Objective To estimate the prevalence of infertility using a current duration approach for comparison with a traditional constructed measure. Design Cross-sectional survey. Setting National Survey of Family Growth, United States, 2002. Participants A nationally-representative sample of females aged 15–44 years. Interventions None Main Outcome Measure(s) Infertility prevalence estimated by two approaches: 1) a constructed measure derived from questions on sexual activity, contraception, relationship status, and pregnancy, and 2) a measure based on estimated time-to-pregnancy (TTP) derived from the respondents’ current duration of pregnancy attempt (i.e., current duration approach). Associations with self-reported descriptive characteristics using weighted logistic regression or parametric survival models for each respective approach. Results Infertility prevalence was approximately twofold higher using the current duration approach (15.5%; 95% CI: 8.6, 27.5) versus the constructed measure (7.0%; 95% CI: 6.2, 7.8). Both methods identified similar patterns of increasing age, lower education, nulliparity, and history of gynecologic disorders as being associated with measures of impaired fecundity, while opposing patterns were seen for racial/ethnic identification and poverty status. Conclusions Infertility prevalence based on a current duration approach was consistent with other U.S. prospective cohort studies with preconception enrollment. These findings underscore the importance of definition and methodologic approach for estimating the prevalence of infertility.

The goal of the NIH Science of Behavior Change (SOBC) Common Fund Program is to provide the basis for an experimental medicine approach to behavior change that focuses on identifying and measuring the mechanisms that underlie behavioral patterns we are trying to change. This paper frames the development of the program within a discussion of the substantial disease burden in the U.S. attributable to behavioral factors, and details our strategies for breaking down the disease- and condition-focused silos in the behavior change field to accelerate discovery and translation. These principles serve as the foundation for our vision for a unified science of behavior change at the NIH and in the broader research community.

The literature on interracial families has examined social stigmas attached to interracial relationships but has not thoroughly documented whether crossing racial boundaries increases the risk of divorce. Using the 2002 National Survey of Family Growth (Cycle VI), we compare the likelihood of divorce for interracial couples to that of same-race couples. Comparisons across marriage cohorts reveal that, overall, interracial couples have higher rates of divorce, particularly for those marrying during the late-1980s. We also find race and gender variation. Compared to White/White couples, White female/Black male, and White female/Asian male marriages were more prone to divorce; meanwhile, those involving non-White females and White males and Hispanics and non-Hispanic persons had similar or lower risks of divorce.

Schedule control and supervisor support for family and personal life are work resources that may help employees manage the work-family interface. However, existing data and designs have made it difficult to conclusively identify the effects of these work resources. This analysis utilizes a group-randomized trial in which some units in an information technology workplace were randomly assigned to participate in an initiative, called STAR, that targeted work practices, interactions, and expectations by (a) training supervisors on the value of demonstrating support for employees’ personal lives and (b) prompting employees to reconsider when and where they work. We find statistically significant, though modest, improvements in employees’ work-family conflict and family time adequacy and larger changes in schedule control and supervisor support for family and personal life. We find no evidence that this intervention increased work hours or perceived job demands, as might have happened with increased permeability of work across time and space. Subgroup analyses suggest the intervention brings greater benefits to employees more vulnerable to work-family conflict. This study advances our understanding of the impact of social structures on individual lives by investigating deliberate organizational changes and their effects on work resources and the work-family interface with a rigorous design.

Recognizing a need for rigorous, experimental research to support the efforts of workplaces and policymakers in improving the health and wellbeing of employees and their families, the National Institutes of Health and the Centers for Disease Control and Prevention formed the Work, Family & Health Network (WFHN). The WFHN is implementing an innovative multisite study with a rigorous experimental design (adaptive randomization, control groups), comprehensive multilevel measures, a novel and theoretically based intervention targeting the psychosocial work environment, and translational activities. This paper describes challenges and benefits of designing a multilevel and transdisciplinary research network that includes an effectiveness study to assess intervention effects on employees, families, and managers; a daily diary study to examine effects on family functioning and daily stress; a process study to understand intervention implementation; and translational research to understand and inform diffusion of innovation. Challenges were both conceptual and logistical, spanning all aspects of study design and implementation. In dealing with these challenges, however, the WFHN developed innovative, transdisciplinary, multi-method approaches to conducting workplace research that will benefit both the research and business communities.

Infertility is a couple based fecundity impairment, though population level research is largely based upon information reported by female partners. Of the few studies focusing on male partners, most focus on the utilization of infertility services rather than efforts to estimate the prevalence and determinants of infertility as reported by male partners. Data from a nationally-representative sample of men aged 15–44 years who participated in the 2002 National Survey of Family Growth (NSFG) were used to estimate the prevalence of infertility and determinants of longer time-to-pregnancy (TTP) using the novel current duration approach. Using backward recurrence time parametric survival methods, we estimated infertility prevalence (TTP > 12 months) and time ratios (TR) associated with TTP as derived from males’ reported current duration of their pregnancy attempt. The estimated prevalence of infertility was 12.0% (95% CI: 7.0, 23.2). Longer TTP was associated with older male age (35–45 vs. 17–24 years) (TR: 2.49; 95% CI: 1.03, 6.03), biological childlessness (TR: 1.53; 95% CI: 1.07, 2.19), and lack of health insurance (TR: 1.73; 95% CI: 1.02, 2.94) after controlling for the differences in couples’ age and other socioeconomic factors. The prevalence of infertility based on male reporting is consistent with estimates of infertility in the United States found in prospective cohort studies and current duration studies based on female reporting. Our findings suggest that males can reliably inform about couple infertility. Interventions and services aimed at reducing couple infertility should include attention to male factors associated with longer TTP identified in this study.

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