(SDAR) Disability-related Disparities in Sex Education, Contraceptive Use and Unintended Pregnancy
Grantee: Brandeis University
Principal Investigator: Monika Mitra
Project Number: R40MC30754
Project Date: 04/01/2017
Final Report
Age group(s)
- Women/Maternal
- Adolescence (12-18 years)
- Young Adulthood (19-25 years)
Abstract
Since the passage of the Americans with Disabilities Act in 1990, there have been extensive gains in attitudes toward and understanding of the abilities and needs of people with disabilities in the United States. Despite these advances, men and women with disabilities still face a myriad of barriers to participation in health care and health promotion programs and face significant disparities in their health and quality of life. Women with disabilities also face numerous inequities in accessing reproductive health care services. They are more likely to experience complications during pregnancy, have less access to prenatal care, and have poor birth outcomes compared to those without disabilities. However, there is a critical gap in our understanding of the sexual and reproductive health of US women with disabilities, particularly with respect to sex education, contraceptive use, and pregnancy intention. We propose to conduct a first-ever national investigation of sex education, contraceptive use and unintended pregnancy among US women with disabilities. Our goal is to assess whether there are significant differences in sex education, contraceptive use and pregnancy intention between women with and without disabilities and among women with cognitive, sensory, independent-living and physical disabilities. For Aim 1 we will compare the prevalence of formal and informal sex education among women with disabilities overall and among women with different types of disabilities compared to those without disabilities. For Aim 2 we will compare the disabilityrelated disparities in the prevalence and types of contraceptive use and the prevalence of unintended pregnancy. Finally in Aim 3 we will examine the predictors of unintended pregnancy among women with disabilities. Predictors will include formal and informal sex education, contraceptive use, non-voluntary sex, socio-demographic characteristics and risk behaviors. To address these three aims, we will use data from the 2011-13 and 2013-15 National Survey of Family Growth (NSFG), which is the primary US survey for producing national estimates of reproductive intentions and behaviors. Since 2011, the NSFG started to include the standard set of six questions from the American Community Survey to assess disability status, which will allow for the first-ever population-based examination of disparities in sex education, contraceptive use, and pregnancy intention among US women with disabilities. The study population consists of reproductive age women (15-44 years) with and without disabilities. We will conduct descriptive and bivariate analyses, and multivariate modeling to describe the extent and correlates of disability-related disparities in the sexual and reproductive health of women. All analyses will be conducted with appropriate weighting and variance adjustment. The proposed study is directly aligned with MCHB's strategic research goals, including Goal 2, to eliminate health disparities and barriers to health care for maternal and child health populations.Publications
Listed is descending order by year published.
Li H, Mitra M, Wu JP, Parish SL, Valentine A, Dembo RS. Female sterilization and cognitive disability in the United States, 2011-2015. Obstetrics & Gynecology, Sep 2018,132(3):559-564.
Wu J, Zhang J, Mitra M, Parish SL, Reddy GKM. Provision of moderately and highly effective reversible contraception to insured women with intellectual and developmental disabilities. Obstetrics & Gynecology, Sep 2018, 132(3):565-574.
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