The Impact of Structural Determinants on Pregnancy Intention and Reproductive Decision-Making Among African American Women.

Introduction: African American women face significant reproductive health inequities rooted in structural and social factors, though few studies have directly engaged them to examine how such factors play a role in their reproductive decision-making. This study draws from a methodology underused in...

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Publicado en:Journal of Racial & Ethnic Health Disparities Vol. 13; no. 4; pp. 2827 - 2843
Autor principal: Strickland Denson, Jill
Formato: research tables/charts Journal Article
Publicado: Springer Nature Aug2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2026
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s40615-025-02459-w
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        atl: The Impact of Structural Determinants on Pregnancy Intention and Reproductive Decision-Making Among African American Women.
      aug:
        au: Strickland Denson, Jill
        affil: https://ror.org/054x00070 Prevention Research Center, University of Wisconsin, Madison, WI, USA
      sug:
        subj:
          Reproductive Behavior
          Decision Making
          Attitude to Pregnancy
          Social Determinants of Health Evaluation
          Women Psychosocial Factors
          African Americans Psychosocial Factors
          Human
          Female
          Adolescence
          Adult
          Childbearing Age
          Pregnancy
          United States
          Reproductive Health
          Women's Health
          Socioeconomic Factors
          Multimethod Studies
          Multivariate Analysis
          Trauma
          Depression
          Stress
          Discrimination
          Life Experiences
          Thematic Analysis
          Autonomy
          Career Planning and Development
          Women Education
          Sexual Partners
          Interpersonal Relations
          Self Concept
          Pregnancy, Unwanted
          Contraception
          Health Status Disparities
          Pregnancy Outcomes
          Racism
          Funding Source
          Data Analysis Software
          Adolescent: 13-18 years
          Adult: 19-44 years
          Female
      ab: Introduction: African American women face significant reproductive health inequities rooted in structural and social factors, though few studies have directly engaged them to examine how such factors play a role in their reproductive decision-making. This study draws from a methodology underused in reproductive health research to understand how African American women of different socioeconomic groups approach reproductive decision-making. Methods: The study employed group concepting mapping (GCM), a participatory, mixed-methods design that integrates qualitative processes with multivariate analyses. Twenty-four African American women between 18 and 44 years were recruited into lower (n = 12) and higher (n = 12) income groups. Based on GCM methods, each group engaged in the participatory data collection analysis process across three sessions. GCM software was used to generate visualizations, such as pattern match maps and go-zones, to identify themes. Results: Participants described experiences with trauma, depression, stress, and everyday interaction with discrimination. Three themes emerged from the GCM process: inward reflection (autonomy in reproductive decision-making, prioritizing career and education, and pressure to push through adversity), relational reflection (expectations of sexual partners in reproductive trajectories), and outward reflection (judgement from providers, reproductive coercion in healthcare systems). Each theme influenced participants' pregnancy trajectories and reproductive decision-making. Conclusions: Participants reported high importance of self-reflection, career and education, and low importance of male partners, when considering whether to pursue pregnancy, prevent pregnancy, and/or use contraception. Findings illustrate participants' reproductive health experiences were impacted by structural and social determinants. Results help document opportunities for policies and practices to attend to structural determinants versus individuals' reproductive trajectories.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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