Kelli Stidham Hall

Columbia University | CU · Department of Population and Family Health

Our population-based survey of 1078 randomly sampled US women, aged 18 to 55 years, sought to characterize their understanding of and attitudes toward the Affordable Care Act (ACA). Most women, especially socially disadvantaged groups, had negative or uncertain attitudes toward the ACA and limited understanding of its health benefits, including its...

Introduction: We have previously documented the relationships between stress and depression symptoms and adolescent women's nonuse and misuse of condoms and other contraceptive methods and on their unintended pregnancy rates. Aim: Here, we examine relationships between mental health symptoms and another understudied adolescent reproductive healt...

Background: Using a multidimensional approach, we assessed young women's knowledge of oral contraceptives (OC) and its influence on OC continuation rates. Methods: We used data from 659 women aged 13-25 years participating in a randomized controlled trial of an educational text message OC continuation intervention. Women received 6 months of dai...

Purpose Poor and disparate reproductive health outcomes in the United States may be related to inadequate and differential women’s health care utilization. We investigated trends in and determinants of adult U.S. women’s health service use, 2006-2010. Methods We analyzed population data from 7,897 women aged 25-44yrs in the National Survey of Fami...

Depression and stress have been linked with poor contraceptive behavior, but whether existing mental health symptoms influence women's subsequent risk of unintended pregnancy is unclear. We prospectively examined the effect of depression and stress symptoms on young women's pregnancy risk over one year. We used panel data from a longitudinal study...

Importance: Following the US Supreme Court ruling in Dobbs v Jackson Women's Health Organization, Georgia's law limiting abortion to early pregnancy, House Bill 481 (HB481), was allowed to go into effect in July 2022. Objectives: To estimate anticipated multiyear effects of HB481, which prohibits abortions after detection of embryonic cardiac ac...

Objectives. To longitudinally examine the legal landscape of laws requiring abortion patients be informed about the possibility of medication abortion (MAB) “reversal” (in quotes as it does not refer to an evidence-based medical procedure). Methods. We collected legal data on enacted state MAB-reversal laws across all 50 US states and Washington, D...

Context There is increasing interest and value in integrating family planning services into primary care. Title X services provide an opportunity to expand low-cost access to these services. This study sought to identify and describe implementation factors that influenced the integration of a package of Title X services into a unique primary care s...

Refugee women have poor outcomes and low utilization of sexual and reproductive health (SRH) services, which may be driven by access to and quality of SRH services at their resettled destinations. While healthcare providers offer valuable insights into these topics, little research has explored United States (U.S.) providers' experiences. To fill t...

Traditional family planning research has excluded Black and Latinx leaders, and little is known about medication abortion (MA) among racial/ethnic minorities, although it is an increasingly vital reproductive health service, particularly after the fall of Roe v. Wade. Reproductive justice (RJ) community-based organisation (CBO) SisterLove led a stu...

Introduction While reproductive injustice indicators are improving globally, they are worsening in the United States particularly for Black and other marginalized communities. Eugenics and obstetric violence against low-income and communities of color create well-founded distrust of sexual and reproductive health (SRH). Transformational, reparative...

Person-centered contraceptive access benefits reproductive autonomy, sexual wellbeing, menstrual regulation, and other preventive health. However, contraceptive access varies by social and geographic position, with policies either perpetuating or alleviating health inequities. We describe geographic and time-trend variation in an index from fewer (...

Introduction Thirty-seven states require minors seeking abortion to involve a parent, either through notification or consent. Little research has examined how implementation of these laws affect service delivery and quality of care for those who involve a parent. Methods Between May 2018 and September 2019, in-depth interviews were conducted with...

The family planning experiences of women diagnosed with severe mental illness (SMI) have been understudied, despite increased risk for unintended pregnancy and barriers to accessing healthcare. We interviewed 17 English-speaking women aged 18 to 55 diagnosed with SMI who were receiving treatment at an outpatient mental health clinic to learn about...

Introduction Sexuality-based stigma is prevalent in the USA and is, in part, based on religious and gender norms. In the South—compared to other regions—religiosity is more salient, gender norms are more conservative, and sexual and reproductive health (SRH) inequities are more prevalent. Methods Guided by a stakeholder Advisory Committee, the res...

Background Since 2011, U.S. states have enacted more than 400 policies restricting abortion access. As structural determinants, abortion policies have the potential to influence maternal and child health access, outcomes, and equity through multiple mechanisms. Limited research has examined their implications for birth outcomes. Methods We created...

Background To examine racial/ethnic and educational inequities in the relationship between state-level restrictive abortion policies and adverse birth outcomes from 2005 to 2015 in the United States. Methods Using a state-level abortion restrictiveness index comprised of 18 restrictive abortion policies, we conducted a retrospective longitudinal a...

Introduction Georgia's 2012 House Bill 954 (HB954) prohibiting abortions after 22 weeks from last menstrual period (LMP) has been associated with a significant decrease in abortions after 22 weeks. However, the policy's effects by race or ethnicity remain unexplored. We investigated whether changes in abortion numbers and ratios (per 1,000 live bir...

Background Young adulthood is a critical transitory period, with various factors impacting mental health and longer-term health outcomes, particularly among racial/ethnic minorities. Drawing from minority stress theory, this study examined correlates of depressive symptoms, specifically adverse childhood experiences (ACEs), racial/ethnic discrimina...

Objective The purpose of this study is to explore Protestant religious leaders’ attitudes towards abortion and their strategies for pastoral care in Georgia, USA. Religious leaders may play an important role in providing sexual and reproductive health pastoral care given a long history of supporting healing and health promotion. Methods We conduct...

Objectives. To measure trends before, during, and after implementation of Georgia House Bill 954, a limit on abortion at 22 or more weeks of gestation passed in 2012, in total abortions and abortions by gestational age and state residence. Methods. We analyzed aggregate year-level induced termination of pregnancy data from the Georgia Department of...

Reproductive autonomy is essential for women to achieve reproductive rights and freedom. However, the factors associated with reproductive autonomy in various contexts have not been explored. The aim of this analysis was to understand the socio-demographic, reproductive history and social context variables associated with two validated reproductive...

Introduction and objective: Studies of Anti-Müllerian Hormone (AMH) rely upon serum measures and clinical samples of older reproductive-aged women intended/attempting pregnancy, with known fertility issues or medical morbidities. We explored the utility of minimally invasive AMH as a measure of fecundability in population-based reproductive health...

Decision-making regarding the outcome of a pregnancy may include participation of the woman herself, her sexual partner, parents, family, and/or community. This paper examines who had the most say in the outcome of young Ghanaian women’s last pregnancy and whether this correlated with her level of reproductive autonomy (RA). We analysed cross-secti...

Purpose: The aim of the study was to determine whether characteristics related to the school, shooter, and guns used are associated with school shooting severity (casualty rates, fatality rates, and likelihood of fatality). Methods: We analyzed associations between individual-, school-, gun-level factors and school shooting severity in the Unite...

Objective We examined the effects of adverse life experiences (ALEs) on rates of unintended first pregnancy, including differential effects by race/ethnicity and socioeconomic status, among women in a national longitudinal cohort study. Methods We drew upon 15-years of data from 8810 adolescent and young adult females in the National Longitudinal...

Objective: To determine the effect of state Medicaid family planning (FP) programs transitioning from a Section 1115 waiver to a State Plan Amendment (SPA) on reproductive health outcomes. Materials and methods: Data were from the Pregnancy Risk Assessment Monitoring System on 75,082 women who had a live birth between 2007 and 2013 and were livi...

We explored whether abortion attitudes differed by respondents’ sex and country-level abortion policy context. Data were collected between 2010 and 2014 from 69,901 respondents from 51 countries. Abortion attitudes were scored on a ten-point Likert scale (1 = “never justifiable”; 10 = “always justifiable”). Country-level abortion policy context was...

Adolescent pregnancy contributes to high maternal mortality rates in Sub-Saharan Africa. We explored stigma surrounding adolescent sexual and reproductive health (SRH) and its impact on young Ghanaian women’s family planning (FP) outcomes. We conducted in-depth, semi-structured interviews with 63 women ages 15-24 recruited from health facilities an...

Objective: Using our previously developed and tested Adolescent Sexual and Reproductive Health (SRH) Stigma Scale, we investigated factors associated with perceived SRH stigma among adolescent girls in Ghana. Methods: We drew upon data from our survey study of 1,063 females 15-24yrs recruited from community- and clinic-based sites in two Ghanaia...

Background Safe and legal abortions are rarely practiced in the public health sector in Kenya, and rates of maternal mortality and morbidity from unsafe abortion is high. Little is known about women’s experiences seeking and accessing abortion in informal settlements in Nairobi, Kenya. Methods Seven focus group discussions were conducted with a to...

IRB self-certification form. Self-Certification Form: Determining Whether Human Subjects Are Involved in Research When Obtaining Coded Private Information (Data) and/or Biological Specimens. (PDF)

Objective Little is known about how women’s social context of unintended pregnancy, particularly adverse social circumstances, relates to their general health and wellbeing. We explored associations between stressful life events around the time of unintended pregnancy and physical and mental health. Methods Data are drawn from a national probabilit...

Little is known about the multi-level social determinants of adolescent sexual and reproductive health (SRH) that shape the use of family planning (FP) among young women in Africa. We conducted in-depth, semi-structured, qualitative interviews with 63 women aged 15-24 years in Accra and Kumasi, Ghana. We used purposive, stratified sampling to recru...

Young women’s experiences with sexual and reproductive health (SRH) stigma may contribute to unintended pregnancy. Thus, stigma interventions and rigorous measures to assess their impact are needed. Based on formative work, we generated a pool of 51 items on perceived stigma around different dimensions of adolescent SRH and family planning (sex, co...

Purpose: We investigated the influence of depression on subsequent risk of unintended pregnancy and social disparities within this relationship, during adolescence and young adulthood. Methods: Drawing upon 15-year, nationally representative data from 8,810 young U.S. women in the National Longitudinal Study of Adolescent to Adult Health, we est...

Purpose: To describe women's preferences for reproductive health providers as sources of primary and mental health care. Methods: This is secondary data analysis of the Women's Health Care Experiences and Preferences Study, an Internet survey conducted in September 2013 of 1,078 women aged 18 to 55 randomly sampled from a U.S. national probabili...

Background: Family planning research has not adequately addressed women's preferences for different contraceptive methods and whether women's contraceptive experiences match their preferences. Methods: Data were drawn from the Women's Healthcare Experiences and Preferences Study, an Internet survey of 1,078 women aged 18-55 randomly sampled from...

Background: Research has not adequately examined the potential negative effects of perceiving routine discrimination on general healthcare utilization or health status, especially among reproductive-aged women. We sought to evaluate the association between everyday discrimination, health service use, and perceived health among a national sample of...

Objective: To assess multiple dimensions of long acting reversible contraception (LARC) knowledge and perceived multi-level barriers to LARC use among a sample of college women. Study design: We conducted an internet-based study of 1,982 female undergraduates at a large mid-western university. Our 55-item survey used a multi-level framework to m...

Introduction: The current sociopolitical climate and context of the Affordable Care Act have led some to question the future role of family planning clinics in reproductive health care. We explored where women plan to get their future contraception, pelvic exam/pap smears, and sexually transmitted infection testing, with a focus on the role of fami...

Notably absent from research and public and policy dialogue on the Affordable Care Act (ACA) and reproductive health care are women's perspectives and a broader understanding of factors that shape ACA attitudes. We investigated social, reproductive, and attitudinal factors associated with women's disagreement with the passage of the ACA. Data were...

To describe the association between weight status and sexual practices among 18- to 19-year-old women. We analyzed a population-based longitudinal study of 18- to 19-year-old women residing in a Michigan county at cohort inception. Weekly journal surveys measured sexual practices, including contraceptive behaviors. Outcomes included proportion of w...

Access to safe water and adequate living standards are recognized as basic health requisites and human rights worldwide. Nevertheless, socially marginalized women across the globe are currently facing threats to safe water access, which has dire implications for their health and that of their children. The City of Detroit, Michigan has recently shu...

The purpose of this study was to characterize the association between pelvic examination and adolescent contraceptive method use in two time periods in the 2006-2010 National Survey of Family Growth (NSFG). Using data from the 2006-2010 NSFG, we used descriptive statistics and multivariable regression models to examine the association between pelvi...

It is unclear how the Patient Protection and Affordable Care Act (ACA) will influence women's use of reproductive health care sources, including family planning clinics, which have traditionally played a key role in safety net services. We explored women's intended sources of care for contraception, pelvic exam/Pap test, and sexually transmitted in...

We characterized U.S. women's preferred and usual sources of reproductive health care. Data were drawn from the Women's Health Care Experiences and Preferences Study, an internet survey of 1,078 women aged 18-55 randomly sampled from a national probability panel. We described and compared women's preferred and usual sources of care (women's health...

Although there is general agreement among various guidelines on benefits of routine screening mammography, the age of screening initiation and the optimal frequency of the test remain controversial. In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended against routine breast cancer screening in women aged younger than 50 years. In t...

Background Supreme Court cases challenging the Affordable Care Act (ACA) mandate for employer-provided reproductive health care have focused on religiously based opposition to coverage. Little is known about women's perspectives on such reproductive health policies. Study design Data were drawn from the Women's Health Care Experiences and Preferen...

Prior research linking young women's mental health to family planning outcomes has often failed to consider their social circumstances and the intersecting biosocial mechanisms that shape stress and depression as well as reproductive outcomes during adolescence and young adulthood. We extend our previous work to investigate relationships between so...

Background: Reproductive autonomy refers to having control over one’s own fertility desires. Religiosity and identification in a religious community may impact a woman’s ability to make decisions surrounding family planning. However, little is known about how religious values and identification in a religious community influence reproductive autono...

Objective: To investigate relationships between social discrimination, stress, depression, and risk of unintended pregnancy. Methods: Data were drawn from a longitudinal cohort study of 992 women ages 18-20yrs, 98% of whom reported a strong desire to avoid pregnancy. Women completed baseline and weekly surveys assessing relationship, sex, contrac...

Objective To characterize knowledge and attitudes of the Affordable Care Act (ACA), and sociodemographic differentials in knowledge and attitudes, among women in the United States. Methods We conducted a population-based, cross-sectional, internet survey of women’s health care experiences and preferences among 1,078 U.S. women 18-55 years. Th...

Objective Previously, we described the effects of young women’s depression and stress symptoms on poor contraceptive behavior and risk of unintended pregnancy. Here, we examine the impact of stress and depression on sexual activity, as a behavioral mechanism linking mental health and pregnancy. Methods We used panel data from a longitudinal, p...

Mental health disorders, which are among the most prevalent chronic diseases affecting reproductive-aged women worldwide, can have adverse reproductive health consequences, including increased risk of unintended pregnancy. Contraception can play an important role in the health and well-being of women with depression, anxiety, and other serious ment...

Millions of people use online search engines everyday to find health-related information and voluntarily share their personal health status and behaviors in various Web sites. Thus, data from tracking of online information seeker's behavior offer potential opportunities for use in public health surveillance and research. Google Trends is a feature...