Unintended pregnancy is of epidemic proportions in the United States: the majority of all pregnancies are unintended, and half of these end in abortion. Among American Indians, the rates may be even higher, given the presence of several key risk factors: they are a youthful population; birthrates are extremely high; and the combination of poverty and isolation results in serious barriers to prescription and non-prescription contraception and abortion services. Research indicates that the intentionality of a conception and the wantedness of a pregnancy are not identical constructs; both phenomena may better be conceptualized along a continuum rather than as dichotomous, either/or constructs. Since some evidence shows that a woman' perspective of conception intentionality may change over time, national estimates of unintended pregnancy based on retrospective reports may underestimate the actual prevalence. Because of problems with measuring conception intent, the determinants of unintended pregnancy have also been difficult to isolate. Working with two American Indian communities, the goal of this project is to develop reliable and valid measures of pregnancy intentionality by more fully and carefully elucidating the cultural, familial, and individual contexts of this phenomenon. Using a paper-and-pencil survey annually for four years, supplemented by interviews after a pregnancy has been reported, this study will explore the determinants of unintended and intended pregnancies among 16- to 24-year-olds. In addition, it will build on three years of earlier data gathered from these participants during middle adolescence. Analyses will capitalize on the strengths of four different analytic approaches--ethnographic, psychometric, structural equation modeling/multiple regression, and logistic/survival methods--in understanding unintended pregnancy in Indian communities. Moreover, in studying this population, we will also collect data which will provide an interesting contrast to most work in this area, which has previously focused on inner-city youth or mainstream middle-class populations.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD033275-01
Application #
2206710
Study Section
Special Emphasis Panel (SRC (22))
Project Start
1995-04-01
Project End
2000-03-31
Budget Start
1995-04-01
Budget End
1996-03-31
Support Year
1
Fiscal Year
1995
Total Cost
Indirect Cost
Name
University of Colorado Denver
Department
Psychiatry
Type
Schools of Medicine
DUNS #
065391526
City
Aurora
State
CO
Country
United States
Zip Code
80045
Croy, Calvin D; Mitchell, Christina M; Bezdek, Marjorie et al. (2009) Young Adult Migration from a Northern Plains Indian Reservation: Who Stays and Who Leaves. Popul Res Policy Rev 28:641-660
Mitchell, Christina M; Beals, Janette; Whitesell, Nancy Rumbaugh et al. (2008) Alcohol use among American Indian high school youths from adolescence and young adulthood: a latent Markov model. J Stud Alcohol Drugs 69:666-75
Kaufman, Carol E; Desserich, Jennifer; Big Crow, Cecelia K et al. (2007) Culture, context, and sexual risk among Northern Plains American Indian Youth. Soc Sci Med 64:2152-64
Mitchell, Christina M; Beals, Janette; Pathways of Choice Team (2006) The development of alcohol use and outcome expectancies among American Indian young adults: a growth mixture model. Addict Behav 31:1-14
Gnanadesikan, Mukund; Novins, Douglas K; Beals, Janette et al. (2005) The relationship of gender and trauma characteristics to posttraumatic stress disorder in a community sample of traumatized northern plains American Indian adolescents and young adults. J Clin Psychiatry 66:1176-83
Mitchell, Christina M; Kaufman, Carol E; Beals, Janette et al. (2004) Identifying diverse HIV risk groups among American Indian young adults: the utility of cluster analysis. AIDS Behav 8:263-75
Mitchell, Christina M; Kaufman, Carol E; Pathways of Choice and Healthy Ways Project Team (2002) Structure of HIV knowledge, attitudes, and behaviors among American Indian young adults. AIDS Educ Prev 14:401-18