Diamond-Smith Nadia G, Moreau Caroline, Bishai David M
Postdoctoral fellow, Global Health Group, University of California, San Francisco, 50 Beale Street, 12th Floor, San Francisco, CA 94105..
Stud Fam Plann. 2014 Dec;45(4):429-41. doi: 10.1111/j.1728-4465.2014.00006.x.
Although the rate of contraceptive use in France is high, more than one-third of pregnancies are unintended. We built a dynamic microsimulation model that applies data from the French COCON study on method switching, discontinuation, and failure rates to a hypothetical population of 20,000 women, followed for five years. We use the model to estimate the adjustment factor needed to make the survey data fit the demographic profile of France by adjusting for underreporting of contraceptive nonuse and abortion. We then test three behavior-change scenarios that could reduce unintended pregnancies: decreasing method failure, increasing time using effective methods, and increasing switching from less effective to more effective methods. Our model suggests that decreasing method failure is the most effective means of reducing unintended pregnancies, but we found that all of the scenarios reduced unintended pregnancies by at least 25 percent. Dynamic microsimulations may have great potential in reproductive health research and prove useful for policymakers.
尽管法国的避孕使用率很高，但仍有超过三分之一的怀孕是意外怀孕。我们构建了一个动态微观模拟模型，该模型将来自法国COCON研究中关于避孕方法转换、停用和失败率的数据应用于一个假设的20000名女性群体，并对其进行了五年的跟踪。我们使用该模型来估计通过调整避孕措施未使用和堕胎的漏报情况，使调查数据符合法国人口特征所需的调整因子。然后，我们测试了三种可以减少意外怀孕的行为改变情景：降低方法失败率、增加使用有效方法的时间，以及增加从不太有效的方法转换为更有效的方法。我们的模型表明，降低方法失败率是减少意外怀孕的最有效手段，但我们发现所有情景都至少将意外怀孕减少了25%。动态微观模拟在生殖健康研究中可能具有巨大潜力，并被证明对政策制定者有用。
