The social context of retrospective-prospective changes in pregnancy desire during the transition to adulthood: The role of fathers and intimate relationships

Background: Researchers have questioned the accuracy of retrospective measures of unintended pregnancy, which ask women whether they wanted a pregnancy before it was conceived. Objective: We investigated whether pregnant women's retrospective recollections of their pre-conception desires for pregnancy were shaped by intimate relationships, their own reactions, and their perceptions of their partners' reactions to their pregnancies. Methods: We used the Relationship Dynamics and Social Life (RDSL) study, which included weekly survey interviews with 971 young women, of whom 175 experienced 203 pregnancies during the 2.5-year study period. We estimated logistic regression models of whether women's retrospective recollections of their pre-conception desires were stable, shifted positive, or shifted negative compared to their prospectively reported desires, along with formal mediation tests of potential mechanisms. Results: Women were more likely to remember their undesired pregnancies as desired before conception if they themselves reacted happily to the pregnancy, they were married or engaged, or they perceived their partner as reacting positively. The association with perceiving her partner as positive was mediated by her own happiness about the pregnancy. Conclusions: Retrospective recollections of pre-conception desire at least partially represent women's current feelings about a pregnancy. Post-conception happiness about a pregnancy may identify mothers and children whose health and well-being are at risk, but prospective measures are necessary to evaluate whether women got what they wanted. Contribution: This paper directly demonstrates that a woman's feelings about a specific pregnancy change over time alongside her experiences with the father of her pregnancy after conception

Contraceptive Desert? Black-White Differences in Characteristics of Nearby Pharmacies

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

Maximizing Data Quality using Mode Switching in Mixed-Device Survey Design: Nonresponse Bias and Models of Demographic Behavior

Conducting survey interviews on the internet has become an attractive method for lowering data collection costs and increasing the frequency of interviewing, especially in longitudinal studies. However, the advantages of the web mode for studies with frequent re-interviews can be offset by the serious disadvantage of low response rates and the potential for nonresponse bias to mislead investigators. Important life events, such as changes in employment status, relationship changes, or moving can cause attrition from longitudinal studies, producing the possibility of attrition bias. The potential extent of such bias in longitudinal web surveys is not well understood. We use data from the Relationship Dynamics and Social Life (RDSL) study to examine the potential for a mixed-device approach with active mode switching to reduce attrition bias. The RDSL design allows panel members to switch modes by integrating telephone interviewing into a longitudinal web survey with the objective of collecting weekly reports. We found that in this design allowing panel members to switch modes kept more participants in the study compared to a web only approach. The characteristics of persons who ever switched modes are different than those who did not – including not only demographic characteristics, but also baseline characteristics related to pregnancy and time-varying characteristics that were collected after the baseline interview. This was true in multivariate models that control for multiple of these dimensions simultaneously. We conclude that mode options and mode switching is important for the success of longitudinal web surveys to maximize participation and minimize attrition

Stress Symptoms and Frequency of Sexual Intercourse Among Young Women

Introduction We have previously documented the relationships between stress and depression symptoms and adolescent women's nonuse and misuse of condoms and other contraceptive methods and on their unintended pregnancy rates. Aim Here, we examine relationships between mental health symptoms and another understudied adolescent reproductive health behavior—frequency of sexual intercourse. Main Outcome Measure Our outcome was weekly sexual intercourse activity. Methods We used panel data from a longitudinal, population‐based cohort study of 992 women ages 18–20. Weekly journals measured sociodemographic, relationship, reproductive, and mental health characteristics, sexual and contraceptive behaviors, and pregnancy history. We examined 27,130 surveys from 952 women during the first study year. Predictors of weekly sexual intercourse were moderate to severe stress (Perceived Stress Scale‐4) and depression (Center for Epidemiologic Studies Depression Scale‐5) symptoms measured at baseline. Multilevel, mixed‐effects logistic regression models estimated the relationships between stress and depression symptoms and the weekly odds of sexual intercourse while adjusting for covariate fixed effects and random woman effects. Results Nearly a quarter of the sample had moderate to severe stress (23%) and depression (24%) symptoms at baseline. Women reported sexual intercourse in 36% of weeks. Proportions of sexually active weeks were higher among women with stress (43%) and depression (40%) compared with those without symptoms (35% and 35%, respectively; P values < 0.001). Controlling for covariates, women with baseline stress symptoms had 1.6 times higher weekly odds of sexual intercourse compared with women without stress (adjusted odds ratio 1.6, confidence interval [1.1, 2.5]; P  = 0.04). Depression symptoms were not associated with sexual intercourse frequency in adjusted models. Conclusions Stress symptoms were positively associated with sexual intercourse frequency among these young women. Research and practice efforts are needed to identify effective sexual health promotion and risk‐reduction strategies, including contraceptive education and counseling, in the context of mental health symptoms and unintended pregnancy. Hall KS, Kusunoki Y, Gatny H, and Barber J. Stress symptoms and frequency of sexual intercourse among young women. J Sex Med 2014;11:1982–1990.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107995/1/jsm12607.pd

DATA & TRENDS (non refereed articles): Design and implementation of an online weekly journal to study unintended pregnancies. Vienna Yearbook of Population Research|Vienna Yearbook of Population Research 2011 9|

In this article we describe new research to investigate unintended pregnancies during the transition to adulthood. The Relationship Dynamics and Social Life (RDSL) study begins with a 60-minute in-person interview about family background and current relationship characteristics. At the conclusion of the interview, respondents are enrolled in an ongoing journal, which consists of a 5-minute survey via web or phone and occurs weekly for 2.5 years. We have enrolled over 1,000 young women in the study and have experienced excellent baseline response rates and high journal participation rates. Below we describe the limitations of past research on unintended pregnancy as a background for our study. Then we provide a detailed description of the study and its design strengths and weaknesses