Exploring new categories of pregnancy intention in African-American women: Triangulation of qualitative and Q Methodology data

Background: Though half of U.S. pregnancies are unintended (mistimed or unwanted) at the time of conception, existing measures may not adequately reflect the nuances and complexities of reproductive desires and intentions. Q Methodology is a promising method for systematically characterizing such subjective viewpoints. It is rare however for Q-sort data to be validated against narrative interview data. We sought to determine whether narratives of women grouped together based on their Q-sort responses reflect the themes of those systematically-derived viewpoints. Methods: 143 low-income, 15-25 year old African-American women participated in a longitudinal study in which they completed a Q-sort task and a semi-structured interview. A subsample of 26 women were selected for this analysis based on having a “defining sort” (i.e. significant loading on only one viewpoint) and no pregnancies during the study. We qualitatively assessed cohesiveness of narrative themes within groups, and consistency of those themes with Q-sort viewpoints. Results: Respondents who shared a Q-sort viewpoint that emphasized family influences and emotional impacts of pregnancy showed the most consistency in their narrative data. Two additional viewpoints, one emphasizing perceived positive partner attitudes and one characterized by a strong sense of reproductive control, had some themes consistent with and others not consistent with their respective Q-sort viewpoints. Conclusion: Q Methodology is a promising method for defining new categories of pregnancy intentions and desires. Attention to inconsistencies in viewpoints about future pregnancy derived from Q-sort and narrative data allows us to further highlight understudied nuances of pregnancy intention.