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We use an experiment based on the relationship dynamics and social life study of sexual behavior, pregnancy, and contraceptive use to investigate whether participation in weekly self-reports over one year result in differential effects on related behaviors and attitudes, compared to participation in a one-time follow-up interview requiring retrospective self-reporting for the prior year. We randomly assigned 200 subjects to either a control group or a journal group. All subjects were interviewed at the beginning of the study (baseline interview) and 12 months later (closeout interview). Subjects in the journal group also completed a five-minute web- or phone-based survey every week during the 12-month study period. We found no statistically significant difference in pregnancy rates across the two groups at closeout. Contrary to our expectation, the control group experienced a slightly larger increase in having ever used a contraceptive method, although this was mainly due to increases in the least effective methods, such as condoms and withdrawal. Respondents in the weekly interview group became slightly more positive toward childbearing in terms of one specific attitude measure, but not for the vast majority of measures. We conclude that intensive longitudinal data collection does not appear to have a large or consistent impact on respondents' pregnancy, contraceptive use, or related attitudes, relative to the more standard longitudinal approach.

Despite the fact that intimate partner violence (IPV) occurs within intimate relationships, we know relatively little about the characteristics of those intimate relationships, and even less about how IPV changes across time within different relationships. We use the Relationship Dynamics and Social Life (RDSL) study, based on a random sample of 1003 18–19-year-old women residing in a Michigan county. Women were interviewed weekly for 2.5 years, resulting in an age range of 18 through 22. We estimate hybrid "within-between" regression models, which allows us to directly compare the same woman's risk of experiencing IPV across her different relationships, varied in terms of resources, balance of power, conflict, childbearing, relationship type, and duration. Our analyses demonstrate that power imbalance in intimate relationships, non-monogamous and unstable relationships, relationships with men who are not the father of a woman's existing children, and serious relationships (especially stayover and cohabiting) place young women in their late teens and early twenties at particularly high risk of multiple dimensions of IPV. Our fixed-effects modeling strategy isolated the increase in IPV risk that is due to these characteristics and experiences within intimate relationships from the risk due to young women being at high risk of IPV for other reasons who might tend to choose these types of relationships. The elevated risk of IPV in relationships with these characteristics and experiences supports a causal link between them. Our research supports the potential efficacy of interventions that reduce conflict, equalize power within relationships, and encourage women—especially young mothers—to delay serious relationships. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objectives: We examined whether and how long young women became more or less likely to desire a pregnancy after experiencing a "pregnancy scare."Study Design: We used data from the Relationship Dynamics and Social Life (RDSL) study, based on a random, population-based sample of 992 young women from a county in Michigan. They were interviewed weekly for 2.5 years. We used fixed-effects logistic regression models to predict pregnancy desire after a pregnancy scare.Results: Of the 759 sexually experienced women we analyzed, 103 (14%) experienced 128 pregnancy scares. A woman's (adjusted) odds of desiring a pregnancy were 3.70 (95% CI 2.27-6.02) times higher during the week after, 3.04 (95% CI 2.30-4.10) times higher during the month after a pregnancy scare, and 2.31 (95% CI 1.71-3.11) times higher during all weeks after the pregnancy scare, compared to her other weeks during the study period. In a final model directly comparing each period to all weeks before the pregnancy scare, the odds of pregnancy desire were highest (aOR 5.08, 95% CI 3.06-8.42) during the first week, slightly smaller (aOR 3.01, 95% CI 2.11 - 4.30) during the subsequent three weeks, and remained elevated (aOR 1.58, 95% CI 1.19-2.09) throughout the remainder of the study period.Conclusions: Our analyses suggest that the experience of a pregnancy "scare" does not scare young women away from wanting pregnancies. On the contrary, the state of possibly being pregnant actually made young women in our study more likely to want to be pregnant, on average.Implications: Very few young women desire a pregnancy during the transition to adulthood; however, a salient life event like a pregnancy scare can abruptly generate a desire for pregnancy. Our study contributes to efforts to help women implement their pregnancy desires by furthering our understanding of those desires and the contexts in which they are formed. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

We examined whether women's experiences across and within their intimate relationships affect their expected level of control over sex and contraceptive use. We used data from 648 women ages 18–20 in the Relationship Dynamics and Social Life (RDSL) study, which interviewed a random, population-based sample in a Michigan county. We used ordered logistic regression with fixed-effects to control for individual- and relationship-level characteristics. We found a u-shaped relationship between intimacy/commitment and expected control, with the lowest expected control in the least intimate/committed and the most intimate/committed relationships, and the highest expected control in the intermediate relationships. Women expected more control in their long-term compared to short-term relationships, and expected control increases over time in a specific relationship. Women also expected less control in their conflictual and/or asymmetric relationships – those with older and/or violent partners, and expected control decreases after experiencing violence or a partner's non-monogamy. Our results are consistent with cross-sectional research suggesting that women in violent relationships experience more reproductive coercion than women in non-violent relationships, but we also found that other aspects of intimate relationships are important determinants of expected control over sex and contraception. Intervention strategies should consider a wider range of intimate relationship characteristics – beyond violence – to improve women's control of their reproductive behaviors. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This paper examines the proposition that sexual and contraceptive behaviours mediate the relationship between the pregnancy desires of young, unmarried women and their having an unplanned pregnancy. The sample consisted of 854 18- to 19-year-old women living in Michigan, USA. First, the positive and negative pregnancy desires of these women were measured, as were the women's perceptions of the positive and negative desires of their sexual partners. Then the extent to which these four types of desires, as well as several types of interactions between them, prospectively predicted the occurrence of subsequent pregnancies were tested with logistic regression analyses, initially alone and then after the addition of several types of sexual and contraceptive mediator variables. The results demonstrated that four of the ten significant motivational predictors became non-significant following the introduction of the contraceptive mediator variables and that the predictive strength of the other six significant motivational predictors was substantially reduced by their introduction. A number of factors that may account for only a partial mediational effect in some models are discussed. [ABSTRACT FROM AUTHOR]

CONTEXT Understanding the causes of early childbearing is important for reducing the persistently high rates of early births in the United States. Perceptions of possible benefits may contribute to these rates, while high opportunity costs may dissuade women from early childbearing. METHODS Perceptions of costs and benefits of pregnancy, as well as later experiences of pregnancy, were assessed for 701 nulligravid women aged 18-22 who entered the Relationship Dynamics and Social Life study in 2008-2009 and were interviewed weekly for up to 30 months. Bivariate t tests, chi-square tests and multivariable discrete-time event history analyses were used to assess associations of perceived personal consequences of childbearing (e.g., predicted financial costs), goals in potentially competing domains (opportunity costs) and social norms with subsequent pregnancy. RESULTS Twenty percent of women reported that early childbearing would have more positive than negative personal consequences. Compared with other women, those who had a pregnancy during follow-up had, at baseline, more positive perceptions of the personal consequences of pregnancy and of their friends' approval of pregnancy, and greater desire for consumer goods. In multivariable analyses, only the scales assessing perceived personal consequences of childbearing and friends' approval of childbearing were associated with pregnancy (odds ratios, 2.0 and 1.2, respectively). Goals in potentially competing domains were not associated with pregnancy. CONCLUSION Young women's perceptions of consequences of early childbearing predict subsequent pregnancy. That these perceptions are distinct from childbearing desires and from other dimensions of costs and benefits illustrates the complex attitudinal underpinnings of reproductive behavior. [ABSTRACT FROM AUTHOR]

Background We aimed to determine patterns of contraceptive consistency among heterosexually active, young adult women who do not desire pregnancy, and to identify factors associated with these patterns. Methods We analyzed longitudinal data from a population-based study of young adult women aged 18 and 19 who were representative of a single county in southeastern Michigan. Using multinomial logistic regression, we identified associations between contraceptive consistency (dependent outcome) and sociodemographic characteristics and personal factors. Findings We categorized women into three patterns of contraceptive consistency: 1) always consistent (40%; reference group), 2) sometimes consistent (49%), 3) never consistent (11%). Not being employed was associated with increased odds of being sometimes consistent (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.1–2.2) and never consistent (OR, 1.9; 95% CI, 1.1–3.4). Those who reported a grade point average of 3.0 or less were more likely to be never consistent (OR, 2.5; 95% CI, 1.2–5.3). Women in a serious relationship had a two times greater odds of being sometimes consistent. Among always consistent users, the oral contraceptive pill was most often used (55%); only 4% used the intrauterine device or implant. Sometimes consistent and never consistent users most frequently relied on condoms (35%) and withdrawal (68%), respectively. Conclusions This analysis of longitudinal data revealed that the majority of young adult women inconsistently used short-acting or coital-specific methods; few used the most effective, long-acting methods. Interventions to improve contraceptive consistency among young adult women should include periodic assessments of personal factors (i.e., work, school, relationships) and promotion of long-acting reversible contraceptive methods when appropriate. [ABSTRACT FROM AUTHOR]

Leveraging spatiotemporal variation in homicides that occurred during a 2.5-year weekly panel survey of 387 women ages 18-22 in Flint, Michigan, we investigate how young women's desires to become pregnant and to avoid pregnancy evolve in response to local homicides during the transition to adulthood. To address the endogeneity of exposure, we explore how the same woman's pregnancy desires (1) differed, on average, across weeks before and after the first homicide occurred within a quarter mile of her home; (2) evolved in the aftermath of this initial homicide exposure; and (3) changed in response to additional nearby homicides. One-fifth (22%) of women were exposed to a nearby homicide at least once during the study, and one-third of these women were exposed multiple times. Overall, the effects of nearby homicides were gradual: although average desires to become pregnant and to avoid pregnancy differed after initial exposure, these differences emerged approximately three to five months post-exposure. Repeated exposure to nearby homicides had nonlinear effects on how much women wanted to become pregnant and how much they wanted to avoid pregnancy. Together, our analyses provide a new explanation for why some young women-especially those who are socially disadvantaged-desire pregnancy at an early age., (Copyright © 2021 The Authors.)

This article explores race differences in the desire to avoid pregnancy or become pregnant using survey data from a random sample of 914 young women (ages 18-22) living in a Michigan county and semi-structured interviews with a subsample of 60 of the women. In the survey data, desire for pregnancy, indifference, and ambivalence are very rare but are more prevalent among Black women than White women. In the semi-structured interviews, although few women described fatalistic beliefs or lack of planning for future pregnancies, Black and White women did so equally often. Women more often described fatalistic beliefs and lack of planning when retrospectively describing their past than when prospectively describing their future. Using the survey data to compare prospective desires for a future pregnancy with women's recollections of those desires after they conceived, more Black women shifted positive than shifted negative, and Black women were more likely to shift positive than White women-that is, Black women do not differentially retrospectively overreport prospectively desired pregnancies as having been undesired before conception. Young women's consistent (over repeated interviews) prospective expression of strong desire to avoid pregnancy and correspondingly weak desire for pregnancy, along with the similarity of Black and White women's pregnancy plans, lead us to conclude that a "planning paradigm"-in which young women are encouraged and supported in implementing their pregnancy desires-is probably appropriate for the vast majority of young women and, most importantly, is similarly appropriate for Black and White young women., (Copyright © 2021 The Authors.)

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.

Objective: To describe the association between weight status and sexual practices among 18- to 19-year-old women., Study Design: We analyzed a population-based longitudinal study of 18- to 19-year-old women residing in a Michigan county at cohort inception. Weekly journal surveys measured sexual practices, including contraceptive behaviors. Outcomes included proportion of weeks with a partner, proportion of weeks with sexual intercourse, number of partners, average length of relationships, proportion of weeks with contraception use, and proportion of weeks where contraception was used consistently. We examined 26,545 journal surveys from 900 women over the first study year. Ordinary least squares regression models for each outcome examined differences by weight status, controlling for sociodemographic characteristics., Results: The mean proportion of weeks in which adolescents reported sexual intercourse was 52%; there was no difference by weight status. Among weeks in which adolescents reported sexual activity, obese adolescents had a lower proportion of weeks where any contraception was used compared with normal weight adolescents (84% vs 91%, P = .011). Among weeks in which adolescents reported sexual activity and contraceptive use, obese adolescents had a lower proportion of weeks with consistent contraceptive use (68% vs 78%, P = .016) and oral contraceptive pill use (27% vs 45%, P = .001) compared with normal weight adolescents. All other relationships by weight status were not statistically significant., Conclusions: In this longitudinal study, obese adolescent women were less likely to use contraception, and less likely to use it consistently when compared with normal weight peers. Findings suggest obesity may be an important factor associated with adolescent women's sexual behavior., (Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: We prospectively examined the influence of young women's depression and stress symptoms on their weekly consistency of contraceptive method use., Study Design: Women ages 18-20 years (n = 689) participating in a longitudinal cohort study completed weekly journals assessing reproductive, relationship and health characteristics. We used data through 12 months of follow-up (n = 8877 journals) to examine relationships between baseline depression (CES-D) and stress (PSS-10) symptoms and consistency of contraceptive methods use with sexual activity each week. We analyzed data with random effects multivarible logistic regression., Results: Consistent contraceptive use (72% of weeks) was 10-15 percentage points lower among women with moderate/severe baseline depression and stress symptoms than those without symptoms (p < .001). Controlling for covariates, women with depression and stress symptoms had 47% and 69% reduced odds of contraceptive consistency each week than those without symptoms, respectively (OR 0.53, CI 0.31-0.91 and OR 0.31, CI 0.18-0.52). Stress predicted inconsistent use of oral contraceptives (OR 0.27, CI 0.12-0.58), condoms (OR 0.40, CI 0.23-0.69) and withdrawal (OR 0.12, CI 0.03-0.50)., Conclusion: Women with depression and stress symptoms appear to be at increased risk for user-related contraceptive failures, especially for the most commonly used methods., Implications: Our study has shown that young women with elevated depression and stress symptoms appear to be at risk for inconsistent contraceptive use patterns, especially for the most common methods that require greater user effort and diligence. Based upon these findings, clinicians should consider women's psychological and emotional status when helping patients with contraceptive decision-making and management. User-dependent contraceptive method efficacy is important to address in education and counseling sessions, and women with stress or depression may be ideal candidates for long-acting reversible methods, which offer highly effective options with less user-related burden. Ongoing research will provide a greater understanding of how young women's dynamic mental health symptoms impact family planning behaviors and outcomes over time., (Copyright © 2013 Elsevier Inc. All rights reserved.)