Unintended PregnancyADAPTNCT03888404
Attitudes and Decision-making After Pregnancy Testing Study
An observational study of Unintended Pregnancy and Undesired Pregnancy, run by University of California, San Francisco at 1 site in United States.
Trial summary
The ADAPT Study is a longitudinal observational cohort study examining women's pregnancy preferences, pregnancy decision-making processes, and the effects of less preferred (commonly called "unintended") pregnancy on women's lives. Read more about this study
- Who is it for?
- Ages 15 to 34 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Unintended Pregnancy, Undesired Pregnancy
- What is being tested?
- Pregnancy preferences (Aim 1), Sociocultural environment (Aim 2) and Pregnancy preferences (Aim 3a)
- How many people
- 2,015 participants
- Where
- 1 siteUnited States
- Study dates
- 16 Mar 2019to Sep 2026
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 15 to 34 years
- Women only
- Healthy volunteers accepted
- Child, Adult
Study population: Women seeking care at participating reproductive health and primary care facilities
Who may be able to join
- Aged 15 to 34
- Is presenting for services at the participating recruitment site
- Speaks and reads English or Spanish
- Sexually active (has had sex in the last 3 months with a man/someone with sperm)
- Has a uterus
- Resides in a study state or one directly bordering a study state
- Has access to a phone, internet, or smartphone
- Willing to be contacted by research team for 1-3 years by phone and either email or mail
Who cannot join
- Reports current pregnancy (unless having or initiating an abortion on the day of enrollment)
- Is sterilized or using an intrauterine device or transdermal implant at enrollment
Trial locations and contacts
1 site in 1 country.
United States1 site
University of California, San Francisco
Oakland, California, 94612
About this study
The ADAPT Study is a longitudinal observational cohort study examining women's pregnancy preferences, pregnancy decision-making processes, and the effects of less preferred (commonly called "unintended") pregnancy on women's lives. This study will enroll and follow prospectively an Underlying Cohort (UC) of women who are not pregnant at baseline. The study will measure the degree to which participants desire to avoid pregnancy multiple times over the course of the year and capture incident pregnancies as they occur over time. Participants experiencing new pregnancies during the one-year UC will be transferred into a new cohort, the Pregnancy and Match Cohort (PMC); these women will be followed over the course of their pregnancy decision-making and health care-seeking to document these processes. In addition, they will be followed through their pregnancies and giving birth to investigate differences in health, well-being, and socioeconomic outcomes associated with carrying a pregnancy to term based on the participant's pre- and post-pregnancy preference about the pregnancy. Finally, a cohort of non-pregnant women from the UC, matched on desire to avoid pregnancy and time at risk of pregnancy, will be followed as part of the PMC. The study will compare the health, well-being, and socioeconomic outcomes of women with new pregnancies and new births to those in the non-pregnant group to assess the effect of pregnancy itself on women.
The ADAPT study has the following aims:
Read more
Aim 1: Assess the factors associated with women's pregnancy preferences, how preferences change over time, and their associations with contraceptive use, incident pregnancy, and feelings about the pregnancy after discovery (Underlying Cohort)
Aim 2: Investigate the options that women consider when they become pregnant and the factors that influence their pregnancy decision-making and ability to access desired reproductive health care and services (prenatal, abortion, adoption) (Study A)
Aim 3a: Examine the effects of giving birth from a less preferred (or "unintended") pregnancy, measured prospectively on a continuum, as compared to a more preferred pregnancy, on women's health and well-being (Study B1)
Aim 3b: Examine the effects of experiencing pregnancy and birth on women's health and well-being, as compared to not experiencing pregnancy (Study B2)
This is a social science, behavioral study and does not use clinical data or biological markers.
Read the detailed description
The ADAPT Study is a longitudinal observational cohort study. The study has four components, each corresponding to a study aim: 1) Underlying Cohort (Aim 1); 2) Pregnancy and Match Cohort, Study A (Aim 2); 3) Pregnancy and Match Cohort, Study B1 (Aim 3a); and 4) Pregnancy and Match Cohort, Study B2 (Aim 3b).
This ADAPT study will recruit an "Underlying Cohort" (UC) of approximately 2,200 English or Spanish-speaking women, ages 15-34, who are not pregnant (or are terminating a pregnancy) and who are seeking care at designated primary and reproductive health care facilities in four states (see Eligibility Criteria). Participants will be followed up to a year as a part of the UC. At the UC baseline and follow-up surveys conducted every 6 weeks, participants will complete a psychometrically validated measure of prospective preferences and feelings about a potential pregnancy, the Desire to Avoid Pregnancy (DAP) scale. Analyses of UC data will examine the degree to which DAP scores change over time, as well as the relationships between DAP score and contraceptive use, pregnancy, feelings about incident pregnancies after they occur, collected at follow-up surveys.
Participants experiencing new pregnancies during the one-year UC will be transferred into a new cohort, the Pregnancy and Match Cohort (PMC), and will be followed for two years. In the PMC, participants will complete 8 surveys at: PMC baseline (right after reporting a new pregnancy), 6 weeks, 3 months, 6 months, 9 months, 12 months, 18 months, and 24 months. Surveys will capture the pregnancy options participants consider (raising child, abortion, adoption), health care and services participants seek (prenatal, abortion, adoption), services obtained and pregnancy outcome. Analyses will examine the factors influencing decision-making and ability to obtain desired care/services, including state sociopolitical environment around reproductive health.
PMC participants will also be a part of PMC-Study B1, in which they will be followed through the course of their pregnancies and childbirth to investigate health, well-being, and socioeconomic outcomes. All PMC surveys will include measures of stress and mental health; well-being; socioeconomics and employment; educational goals and attainment; alcohol, tobacco and drug use; physical health; and intimate partner violence so that individual trajectories of these outcomes will be available over time. Surveys administered after the birth of a child will also assess birth, maternal and child outcomes, including prematurity, low birth weight, breast-feeding, post-partum depression, maternal bonding, and child development. Study B1 will investigate how these outcomes differ based on the woman's prospective preference about the pregnancy, as well as her attitudes and feelings about it upon discovery. Analyses will compare outcomes among women giving birth by pregnancy preferences level; separately, analyses will also include the women who experienced miscarriage or terminated pregnancies. The hypothesis is that women with higher DAP scores will experience poorer outcomes after pregnancy and birth than those with higher DAP scores.
Finally, PMC-Study B2 will examine the effect of pregnancy itself on health and well-being outcomes. Throughout the UC as new pregnancies occur, a cohort, frequency matched on pregnancy preference score and time at risk of pregnancy, will also be followed as part of the PMC. Non-pregnant matches who experience pregnancy within a year of enrollment will themselves enter the pregnancy cohort and be assigned a non-pregnant match for the remainder of their time in the PMC. Analyses will compare the health, well-being, and socioeconomic outcomes of women with new pregnancies (and, separately, new births) to those the non-pregnant group to assess the effect of pregnancy itself on women. Analyses will account for the interaction between pregnancy preferences and pregnancy. The hypothesis is that experiencing a less preferred pregnancy (higher DAP score) will result in poorer health outcomes than avoiding a less preferred pregnancy.
Research activities will be conducted and coordinated by trained University of California, San Francisco (UCSF) research associates. Staff members at recruitment sites will not be engaged in the research. Data collection will involve completing confidential self-administered surveys using secure electronic systems (i.e., Qualtrics) or phone interviews over the course of the study. Participants will be followed for up to one year in the UC; those who transfer to the PMC will be followed for between 2-3 years overall. Participants will be remunerated with gift cards after each survey.
- Conditions
- Unintended Pregnancy, Undesired Pregnancy
- Being tested
- Pregnancy preferences (Aim 1), Sociocultural environment (Aim 2), Pregnancy preferences (Aim 3a), Pregnancy (Aim 3b)
- Keywords
- Unintended Pregnancy, Unintended Birth, Pregnancy Preferences, Pregnancy Desires, Prenatal Care, Abortion, Adoption, Pregnancy Decision-Making, Mental Health, Stress, Socioeconomic Status, Education
- Medical subject headings
- Psychological Well-Being
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Pregnancy preferences (Aim 1)Other
The primary exposure of interest for Aim 1 will be pregnancy preferences, measured with the Desire to Avoid Pregnancy scale.
Sociocultural environment (Aim 2)Other
For Aim 2 will assess the roles of contextual and individual variables on pregnancy decision-making and care-seeking outcomes (including state political environment, stigma, social emotional and instrumental support, feelings about the pregnancy, SES).
Pregnancy preferences (Aim 3a)Other
The primary exposure of interest for Aim 3a will be pregnancy preferences, measured with the Desire to Avoid Pregnancy scale.
Pregnancy (Aim 3b)Other
The exposure of interest for Aim 3b will be experiencing pregnancy. DAP level will be examined as an effect modifier.
| Study group | Role | What they receive |
|---|---|---|
| Underlying Cohort | The study will recruit and follow a prospective cohort of women "at risk" of pregnancy for one year. Receives: Other: Pregnancy preferences (Aim 1) | |
| Pregnancy Match Cohort, Pregnant Group | Women from the Underlying Cohort who become pregnant will be transferred into the Pregnancy Match Cohort to be followed for two years. Receives: Other: Sociocultural environment (Aim 2); Other: Pregnancy preferences (Aim 3a) | |
| Pregnancy Match Cohort, Not Pregnant Group | The study will also follow a comparison cohort of non-pregnant women from the Underlying Cohort, frequency matched to the pregnant participants on Desire to Avoid Pregnancy score and time at risk of pregnancy. Receives: Other: Pregnancy (Aim 3b) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean score on Cohen's Perceived Stress Scale over 24 months (Aims 3a/3b)
The Perceived Stress Scale (PSS) measures stress; scores are summed across 4 scale items (brief version), each with responses never to very often, on a 5-point scale, for a score ranging 0-16. The outcome will be the predicted mean PSS score over the 8 PMC survey observations (a single measure of effect), based on the marginal effect from a longitudinal multivariable mixed effects model.
Measured: PMC baseline through 24 months
Proportion experiencing moderate to severe depressive symptoms on the PHQ-8 over 24 months (Aims 3a/3b)
Patient Health Questionnaire (PHQ-8) measures depression symptoms; scores are summed across the 8 items, each with responses not at all to nearly every day, on a 4-point scale, for a score ranging 0-24. Those scoring ≥ 10 are considered to have moderate to severe depression. The outcome will be the predicted probability of a PHQ-8 score ≥ 10 over the 8 PMC survey observations (a single measure of effect), based on the marginal effect from a longitudinal multivariable mixed effects model.
Measured: PMC baseline through 24 months
Proportion experiencing moderate to severe anxiety symptoms on the GAD-7 over 24 months (Aims 3a/3b)
Generalized Anxiety Disorder (GAD-7) measures anxiety symptoms; scores are summed across the 7 items, each with responses not at all to nearly every day, on a 4-point scale, for a score ranging 0-21. Those scoring ≥ 10 are considered to have moderate to severe anxiety. The outcome will be the predicted probability of a GAD-7 score ≥ 10 over the 8 PMC survey observations (a single measure of effect), based on the marginal effect from a longitudinal multivariable mixed effects model.
Measured: PMC baseline through 24 months
Proportion of pregnancies ending in childbirth and childraising, among those who reported ever considering the option (Aim 2)
Participants will report at each survey whether they considered each pregnancy option, as well as the status and outcome of their pregnancy. The outcome will be the proportion of participants whose pregnancies ended in childbirth and childraising, among those who ever reported considering giving birth and raising the child on a follow-up survey.
Measured: PMC baseline through 12 months
Proportion of pregnancies ending in abortion, among those who reported ever considering the option (Aim 2)
Participants will report at each survey whether they considered each pregnancy option, as well as the status and outcome of their pregnancy. The outcome will be the proportion of participants whose pregnancies ended in abortion, among those who ever reported considering abortion on a follow-up survey.
Measured: PMC baseline through 12 months
Proportion of participants obtaining prenatal care, among those who ever reported seeking prenatal care (Aim 2)
Participants will report at each survey whether they sought prenatal care, abortion care and/or adoption services and whether they obtained each type of care. The outcome will be the proportion of participants who obtained prenatal care, among those who ever reported seeking prenatal care.
Measured: PMC baseline through 12 months
Proportion of participants obtaining abortion care, among those who ever reported seeking abortion care (Aim 2)
Participants will report at each survey whether they sought prenatal care, abortion care and/or adoption services and whether they obtained each type of care. The outcome will be the proportion of participants who obtained abortion care, among those who ever reported seeking abortion care.
Measured: PMC baseline through 12 months
Secondary outcomes (5)
Proportion living below 100% of the Federal Poverty Level (FPL) (Aims 3a/3b)
Participants will report on all surveys their household income and size. We will calculate the FPL cut-point based on the specific year's US Census Bureau FPL. The outcome will be the predicted probability of living below 100% FPL over the 8 PMC survey observations, based on the marginal effect from a longitudinal multivariable mixed effects model.
Measured: PMC baseline through 24 months
Mean MacArthur Scale of Subjective Social Status score over 24 months (Aims 3a/3b)
Participants will rank themselves on the MacArthur Scale of Subjective Social Status (SSS) ladder (1-10) at all surveys. The outcome will be the predicted mean score over the 8 PMC survey observations, based on the marginal effect from a longitudinal multivariable mixed effects model.
Measured: PMC baseline through 24 months
Proportion employed full or part time (Aims 3a/3b)
Participants will report on all surveys their current employment status. The outcome will be the predicted probability of being employed (full or part time) over the 8 PMC survey observations, based on the marginal effect from a longitudinal multivariable mixed effects model.
Measured: PMC baseline through 24 months
Time until dropping out of or leaving school (Aims 3a/3b)
Participants will respond to questions at each survey about their current enrollment in school, type of school attended, degree sought, changes in enrollment since prior survey, degree completion/incompletion, and educational aspirations. Dropping out will be examined as, among those in a degree or other educational program at PMC baseline, time until stopping the degree for a reason other than completion.
Measured: PMC baseline through 24 months
Mean Diener's Flourishing Scale scores over 24 months (Aims 3a/3b)
Diener's Flourishing Scale scores measures eudaimonic well-being; scores are summed across the 8 items, each with responses strongly agree to strongly disagree, on a 7-point scale, for total scores of 0-46. The outcome will be the predicted mean scale score over the 8 PMC survey observations, based on the marginal effect from a longitudinal multivariable mixed effects model.
Measured: PMC baseline through 24 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Mar 2019
- Study start16 Mar 2019
- Primary completionSep 2026 (estimated)
- Study completionSep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Unintended PregnancyStudies of the same condition, open and under way.
- More trials run by University of California, San FranciscoThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 2,015 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of California, San Francisco
- Sponsor type
- University, hospital or other
- Collaborators
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- Responsible party
- Sponsor
- Investigators
- Corinne Rocca, PhD, Principal investigator, University of California, San Francisco
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03888404
- Sponsor's protocol ID
- 17-23592
- Other IDs
- R01HD108643
- Acronym
- ADAPT
- Status last verified
- Apr 2026
- First submitted
- 19 Mar 2019
- Last updated
- 28 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Rocca CH, Gould H, Gonzalez E, Foster DG, Munoz I, Parra M, Ralph LJ. Cohort profile: the ADAPT study, a prospective study of pregnancy preferences, pregnancy, and health and well-being in the southwestern USA. BMJ Open. 2024 Sep 25;14(9):e085372. doi: 10.1136/bmjopen-2024-085372.
PubMed 39322600Biggs MA, Ralph L, Foster DG, Arteaga S, Rocca CH. Pregnancy care-seeking stress in the USA: a prospective cohort study. BMJ Open. 2026 Jun 11;16(6):e117096. doi: 10.1136/bmjopen-2026-117096.
PubMed 42276814
Study at a glance
From the registry record, last updated by the sponsor on 28 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Attitudes and Decision-making After Pregnancy Testing Study
- ClinicalTrials.gov ID
- NCT03888404
- Acronym / sponsor ID
- ADAPT / 17-23592
- Conditions
- Unintended Pregnancy, Undesired Pregnancy
- Keywords
- Unintended Pregnancy, Unintended Birth, Pregnancy Preferences, Pregnancy Desires, Prenatal Care, Abortion, Adoption, Pregnancy Decision-Making
- Study type
- Observational
- Recruitment status
- Active, not recruiting
- Enrolment
- 2,015 participants (actual)
- Lead sponsor
- University of California, San FranciscoUniversity, hospital or other
- Collaborators
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- Study start
- 16 Mar 2019 (actual)
- Primary completion
- Sep 2026 (estimated)
- Study completion
- Sep 2026 (estimated)
- First posted
- 25 Mar 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The ADAPT Study is a longitudinal observational cohort study examining women's pregnancy preferences, pregnancy decision-making processes, and the effects of less preferred (commonly called "unintended") pregnancy on women's lives. This study will enroll and follow prospectively an Underlying Cohort (UC) of women who are not pregnant at baseline. The study will measure the degree to which participants desire to avoid pregnancy multiple times over the course of the year and capture incident pregnancies as they occur over time. Participants experiencing new pregnancies during the one-year UC will be transferred into a new cohort, the Pregnancy and Match Cohort (PMC); these women will be followed over the course of their pregnancy decision-making and health care-seeking to document these processes. In addition, they will be followed through their pregnancies and giving birth to investigate differences in health, well-being, and socioeconomic outcomes associated with carrying a pregnancy to term based on the participant's pre- and post-pregnancy preference about the pregnancy. Finally, a cohort of non-pregnant women from the UC, matched on desire to avoid pregnancy and time at risk of pregnancy, will be followed as part of the PMC. The study will compare the health, well-being, and socioeconomic outcomes of women with new pregnancies and new births to those in the non-pregnant group to assess the effect of pregnancy itself on women.
The ADAPT study has the following aims:
Aim 1: Assess the factors associated with women's pregnancy preferences, how preferences change over time, and their associations with contraceptive use, incident pregnancy, and feelings about the pregnancy after discovery (Underlying Cohort)
Aim 2: Investigate the options that women consider when they become pregnant and the factors that influence their pregnancy decision-making and ability to access desired reproductive health care and services (prenatal, abortion, adoption) (Study A)
Aim 3a: Examine the effects of giving birth from a less preferred (or "unintended") pregnancy, measured prospectively on a continuum, as compared to a more preferred pregnancy, on women's health and well-being (Study B1)
Aim 3b: Examine the effects of experiencing pregnancy and birth on women's health and well-being, as compared to not experiencing pregnancy (Study B2)
This is a social science, behavioral study and does not use clinical data or biological markers.
Detailed description
The ADAPT Study is a longitudinal observational cohort study. The study has four components, each corresponding to a study aim: 1) Underlying Cohort (Aim 1); 2) Pregnancy and Match Cohort, Study A (Aim 2); 3) Pregnancy and Match Cohort, Study B1 (Aim 3a); and 4) Pregnancy and Match Cohort, Study B2 (Aim 3b).
This ADAPT study will recruit an "Underlying Cohort" (UC) of approximately 2,200 English or Spanish-speaking women, ages 15-34, who are not pregnant (or are terminating a pregnancy) and who are seeking care at designated primary and reproductive health care facilities in four states (see Eligibility Criteria). Participants will be followed up to a year as a part of the UC. At the UC baseline and follow-up surveys conducted every 6 weeks, participants will complete a psychometrically validated measure of prospective preferences and feelings about a potential pregnancy, the Desire to Avoid Pregnancy (DAP) scale. Analyses of UC data will examine the degree to which DAP scores change over time, as well as the relationships between DAP score and contraceptive use, pregnancy, feelings about incident pregnancies after they occur, collected at follow-up surveys.
Participants experiencing new pregnancies during the one-year UC will be transferred into a new cohort, the Pregnancy and Match Cohort (PMC), and will be followed for two years. In the PMC, participants will complete 8 surveys at: PMC baseline (right after reporting a new pregnancy), 6 weeks, 3 months, 6 months, 9 months, 12 months, 18 months, and 24 months. Surveys will capture the pregnancy options participants consider (raising child, abortion, adoption), health care and services participants seek (prenatal, abortion, adoption), services obtained and pregnancy outcome. Analyses will examine the factors influencing decision-making and ability to obtain desired care/services, including state sociopolitical environment around reproductive health.
PMC participants will also be a part of PMC-Study B1, in which they will be followed through the course of their pregnancies and childbirth to investigate health, well-being, and socioeconomic outcomes. All PMC surveys will include measures of stress and mental health; well-being; socioeconomics and employment; educational goals and attainment; alcohol, tobacco and drug use; physical health; and intimate partner violence so that individual trajectories of these outcomes will be available over time. Surveys administered after the birth of a child will also assess birth, maternal and child outcomes, including prematurity, low birth weight, breast-feeding, post-partum depression, maternal bonding, and child development. Study B1 will investigate how these outcomes differ based on the woman's prospective preference about the pregnancy, as well as her attitudes and feelings about it upon discovery. Analyses will compare outcomes among women giving birth by pregnancy preferences level; separately, analyses will also include the women who experienced miscarriage or terminated pregnancies. The hypothesis is that women with higher DAP scores will experience poorer outcomes after pregnancy and birth than those with higher DAP scores.
Finally, PMC-Study B2 will examine the effect of pregnancy itself on health and well-being outcomes. Throughout the UC as new pregnancies occur, a cohort, frequency matched on pregnancy preference score and time at risk of pregnancy, will also be followed as part of the PMC. Non-pregnant matches who experience pregnancy within a year of enrollment will themselves enter the pregnancy cohort and be assigned a non-pregnant match for the remainder of their time in the PMC. Analyses will compare the health, well-being, and socioeconomic outcomes of women with new pregnancies (and, separately, new births) to those the non-pregnant group to assess the effect of pregnancy itself on women. Analyses will account for the interaction between pregnancy preferences and pregnancy. The hypothesis is that experiencing a less preferred pregnancy (higher DAP score) will result in poorer health outcomes than avoiding a less preferred pregnancy.
Research activities will be conducted and coordinated by trained University of California, San Francisco (UCSF) research associates. Staff members at recruitment sites will not be engaged in the research. Data collection will involve completing confidential self-administered surveys using secure electronic systems (i.e., Qualtrics) or phone interviews over the course of the study. Participants will be followed for up to one year in the UC; those who transfer to the PMC will be followed for between 2-3 years overall. Participants will be remunerated with gift cards after each survey.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Underlying Cohort | – | Other: Pregnancy preferences (Aim 1)The study will recruit and follow a prospective cohort of women "at risk" of pregnancy for one year. |
| Pregnancy Match Cohort, Pregnant Group | – | Other: Sociocultural environment (Aim 2), Other: Pregnancy preferences (Aim 3a)Women from the Underlying Cohort who become pregnant will be transferred into the Pregnancy Match Cohort to be followed for two years. |
| Pregnancy Match Cohort, Not Pregnant Group | – | Other: Pregnancy (Aim 3b)The study will also follow a comparison cohort of non-pregnant women from the Underlying Cohort, frequency matched to the pregnant participants on Desire to Avoid Pregnancy score and time at risk of pregnancy. |
Who may qualify
- Ages
- 15 to 34 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult
- Study population
- Women seeking care at participating reproductive health and primary care facilities
Key inclusion criteria (8 listed)
- Aged 15 to 34
- Is presenting for services at the participating recruitment site
- Speaks and reads English or Spanish
- Sexually active (has had sex in the last 3 months with a man/someone with sperm)
- Has a uterus
Key exclusion criteria (2 listed)
- Reports current pregnancy (unless having or initiating an abortion on the day of enrollment)
- Is sterilized or using an intrauterine device or transdermal implant at enrollment
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Pregnancy preferences (Aim 1)The primary exposure of interest for Aim 1 will be pregnancy preferences, measured with the Desire to Avoid Pregnancy scale. | Other | Underlying Cohort |
| Sociocultural environment (Aim 2)For Aim 2 will assess the roles of contextual and individual variables on pregnancy decision-making and care-seeking outcomes (including state political environment, stigma, social emotional and instrumental support, feelings about the pregnancy, SES). | Other | Pregnancy Match Cohort, Pregnant Group |
| Pregnancy preferences (Aim 3a)The primary exposure of interest for Aim 3a will be pregnancy preferences, measured with the Desire to Avoid Pregnancy scale. | Other | Pregnancy Match Cohort, Pregnant Group |
| Pregnancy (Aim 3b)The exposure of interest for Aim 3b will be experiencing pregnancy. DAP level will be examined as an effect modifier. | Other | Pregnancy Match Cohort, Not Pregnant Group |
Primary outcome
Mean score on Cohen's Perceived Stress Scale over 24 months (Aims 3a/3b)
Time frame: PMC baseline through 24 months
The Perceived Stress Scale (PSS) measures stress; scores are summed across 4 scale items (brief version), each with responses never to very often, on a 5-point scale, for a score ranging 0-16. The outcome will be the predicted mean PSS score over the 8 PMC survey observations (a single measure of effect), based on the marginal effect from a longitudinal multivariable mixed effects model.
Proportion experiencing moderate to severe depressive symptoms on the PHQ-8 over 24 months (Aims 3a/3b)
Time frame: PMC baseline through 24 months
Patient Health Questionnaire (PHQ-8) measures depression symptoms; scores are summed across the 8 items, each with responses not at all to nearly every day, on a 4-point scale, for a score ranging 0-24. Those scoring ≥ 10 are considered to have moderate to severe depression. The outcome will be the predicted probability of a PHQ-8 score ≥ 10 over the 8 PMC survey observations (a single measure of effect), based on the marginal effect from a longitudinal multivariable mixed effects model.
Proportion experiencing moderate to severe anxiety symptoms on the GAD-7 over 24 months (Aims 3a/3b)
Time frame: PMC baseline through 24 months
Generalized Anxiety Disorder (GAD-7) measures anxiety symptoms; scores are summed across the 7 items, each with responses not at all to nearly every day, on a 4-point scale, for a score ranging 0-21. Those scoring ≥ 10 are considered to have moderate to severe anxiety. The outcome will be the predicted probability of a GAD-7 score ≥ 10 over the 8 PMC survey observations (a single measure of effect), based on the marginal effect from a longitudinal multivariable mixed effects model.
Proportion of pregnancies ending in childbirth and childraising, among those who reported ever considering the option (Aim 2)
Time frame: PMC baseline through 12 months
Participants will report at each survey whether they considered each pregnancy option, as well as the status and outcome of their pregnancy. The outcome will be the proportion of participants whose pregnancies ended in childbirth and childraising, among those who ever reported considering giving birth and raising the child on a follow-up survey.
Proportion of pregnancies ending in abortion, among those who reported ever considering the option (Aim 2)
Time frame: PMC baseline through 12 months
Participants will report at each survey whether they considered each pregnancy option, as well as the status and outcome of their pregnancy. The outcome will be the proportion of participants whose pregnancies ended in abortion, among those who ever reported considering abortion on a follow-up survey.
Proportion of participants obtaining prenatal care, among those who ever reported seeking prenatal care (Aim 2)
Time frame: PMC baseline through 12 months
Participants will report at each survey whether they sought prenatal care, abortion care and/or adoption services and whether they obtained each type of care. The outcome will be the proportion of participants who obtained prenatal care, among those who ever reported seeking prenatal care.
Proportion of participants obtaining abortion care, among those who ever reported seeking abortion care (Aim 2)
Time frame: PMC baseline through 12 months
Participants will report at each survey whether they sought prenatal care, abortion care and/or adoption services and whether they obtained each type of care. The outcome will be the proportion of participants who obtained abortion care, among those who ever reported seeking abortion care.
5 secondary outcomes
Proportion living below 100% of the Federal Poverty Level (FPL) (Aims 3a/3b)
Time frame: PMC baseline through 24 months
Mean MacArthur Scale of Subjective Social Status score over 24 months (Aims 3a/3b)
Time frame: PMC baseline through 24 months
Proportion employed full or part time (Aims 3a/3b)
Time frame: PMC baseline through 24 months
Time until dropping out of or leaving school (Aims 3a/3b)
Time frame: PMC baseline through 24 months
Mean Diener's Flourishing Scale scores over 24 months (Aims 3a/3b)
Time frame: PMC baseline through 24 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Apr 2026.
- Results publication: PubMed 39322600Rocca CH, Gould H, Gonzalez E, Foster DG, Munoz I, Parra M, Ralph LJ. Cohort profile: the ADAPT study, a prospective study of pregnancy preferences, pregnancy, and health and well-being in the southwestern USA. BMJ Open. 2024 Sep 25;14(9):e085372. doi: 10.1136/bmjopen-2024-085372.
- Derived from this study: PubMed 42276814Biggs MA, Ralph L, Foster DG, Arteaga S, Rocca CH. Pregnancy care-seeking stress in the USA: a prospective cohort study. BMJ Open. 2026 Jun 11;16(6):e117096. doi: 10.1136/bmjopen-2026-117096.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Corinne Rocca, PhD principal investigator
University of California, San Francisco
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Unintended Pregnancy and Undesired Pregnancy, run by University of California, San Francisco at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 28 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Mean score on Cohen's Perceived Stress Scale over 24 months (Aims 3a/3b) (time frame: PMC baseline through 24 months). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03888404, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Apr 2026.