Dr. Chuang is a General Internist with the long-term career goal of being an independent investigator in the study of reproductive health for women with chronic medical conditions. With General Internal Medicine fellowship training and a Masters of Science in Epidemiology, she has developed the necessary groundwork to pursue the work described in this application. Her immediate goal during the proposed grant period is to conduct research on risk factors of unintended pregnancy in women with prevalent chronic conditions, specifically diabetes, hypertension, and obesity. To achieve this goal, she will work closely with mentors with expertise in reproductive health research, survey research, demography, social psychology, and longitudinal data analysis. She has developed a training program consisting of formal coursework and other activities that will allow her to develop her research skills to become an independent investigator in this area. The aims of the research project are to compare 1) the future childbearing intentions, 2) contraceptive use, and 3) unintended pregnancy occurrence in women with and without chronic medical conditions. These aims will be achieved through cross-sectional analysis of the 2004 Behavioral Risk Factor Surveillance System and longitudinal analysis of the Central Pennsylvania Women's Health Study, a unique ongoing prospective cohort study of pre-conceptional health. This quantitative work will be complemented by a focus group study to explore the meaning of childbearing intentions, risk perception of adverse pregnancy outcomes, and contraceptive use in women with chronic medical conditions. This research will begin to define how women with chronic medical conditions experience intended and unintended pregnancy. Since women with medical conditions are at increased risk for pregnancy-related morbidity and adverse pregnancy outcomes, avoidance of unintended pregnancy is critically important. The work proposed by the candidate is congruent with the National Institute of Child Health and Human Development mission to ensure healthy and wanted pregnancies, and is a necessary first step toward reducing unintended pregnancies and promoting healthy pregnancy in this high-risk group of women.