(SDAS) Risk for unintended pregnancy among American Indian and Alaska Native Women
Grantee: Seattle Indian Health Board, Inc.
Principal Investigator: Ralph Forquera
Project Number: R40MC08954
Project Date: 2/1/2008
Final Report
Age group(s)
- Perinatal/Infancy (0-12 months)
- Toddlerhood (13-35 months)
- Early Childhood (3-5 years)
Targeted/Underserved Population
- Native American/Alaskan Native
Abstract
Unintended pregnancy is associated with adverse health behaviors and outcomes that may affect the mother, infant, and family (Hellerstedt, 1998; Joyce, 2000). Rates of unintended pregnancy are much higher in subgroups with demographic and behavioral characteristics, which themselves carry increased health risks, than for the nation as a whole (Brown, 1995). The U.S. Department of Health and Human Services (DHHS) Healthy People 2010 (HP2010) family planning objectives call for an increase in contraception use by women at risk of unintended pregnancy (US DHHS, 2000). The overall goal of the proposed study is to use available data to examine unintended pregnancy and its correlates among American Indian/Alaska Native (AIAN) women, as compared to non-AIAN women. Specifically, this proposal seeks to determine the rates of and risk for unintended pregnancy, as well as the size of the population at risk for unintended pregnancy in the AIAN population, as compared to non-AIAN. The project aims to establish a clearer understanding of these issues among AIAN, and of the potential disparities between AIAN and non-AIAN, by looking closely at factors such as sexual history and behaviors, contraceptive patterns, and the association of these factors with unintended pregnancy in these groups. We will explore the potential variations in risk within our study population, by examining the magnitude of risk for unintended pregnancy, as related to these and other factors. Data for this study will be obtained from the federally-sponsored National Survey of Family Growth (NSFG); a survey with detailed definitions to measure "unintended pregnancy" and its correlates. In 2002, 7,643 females 15-44 years of age were interviewed for Cycle 6 of the NSFG, of which 6.5% reported AIAN race. Data are based on a nationally representative multistage area probability sample. The NSFG documents trends in pregnancy and contraception among Whites, Blacks and Hispanics, but specific information on AIAN have not been published from these data. Although data is severely lacking on unintended pregnancy, contraceptive use and sexual behavior among AIAN, the data that do exist are concerning. Examinations of Youth Risk Behavior Survey data from 1997-2003 showed urban AIAN youth were significantly more likely than urban white youth to engage in risky sexual behaviors (UIHI, 2006). For example, early sexual initiation (before age 13) and teen pregnancy were nearly three-fold higher among AIAN compared to white youth. These disparities are particularly relevant to the aims of the proposed study and suggest the need for additional research, especially among urban subgroups. Urban AIAN comprise a majority of the AIAN population, yet little is known about their health status (2000 US Census). Current information on AIAN suggests disparities may exist in rates of and risk for unintended pregnancy compared to non-AIAN, but these relationships are not confirmed. If the proposed study aims are achieved, gaps in understanding of racial disparities in unintended pregnancy will be filled. Through the specific aims of our proposed study, we will determine rates of and risk for unintended pregnancy, as well as patterns of contraceptive use and sexual history and behavior, and identify potential disparities between AIAN and non-AIAN women, thereby addressing MCHB Strategic Research Issue #II. The findings of this study may assist policymakers in targeting reproductive health services to those women most in need and further reach HP2010 objectives by helping to increase contraceptive use in subgroups of women at highest risk of unintended pregnancy.Publications
Listed is descending order by year published.
Rutman S, Taualii M, Ned D, et al. Reproductive health and sexual violence among urban American Indian and Alaska Native young women: An analysis of National Survey of Family Growth data (2002). Maternal and Child Health Journal. December 2012;16(2):347-352.
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