Risk Perception and Tolerance in Contraceptive Use

Project Summary Reducing the large percentage of undesired pregnancies in the United States (43%) is a top public health priority because control over pregnancy is crucial for women’s well-being and most undesired pregnancies result from non-use or inconsistent use of contraceptives. Key barriers to scientific progress are a lack of tools to examine

risk perceptions and tolerance as key psychological mechanisms motivating contraceptive use among men and women who do not desire a pregnancy and a lack of data from male partners who play a key role in contraceptive decision-making. To help remedy barriers to understanding the mismatch between pregnancy desires and

contraceptive use that undergird the large fraction of undesired pregnancies in the United States, Dr. Littlejohn and her mentoring team have designed training and research activities to give her key missing skills to become an independent investigator in the interdisciplinary study of risk tolerance in contraceptive use among couples.

The key objective of this application is for Dr. Littlejohn, a sociologist, to gain the needed expertise to integrate approaches from demography and psychology to generate and test novel hypotheses on risk perception and tolerance among couples in the near-term and to learn how to prepare a successful R01 grant application for a

longitudinal study on risk tolerance among couples to achieve scientific independence in the long-term. To gain the skills that Dr. Littlejohn needs to be a leader in this new field, she will pursue training in: (1) theories on the psychology of risk perceptions/tolerance and the demography of human fertility, (2) cognitive interviewing to

pretest innovative adapted measures on risk tolerance, and (3) longitudinal analyses of data on couples. To gain necessary skills to successfully apply for an R01 grant by the end of the award period, she will also pursue training in (4) grant writing. These activities will allow her to achieve her two research aims: (1) Identify the

association between risk tolerance and contraceptive use among men and women who do not desire pregnancy using systematically adapted validated measures of risk tolerance from health psychology, and (2) Quantify how risk perceptions relate to contraceptive use among couples using longitudinal data. The application aligns with

the NICHD Population Dynamics Branch’s key priority in contraceptive use and non-use and will deploy interdisciplinary insights to address the multiple levels of analysis required to robustly model contraceptive

behavior. Dr. Littlejohn’s activities will be supervised by a multidisciplinary team: co-primary mentors, Dr. Jennifer Barber (sociology/demography, Indiana University) and Dr. Elliot Berkman (psychology/neuroscience, University of Oregon), and advisory team members Dr. Ellen Peters (psychology, University of Oregon), Dr. Sharon Sassler

(sociology/demography, Cornell University), and Dr. Kari White (sociology/demography, University of Texas- Austin). This K01 project will give Dr. Littlejohn the skills to achieve her goal of being an independent investigator innovatively studying risk tolerance in contraceptive use among couples over time in service of improving

population health by helping people achieve their fertility goals.