trajectory characterized by simultaneous relationship, sex, and contraceptive instability, and this holds net of earlier experiences and attitudes. CONTRIBUTION We provide a novel way of understanding how women's relationship, sexual, and contraceptive trajectories co-evolve and vary by sociodemographic characteristics. Results highlight that instability is common in the young adult years but that differences in how trajectories unfold suggest greater risk of unintended pregnancies for socially disadvantaged and black women.
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Affiliation(s)
- Bridget Brew
- University of Mary Washington, Fredericksburg, VA, USA
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22
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Verbus E, Ascha M, Wilkinson B, Montague M, Morris J, Mercer BM, Arora KS. The Association of Public Insurance with Postpartum Contraception Preference and Provision. Open Access J Contracept 2019; 10:103-110. [PMID: 31908549 PMCID: PMC6927572 DOI: 10.2147/oajc.s231196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 12/07/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Prior studies have noted that public insurance status is associated with increased uptake of postpartum contraception whereas others have pointed to public insurance as a barrier to accessing highly effective forms of contraception. OBJECTIVE To assess differences in planned method and provision of postpartum contraception according to insurance type. STUDY DESIGN This is a secondary analysis of a retrospective cohort study examining postpartum women delivered at a single hospital in Cleveland, Ohio from 2012-2014. Contraceptive methods were analyzed according to Tier-based effectiveness as defined by the Centers for Disease Control and Prevention. The primary outcome was postpartum contraception method preference. Additional outcomes included method provision, postpartum visit attendance, and subsequent pregnancy within 365 days of delivery. RESULTS Of the 8281 patients in the study cohort, 1372 (16.6%) were privately and 6990 (83.4%) were publicly insured. After adjusting for the potentially confounding clinical and demographic factors through propensity score analysis, public insurance was not associated with preference for a Tier 1 versus Tier 2 postpartum contraceptive method (matched adjusted odds ratio [maOR] 0.89, 95% CI 0.69-1.15), but was associated with a preference for Tier 1/2 vs Tier 3/None (maOR 1.41, 95% CI 1.17-1.69). There was no difference between women with private or public insurance in terms of method provision by 90 days after delivery (maOR 0.94, 95% CI 0.75-1.17). Public insurance status was also associated with decreased postpartum visit attendance (maOR 0.54, 95% CI 0.43-0.68) and increased rates of subsequent pregnancy within 365 days of delivery (maOR 1.29, 95% CI 1.05-1.59). CONCLUSION Public insurance status does not serve as a barrier to either the preference or provision of effective postpartum contraception. Women desiring highly- or moderately effective methods of contraception should have these methods provided prior to hospital discharge to minimize barriers to method provision.
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Affiliation(s)
- Emily Verbus
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Mustafa Ascha
- Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
| | - Barbara Wilkinson
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Mary Montague
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Jane Morris
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, OH, USA
| | - Brian M Mercer
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, OH, USA
| | - Kavita Shah Arora
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, OH, USA
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23
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Shepherd H, Marshall EA. Childbearing Worldviews and Contraceptive Behavior Among Young Women. JOURNAL OF MARRIAGE AND THE FAMILY 2019; 81:1144-1161. [PMID: 33041369 PMCID: PMC7546315 DOI: 10.1111/jomf.12581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To classify young women into groups based on their childbearing worldviews-patterns of attitudes about domains related to childbearing-and to test whether these groups predict contraceptive behavior. BACKGROUND Contraceptive behavior-defined here as contraceptive use or abstinence-among young women in the United States illustrates the often puzzling relationship between attitudes and behavior. This study argues that considering sets of attitudes relevant to childbearing in relation to each other can explain apparent contradictions between attitudes and contraceptive behavior. METHOD Using data from the Relationship Dynamics and Social Life study of young women (N=832), this study analyzes the relationships among attitudes about childbearing by using latent class analysis to partition survey respondents into meaningful groups, and then multinomial logistic regression analysis to examine the relationship between group membership and contraceptive behavior. Latent class analysis (LCA) identifies classes that share similar relationships between responses across a series of variables to measure childbearing worldviews. RESULTS Latent class analysis identifies six classes of young women that share childbearing worldviews, four of which were predicted by existing literature. Membership in those classes is then shown to predict contraceptive behavior, an important behavioral outcome. CONCLUSION The concept of worldviews and the method for identifying them will allow family researchers to identify meaningful groups in a population, as well as to generate theories about childbearing and contraceptive behavior.
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Affiliation(s)
- Hana Shepherd
- Rutgers University, Department of Sociology, Davison Hall, New Brunswick, NJ 08901
| | - Emily A Marshall
- Franklin and Marshall College, Department of Sociology and Public Health Program, Gerhart House, Lancaster, PA 17604
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24
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Barber JS, Miller W, Kusunoki Y, Hayford SR, Guzzo KB. Intimate Relationship Dynamics and Changing Desire for Pregnancy Among Young Women. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2019; 51:143-152. [PMID: 31518052 PMCID: PMC7100877 DOI: 10.1363/psrh.12119] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 05/26/2023]
Abstract
CONTEXT Although substantial research has focused on unintended pregnancy among young women, less is known about the circumstances under which pregnancy is desired. Whether a young woman's pregnancy desire changes across her different relationships, or over time within a relationship, has not been directly assessed. METHODS Data on intimate relationships and pregnancy desire were assessed weekly for 895 women aged 18-22 who participated in the Relationship Dynamics and Social Life study in a county in Michigan (2008-2012). Within-between logistic regression models were used to examine within-cluster and between-cluster differences-comparisons of a woman's pregnancy desire within a relationship over time as well as across a woman's different relationships. RESULTS Young women were more likely to desire pregnancy if they were in any relationship more intimate and committed than a casual relationship (odds ratios, 1.6-9.2); the odds of desiring pregnancy were also higher in long-term relationships rather than in short-term ones (2.1). In general, pregnancy desire increased over time as a relationship endured and became more serious. The odds of desiring pregnancy were lower among women with less educated, rather than equally educated, partners (0.7), while the odds were higher in nonmonogamous or violent relationships than in monogamous or nonviolent relationships (1.6 and 1.9, respectively). CONCLUSIONS Young women's pregnancy desire changes depending on their intimate relationship context, across the range of relationships they experience during the transition to adulthood.
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Affiliation(s)
- Jennifer S. Barber
- Corresponding author, Department of Sociology, University of Michigan, 500 S. State Street, Ann Arbor, MI 48109-1382, 734-647-6324 ph,
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25
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Wagner J, Couper MP, Axinn WG, Gatny H. The utility of a follow-up interview for respondents to a longitudinal survey with frequent measurement. SOCIAL SCIENCE RESEARCH 2019; 82:113-125. [PMID: 31300072 PMCID: PMC7029379 DOI: 10.1016/j.ssresearch.2019.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 02/05/2019] [Accepted: 04/16/2019] [Indexed: 06/10/2023]
Abstract
Social processes that change quickly are difficult to study, because they require frequent survey measurement. Weekly, daily, or even hourly measurement may be needed depending on the topic. With more frequent measurement comes the prospect of more complex patterns of missing data. The mechanisms creating the missing data may be varied, ranging from technical issues such as lack of an Internet connection to refusal to complete a requested survey. We examine one approach to mitigating the damage of these missing data - a follow-up or closeout interview that is completed after the frequent measurement. The Relationship Dynamics and Social Life (RDSL) study used this approach. The study asked women weekly about their attitudes and behaviors related to sexual relationships and pregnancy. The surveys were carried out for 130 weeks and concluded with a closeout interview. We explore the patterns of missing data in the RDSL study and then examine associations between the data collected in the closeout survey and key variables collected in the weekly survey. We then assess the extent to which data from the closeout survey are useful in repairing the damage caused by missing data.
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Affiliation(s)
- James Wagner
- Survey Research Center, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48104, USA.
| | - Mick P Couper
- Survey Research Center, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48104, USA
| | - William G Axinn
- Survey Research Center, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48104, USA
| | - Heather Gatny
- Survey Research Center, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48104, USA
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26
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Barber JS, Ela E, Gatny H, Kusunoki Y, Fakih S, Batra P, Farris K. Contraceptive Desert? Black-White Differences in Characteristics of Nearby Pharmacies. J Racial Ethn Health Disparities 2019; 6:719-732. [PMID: 30788813 PMCID: PMC6660992 DOI: 10.1007/s40615-019-00570-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/31/2019] [Accepted: 02/04/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Race differences in contraceptive use and in geographic access to pharmacies are well established. We explore race differences in characteristics of nearby pharmacies that are likely to facilitate (or not) contraceptive purchase. STUDY DESIGN We conducted analyses with two geocode-linked datasets: (1) the Relationship Dynamics and Social Life (RDSL) project, a study of a random sample of 1003 women ages 18-19 living in a county in Michigan in 2008-09; and (2) the Community Pharmacy Survey, which collected data on 82 pharmacies in the county in which the RDSL study was conducted. RESULTS Although young African-American women tend to live closer to pharmacies than their white counterparts (1.2 miles to the nearest pharmacy for African Americans vs. 2.1 miles for whites), those pharmacies tend to be independent pharmacies (59 vs. 16%) that are open fewer hours per week (64.6 vs. 77.8) and have fewer female pharmacists (17 vs. 50%), fewer patient brochures on contraception (2 vs. 5%), more difficult access to condoms (49% vs. 85% on the shelf instead of behind glass, behind the counter, or not available), and fewer self-check-out options (3 vs. 9%). More African-American than white women live near African-American pharmacists (8 vs. 3%). These race differences are regardless of poverty, measured by the receipt of public assistance. CONCLUSIONS Relative to white women, African-American women may face a "contraception desert," wherein they live nearer to pharmacies, but those pharmacies have characteristics that may impede the purchase of contraception.
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Affiliation(s)
- Jennifer S Barber
- Department of Sociology, University of Michigan, 500 S. State St., Ann Arbor, MI, 48109, USA.
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48104, USA.
| | - Elizabeth Ela
- Population Research Center, University of Michigan, 305 E. 23rd Street, Austin, MI, TX 78712, USA
| | - Heather Gatny
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48104, USA
| | - Yasamin Kusunoki
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48104, USA
- School of Nursing, University of Michigan, 400 N. Ingalls, Ann Arbor, MI, 48109, USA
| | - Souhiela Fakih
- School of Pharmacy, Chapman University, 9401 Jeronima Road, Irvine, CA, 92618, USA
| | - Peter Batra
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48104, USA
| | - Karen Farris
- College of Pharmacy, University of Michigan, 428 Church St., Ann Arbor, MI, 48109, USA
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Guzzo KB, Hayford SR, Lang VW, Wu HS, Barber J, Kusunoki Y. Dimensions of Reproductive Attitudes and Knowledge Related to Unintended Childbearing Among U.S. Adolescents and Young Adults. Demography 2019; 56:201-228. [PMID: 30523559 DOI: 10.1007/s13524-018-0747-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Measures of attitudes and knowledge predict reproductive behavior, such as unintended fertility among adolescents and young adults. However, there is little consensus as to the underlying dimensions these measures represent, how to compare findings across surveys using different measures, or how to interpret the concepts captured by existing measures. To guide future research on reproductive behavior, we propose an organizing framework for existing measures. We suggest that two overarching multidimensional concepts-reproductive attitudes and reproductive knowledge-can be applied to understand existing research using various measures. We adapt psychometric analytic techniques to analyze two data sets: the National Longitudinal Survey of Adolescent to Adult Health (Add Health) and the Relationship Dynamics and Social Life study (RDSL). Although the specific survey measures and sample composition of the two data sets are different, the dimensionality of the concepts and the content of the items used to measure their latent factors are remarkably consistent across the two data sets, and the factors are predictive of subsequent contraceptive behavior. However, some survey items do not seem strongly related to any dimension of either construct, and some dimensions of the two concepts appear to be poorly measured with existing survey questions. Nonetheless, we argue that the concepts of reproductive attitudes and reproductive knowledge are useful for categorizing and analyzing social psychological measures related to unintended fertility. The results can be used to guide secondary data analyses to predict reproductive behavior, compare results across data sets, and structure future data collection efforts.
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Affiliation(s)
- Karen Benjamin Guzzo
- Department of Sociology, Bowling Green State University, Bowling Green, OH, 43403-0222, USA.
| | - Sarah R Hayford
- Department of Sociology, Ohio State University, 238 Townshend Hall, 1885 Neil Avenue Mall, Columbus, OH, 43210, USA
| | - Vanessa Wanner Lang
- Department of Sociology, Bowling Green State University, Bowling Green, OH, 43403-0222, USA
| | - Hsueh-Sheng Wu
- Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH, 43403-0222, USA
| | - Jennifer Barber
- Department of Sociology, University of Michigan, 500 S. State Street, Ann Arbor, MI, 48109, USA
| | - Yasamin Kusunoki
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, 400 N. Ingalls Street, Ann Arbor, MI, 48109, USA
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28
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Oduyebo T, Zapata LB, Boutot ME, Tepper NK, Curtis KM, D'Angelo DV, Marchbanks PA, Whiteman MK. Factors associated with postpartum use of long-acting reversible contraception. Am J Obstet Gynecol 2019; 221:43.e1-43.e11. [PMID: 30885772 DOI: 10.1016/j.ajog.2019.03.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/14/2019] [Accepted: 03/11/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Contraception use among postpartum women is important to prevent unintended pregnancies and optimize birth spacing. Long-acting reversible contraception, including intrauterine devices and implants, is highly effective, yet compared to less effective methods utilization rates are low. OBJECTIVES We sought to estimate prevalence of long-acting reversible contraception use among postpartum women and examine factors associated with long-acting reversible contraception use among those using any reversible contraception. STUDY DESIGN We analyzed 2012-2015 data from the Pregnancy Risk Assessment Monitoring System, a population-based survey among women with recent live births. We included data from 37 sites that achieved the minimum overall response rate threshold for data release. We estimated the prevalence of long-acting reversible contraception use in our sample (n = 143,335). We examined maternal factors associated with long-acting reversible contraception use among women using reversible contraception (n = 97,013) using multivariable logistic regression (long-acting reversible contraception vs other type of reversible contraception) and multinomial regression (long-acting reversible contraception vs other hormonal contraception and long-acting reversible contraception vs other nonhormonal contraception). RESULTS The prevalence of long-acting reversible contraception use overall was 15.3%. Among postpartum women using reversible contraception, 22.5% reported long-acting reversible contraception use, which varied by site, ranging from 11.2% in New Jersey to 37.6% in Alaska. Factors associated with postpartum long-acting reversible contraception use vs use of another reversible contraceptive method included age ≤24 years (adjusted odds ratio = 1.43; 95% confidence interval = 1.33-1.54) and ≥35 years (adjusted odds ratio = 0.87; 95% confidence interval = 0.80-0.96) vs 25-34 years; public insurance (adjusted odds ratio = 1.15; 95% confidence interval = 1.08-1.24) and no insurance (adjusted odds ratio = 0.73; 95% confidence interval = 0.55-0.96) vs private insurance at delivery; having a recent unintended pregnancy (adjusted odds ratio = 1.44; 95% confidence interval = 1.34-1.54) or being unsure about the recent pregnancy (adjusted odds ratio = 1.29; 95% confidence interval = 1.18-1.40) vs recent pregnancy intended; having ≥1 previous live birth (adjusted odds ratio = 1.40; 95% confidence interval = 1.31-1.48); and having a postpartum check-up after recent live birth (adjusted odds ratio = 2.70; 95% confidence interval = 2.35-3.11). Hispanic and non-Hispanic black postpartum women had a higher rate of long-acting reversible contraception use (26.6% and 23.4%, respectively) compared to non-Hispanic white women (21.5%), and there was significant race/ethnicity interaction with educational level. CONCLUSION Nearly 1 in 6 (15.3%) postpartum women with a recent live birth and nearly 1 in 4 (22.5%) postpartum women using reversible contraception reported long-acting reversible contraception use. Our analysis suggests that factors such as age, race/ethnicity, education, insurance, parity, intendedness of recent pregnancy, and postpartum visit attendance may be associated with postpartum long-acting reversible contraception use. Ensuring all postpartum women have access to the full range of contraceptive methods, including long-acting reversible contraception, is important to prevent unintended pregnancy and optimize birth spacing. Contraceptive access may be improved by public health efforts and programs that address barriers in the postpartum period, including increasing awareness of the availability, effectiveness, and safety of long-acting reversible contraception (and other methods), as well as providing full reimbursement for contraceptive services and removal of administrative and logistical barriers.
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Affiliation(s)
- Titilope Oduyebo
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, GA.
| | - Lauren B Zapata
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, GA
| | - Maegan E Boutot
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, GA
| | - Naomi K Tepper
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, GA
| | - Kathryn M Curtis
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, GA
| | - Denise V D'Angelo
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, GA
| | - Polly A Marchbanks
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, GA
| | - Maura K Whiteman
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, GA
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Weitzman A, Mallory AB. Racial, Socioeconomic, and Attitudinal Disparities in Trajectories of Young Women's Willingness to Refuse Unwanted Sex. J Adolesc Health 2019; 64:746-752. [PMID: 30850309 PMCID: PMC6534481 DOI: 10.1016/j.jadohealth.2018.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/28/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE We identify trajectories of young women's willingness to refuse unwanted sex, assess racial, socioeconomic, and attitudinal variation across trajectory groups, and describe the sexual and relationship behaviors of different trajectory groups. METHODS Panel data from the Relationship Dynamics and Social Life study facilitate a latent class analysis identifying trajectories of women's willingness to refuse unwanted sex, followed by bivariate analyses illuminating demographic, attitudinal, experiential, and behavioral correlates of each trajectory. RESULTS Three trajectories emerge confident (stable high), moderate (slightly declining moderate), and reluctant (low-U). Socially advantaged women were most likely to follow a confident trajectory. Black women, socially disadvantaged women, women with early sexual debut, women with early births, and women who adhere to rape myths were most likely to follow a reluctant trajectory. Women whose trajectory was moderate spent the most time in relationships and had sex most often. CONCLUSIONS How much young women are willing to refuse unwanted sex and how this willingness changes during the transition to adulthood vary with key characteristics of their demographic background, earlier sexual experiences, and perceptions of rape. The trajectories by which this willingness evolves further correspond with sexual and relationship behaviors during the transition to adulthood. Greater research on whether willingness to refuse unwanted sex affects behavior and/or vice versa is needed to more fully understand the diversity of women's sexual experiences and to develop effective interventions for improving women's willingness to refuse unwanted sex.
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Affiliation(s)
- Abigail Weitzman
- Department of Sociology, University of Texas at Austin, Austin, Texas.
| | - Allen B Mallory
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas
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Lyons S, Arcara J, Deardorff J, Gomez AM. Financial Strain and Contraceptive Use Among Women in the United States: Differential Effects by Age. Womens Health Issues 2019; 29:153-160. [PMID: 30723058 DOI: 10.1016/j.whi.2018.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/27/2018] [Accepted: 12/27/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Low-income and young women experience disproportionately high rates of unintended pregnancy. Traditional measures of socioeconomic status may not be appropriate indicators of financial status, particularly during emerging adulthood. This study investigates the relationship between financial strain and contraceptive use, focusing on the differential effects by age group. METHODS Multinomial logistic regression analyses assessed the relationship between financial strain and contraceptive use in a national sample of U.S. women ages 18-39 years (N = 932). Models were adjusted for income, employment status, and other sociodemographic characteristics and tested the interaction of financial strain and age group. RESULTS Women with high financial strain were less likely to use short-acting methods (compared with using no method) in the adjusted model; when the age and financial strain interaction was included, associations held only for women ages 18-24 and 25-29 years of age. Relative to contraceptive nonuse, women ages 18-24 years with high financial strain were less likely to use long-acting reversible (relative risk ratio [RRR], 0.10; 95% confidence interval [CI], 0.01-0.99) and short-acting hormonal (RRR, 0.03; 95% CI, 0.00-0.18) methods. Women ages 25-29 with high financial strain were less likely to use short-acting hormonal (RRR, 0.20; 95% CI, 0.05-0.87) and coital-specific (RRR, 0.11; 95% CI, 0.02-0.51) methods. IMPLICATIONS FOR PRACTICE AND/OR POLICY Young women may be vulnerable to the effect of high financial strain on contraceptive nonuse. Providers working with this group should consider incorporating financial strain into screening tools to identify patients who may need extra attention in contraceptive decision-making conversations. Antipoverty programs could also have a positive effect on effective contraceptive use.
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Affiliation(s)
- Sophie Lyons
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, California; Department of Maternal, Child and Adolescent Health, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Jennet Arcara
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, California
| | - Julianna Deardorff
- Department of Maternal, Child and Adolescent Health, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Anu Manchikanti Gomez
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, California.
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Kusunoki Y, Barber JS, Gatny HH, Melendez R. Physical Intimate Partner Violence and Contraceptive Behaviors Among Young Women. J Womens Health (Larchmt) 2018; 27:1016-1025. [PMID: 28956704 PMCID: PMC6104244 DOI: 10.1089/jwh.2016.6246] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Understanding the link between physical intimate partner violence (IPV) and contraception is key to preventing unintended pregnancy and sexually transmitted infections. MATERIALS AND METHODS Data from the Relationship Dynamics and Social Life study, a longitudinal study of a racially and socioeconomically diverse population-representative random sample of 18- to 19-year-old women residing in a Michigan county in 2008-2009 and followed weekly through 2011-2012, were used. Logistic regression models of contraceptive behaviors on temporally specific measures of physical violence victimization: recent, history in the current relationship, and history in prior relationships were conducted among 711 women. RESULTS Women who experienced physical IPV in their current relationship had lower odds of using contraception (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.28, 0.76 for recent; OR, 0.53; 95% CI, 0.33, 0.83 for past). Condom use was lower among women who experienced past physical IPV in their current relationship (OR, 0.44; 95% CI, 0.26, 0.73), while withdrawal use was higher (OR, 1.99; 95% CI, 1.24, 3.19). Women who experienced physical IPV used condoms less consistently (OR, 0.34; 95% CI, 0.13, 0.85 for recent; OR, 0.27; 95% CI, 0.14, 0.52 for prior relationships). CONCLUSIONS Physical IPV victimization is a dynamic and strong predictor of contraceptive use, method type, and consistency of condom use.
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Affiliation(s)
- Yasamin Kusunoki
- School of Nursing, Department of Systems, Populations and Leadership, and Institute for Social Research Population Studies Center and Survey Research Center, University of Michigan, Ann Arbor, Michigan
| | | | - Heather H. Gatny
- Institute for Social Research Survey Research, University of Michigan, Ann Arbor, Michigan
| | - Robert Melendez
- Institute for Social Research Survey Research, University of Michigan, Ann Arbor, Michigan
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32
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Moseson H, Dehlendorf C, Gerdts C, Vittinghoff E, Hiatt RA, Barber J. No one to turn to: low social support and the incidence of undesired pregnancy in the United States. Contraception 2018; 98:275-280. [PMID: 30220308 DOI: 10.1016/j.contraception.2018.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 06/20/2018] [Accepted: 06/23/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Young women may experience social barriers to achieving their reproductive goals. This analysis explored whether low social support may contribute to the high incidence of undesired pregnancy in young women in the United States. STUDY DESIGN Using 6 months of data from a prospective cohort of 970 women ages 18-22 years in the United States, we described contraceptive use and applied multivariable logistic regression and standardization to estimate adjusted odds and absolute risk of undesired pregnancy among women reporting low social support versus higher social support. We investigated several measures of contraceptive use as possible explanations for this pathway. RESULTS Sixty-five pregnancies were reported in the 6 months of the study, of which 30 (46%) were classified as undesired prior to conception. Among young women who reported low social support, 8% reported an undesired pregnancy during the study period as compared to 3% of the young women who reported higher levels of social support. Among non-black women, those who reported low social support had nearly seven times the odds of an undesired pregnancy as compared to women who reported higher social support (aOR: 6.8, 95%CI: 1.7, 27.1). We found no association between social support and undesired pregnancy among young black women. Contraceptive method use differed by social support at baseline, and throughout follow-up. CONCLUSIONS Low social support - defined as the feeling of not having anyone to turn to - may be a risk factor for persistently high levels of undesired pregnancy among young women in the U.S. This association may be driven by differences in contraceptive use by level of social support. IMPLICATIONS Interventions to increase young women's perceptions of social support may reduce the risk of undesired pregnancy for some individuals.
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Affiliation(s)
- Heidi Moseson
- Department of Epidemiology & Biostatistics, University of California, San Francisco, 550 16(th) Street, 2(nd) floor, San Francisco, CA, USA 94158.
| | - Christine Dehlendorf
- Department of Epidemiology & Biostatistics, University of California, San Francisco, 550 16(th) Street, 2(nd) floor, San Francisco, CA, USA 94158; Department of Family & Community Medicine, University of California, San Francisco, 500 Parnassus Ave, MUE3, San Francisco, CA, USA 94143.
| | - Caitlin Gerdts
- Ibis Reproductive Health, 1330 Broadway St, Suite 1100, Oakland, CA, USA 94612.
| | - Eric Vittinghoff
- Department of Epidemiology & Biostatistics, University of California, San Francisco, 550 16(th) Street, 2(nd) floor, San Francisco, CA, USA 94158.
| | - Robert A Hiatt
- Department of Epidemiology & Biostatistics, University of California, San Francisco, 550 16(th) Street, 2(nd) floor, San Francisco, CA, USA 94158.
| | - Jennifer Barber
- Department of Sociology and Institute for Social Research, University of Michigan, Ann Arbor, 500 S State Street, Ann Arbor, MI, USA 48109.
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Kramer RD, Higgins JA, Godecker AL, Ehrenthal DB. Racial and ethnic differences in patterns of long-acting reversible contraceptive use in the United States, 2011-2015. Contraception 2018; 97:399-404. [PMID: 29355492 PMCID: PMC5965256 DOI: 10.1016/j.contraception.2018.01.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/10/2018] [Accepted: 01/11/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate whether demographic, socioeconomic, and reproductive health characteristics affect long-acting reversible contraceptive (LARC) use differently by race-ethnicity. Results may inform the dialogue on racial pressure and bias in LARC promotion. STUDY DESIGN Data derived from the 2011-2013 and 2013-2015 National Surveys of Family Growth (NSFG). Our study sample included 9321 women aged 15-44. Logistic regression analyses predicted current LARC use (yes vs. no). We tested interaction terms between race-ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic) and covariates (for example, education, parity, poverty level) to explore whether their effects on LARC use vary by race-ethnicity. RESULTS In the race-interactions model, data did not show that low income and education predict LARC use more strongly among Black and Hispanic women than among White women. There was just one statistically significant race-interaction: experience of unintended pregnancy (p=.014). Among Whites and Hispanics, women who reported ever experiencing an unintended pregnancy had a higher predicted probability of LARC use than those who did not. On the other hand, among Black women, the experience of unintended pregnancy was not associated with a higher predicted probability of LARC use. CONCLUSIONS With the exception of the experience of unintended pregnancy, findings from this large, nationally representative sample of women suggest similar patterns in LARC use by race-ethnicity. IMPLICATIONS Results from this analysis of NSFG data do not provide evidence that observed differences in LARC use by race-ethnicity represent socioeconomic disparities, and may assuage some concerns about reproductive coercion among women of color. Nevertheless, it is absolutely critical that providers use patient-centered approaches for contraceptive counseling that promote women's autonomy in their reproductive health care decision-making.
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Affiliation(s)
- Renee D Kramer
- Department of Population Health, School of Medicine and Public Health, University of Wisconsin-Madison, WARF Office Building Room 675, 610 Walnut Street, Madison, WI 53726, USA.
| | - Jenny A Higgins
- Department of Gender and Women's Studies, University of Wisconsin-Madison, Sterling Hall Room 3309, 475 North Charter Street, Madison, WI 53706, USA.
| | - Amy L Godecker
- Population Health Institute, School of Medicine and Public Health, University of Wisconsin-Madison, WARF Office Building Room 656, 610 Walnut Street, Madison, WI 53726, USA.
| | - Deborah B Ehrenthal
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, WARF Office Building Room 658, 610 Walnut St., Madison, WI 53726, USA.
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Ela EJ, Budnick J. Non-Heterosexuality, Relationships, and Young Women's Contraceptive Behavior. Demography 2018; 54:887-909. [PMID: 28466434 DOI: 10.1007/s13524-017-0578-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Non-heterosexual young women have a higher rate of unintended pregnancy than their heterosexual peers, but their fertility behaviors are understudied. We use longitudinal data from the Relationship Dynamics and Social Life study to investigate mechanisms contributing to non-heterosexual women's higher pregnancy risk. These data include weekly reports of relationships, sex, and contraceptive use over 30 months. We compare the relationships and fertility behaviors of three groups: exclusively heterosexual (consistent heterosexual behavior, identity, and attraction); mostly heterosexual (heterosexual identity with same-sex behavior and/or same-sex attraction); and LGBTQ (any non-heterosexual identity). We find that mostly heterosexual and LGBTQ women behave differently from exclusively heterosexual women in ways likely to elevate their risk of unintended pregnancy: more distinct partners during the study period, more sexual intercourse with men, less frequent contraceptive use, less use of a dual method (condom plus hormonal method), and more gaps in contraceptive coverage. Mostly heterosexual women resemble LGBTQ women in their contraceptive behavior but have significantly more intercourse with men, which may increase their pregnancy risk relative to both LGBTQ and exclusively heterosexual women. We conclude by considering implications for LGBTQ health and the measurement of sexual minority populations.
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Affiliation(s)
- Elizabeth J Ela
- Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48106-1248, USA.
| | - Jamie Budnick
- Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48106-1248, USA
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35
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Barber JS, Kusunoki Y, Gatny H, Melendez R. The Relationship Context of Young Pregnancies. LAW & INEQUALITY 2017; 35:175. [PMID: 29622858 PMCID: PMC5881929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Jennifer S Barber
- Department of Sociology, and Institute for Social Research, Population Studies Center and Survey Research Center, University of Michigan, Ann Arbor, Michigan
| | - Yasamin Kusunoki
- School of Nursing, Department of Systems, Populations and Leadership, and Institute for Social Research, Population Studies Center and Survey Research Center, University of Michigan, Ann Arbor, Michigan
| | - Heather Gatny
- Institute for Social Research, Survey Research Center, University of Michigan, Ann Arbor, Michigan
| | - Robert Melendez
- Institute for Social Research, Survey Research Center, University of Michigan, Ann Arbor, Michigan
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