Grants and Funded Projects

The Social Context of Unintended Pregnancy in College-Aged Women
(National Institute of Nursing Research - F31 NR010287)
Principal Investigator: Melissa Lehan-Mackin, BSN

Unintended pregnancies (UIPs) affect 3 million women each year and women 18-24 account for more than 21% of the total number. UIP is a risk factor for inadequate pre-natal care, poor maternal-child outcomes, abortion (1.3 million annually), and costs the health care system $13 billion a year. Although abstinence remains the best means of pregnancy prevention, researchers and clinical professionals have proposed that emergency contraception (EC) may provide one solution to prevention of UIP. Currently, EC is the only way to prevent pregnancy after unprotected, unintended, or unwanted sex has occurred, potentially avoiding more than 700,000 abortions each year.

Social context is the interaction of an individual’s demographic profile, interpersonal relationships, and sociopolitical environment. The social context influences women when confronted with UIP by encouraging or discouraging certain health behaviors by establishing norms, creating patterns of resource utilization, and determining access to health materials and resources. Understanding the complex circumstances through which women must navigate is necessary in order to understand the processes that impact health care access and health policy. EC presents as a unique opportunity to examine social context and health behavior. Access issues, efficacy time frame, low levels of knowledge and use combine to allow an examination of elements of the social context not present in other women’s health issues.

The purpose of this study is to use a sequential, exploratory mixed-methods design to examine the impact of social context on women’s knowledge and use of EC. The specific aims of this study are to:

1. Describe college women's levels of EC knowledge and prevalence of use;
2. Explore the role of social context in the experiences of women who have used or considered using EC; and
3. Integrate quantitative and qualitative study outcomes to identify critical concepts related to knowledge, use, and accessibility, as well as, barriers and facilitators to appropriate use of EC.

This research is motivated by a long-term goal to examine the context in which health disparities are created or perpetuated, a goal consistent with NINR’s mission and research portfolio. The findings of the study will have several potential public health benefits, including a better understanding of how society’s beliefs influence health behavior. This knowledge will improve public health interventions and inform health policy decisions leading to a decrease in disparities in access to health care.