Lauren Ralph, PhD, MPH
Assistant Professor, Department of Obstetrics, Gynecology & Reproductive Sciences
Epidemiologist, Advancing New Standards in Reproductive Health
Dr. Ralph is an epidemiologist whose research examines the context in which women, and in particular adolescents, make decisions around pregnancy and childbirth, and the consequences of unintended childbearing on women’s health and well-being. Her current work includes research on the longitudinal effect of being denied a wanted abortion on women’s health and well-being; the effect of abortion restrictions, particularly parental involvement requirements, on young women’s experience seeking abortion care. As a current UCSF-Kaiser BIRCWH scholar, Dr. Ralph is expanding these areas of research to characterize adolescents’ capacity for autonomous decision-making around pregnancy and better understand the causal impact of unintended childbearing on women’s educational trajectories. Dr. Ralph is also engaged in research to understand the relationship between hormonal contraceptive use and women’s risk of HIV acquisition, measure women’s certainty about the decision to seek abortion care and other health decisions, evaluate innovative strategies to stimulate demand for contraception, and better understand and address the methodological challenges associated with studying complex, reproductive health behaviors. Across all areas of research, she draws on a combination of quantitative and qualitative methods to answer research questions that can directly inform policy. Dr. Ralph received her BS from the University of California, Santa Barbara, and MPH and PhD from the University of California, Berkeley.
Education:
- University of California, Berkeley, Masters in Public Health and Doctorate
- University of California, Santa Barbara, Bachelor of Science
In the news:
- Women who are denied abortions may face long-lasting health problems, study says | TIME
- Denying women abortions can hurt their health for years | MSN
- Women's health worsened over 5 years after being denied an abortion | Los Angeles Times
- People are already dying from being denied abortions | Vice
- Parental notification law appears to limit, delay abortions | Reuters
- Do minors need parental involvement for an abortion? These laws can present barriers | Elite Daily
- The myth of abortion regret | Slate
- A new front in the war over reproductive rights: "abortion pill reversal" | New York Times Magazine
- Parental notification laws delay minors' access to abortion care, study finds | Think Progress
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Adolescents and Abortion Restrictions: Disproportionate Burdens and Critical Warnings. J Adolesc Health. 2023 08; 73(2):221-223. Ralph L, Hasselbacher L. PMID: 37455044.
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Accuracy of Self-assessment of Gestational Duration Among Adolescents Seeking Abortion Using Information in Addition to Date of Last Menstrual Period. JAMA Pediatr. 2023 06 01; 177(6):642-644. Ralph L, Biggs MA, Ehrenreich K, Grossman D. PMID: 37067809; PMCID: PMC10111228.
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Awareness of medication abortion among a nationally representative U.S. sample, 2021-2022. Contraception. 2023 May 26; 110078. Kaller S, Upadhyay UD, Ralph LJ, Schroeder R, Biggs MA. PMID: 37245783.
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Abortion terminology preferences: a cross-sectional survey of people accessing abortion care. BMC Womens Health. 2023 01 19; 23(1):26. Kaller S, Ralph L, Wingo E, Biggs MA. PMID: 36658525; PMCID: PMC9850636.
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Commentary: The Turnaway Study: A case of self-correction in science upended by political motivation and unvetted findings. Front Psychol. 2022; 13:1003116. Biggs A, Foster DG, Gould H, Kimport K, Ralph L, Roberts S, Rocca C, Sisson G, Upadhyay U, Woodruff K. PMID: 36533007; PMCID: PMC9755483.View in: PubMed Mentions:
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O13Prevalence of self-managed abortion among us women of reproductive age: New and expanded estimates from 2021/2022. Contraception. 2022 Dec 1; 116:72. Ralph RL, Schroeder SR, Grossman GD, Kaller KS, Biggs BM. .View in: Publisher Site Mentions:
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O14Pregnancy and abortion: A longitudinal study of the predictive ability of people's desire to avoid pregnancy. Contraception. 2022 Dec 1; 116:72. Rocca RC, Muñoz MI, Gonzalez GE, Gould GH, Foster FD, Bonilla BI, Ralph RL. .View in: Publisher Site Mentions:
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P007Accuracy of self-assessment of pregnancy duration eligibility for medication abortion among young people: The advantages of expanding screening questions beyond date of last menstrual period. Contraception. 2022 Dec 1; 116:75. Ralph RL, Biggs BM, Ehrenreich EK, Grossman GD. .View in: Publisher Site Mentions:
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P021National levels of support for legalizing and not criminalizing people involved in self-managed abortion (SMA): A national representative survey. Contraception. 2022 Dec 1; 116:78-79. Biggs BM, Ralph RL, Schroeder SR, Kaller KS, Grossman GD. .View in: Publisher Site Mentions:
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P022Growing national interest and support for advance provision and over-the-counter access to medication abortion. Contraception. 2022 Dec 1; 116:79. Biggs BM, Grossman GD, Kaller KS, Schroeder SR, Ralph RL. .View in: Publisher Site Mentions:
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P029Barriers to abortion and timing of presentation for care. Contraception. 2022 Dec 1; 116:80. Krems KJ, Ralph RL, Grossman GD, Ehrenreich EK. .View in: Publisher Site Mentions:
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A cross-sectional study examining consideration of self-managed abortion among people seeking facility-based care in the United States. Reprod Health. 2022 Aug 12; 19(1):176. Ralph L, Ehrenreich K, Kaller S, Biggs MA. PMID: 35962384; PMCID: PMC9375262.
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Accuracy of Self-Assessment of Gestational Duration Among People Seeking Abortion. Obstetrical & Gynecological Survey. 2022 Aug 1; 77(8):473-475. Ralph RL, Ehrenreich EK, Barar BR, Biggs BM, Morris MN, Blanchard BK, Kapp KN, Moayedi MG, Perritt PJ, Raymond RE, White WK, Grossman GD. .View in: Publisher Site Mentions:
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Comparison of Pregnancy Preferences Preceding vs Year 1 of the COVID-19 Pandemic. JAMA Netw Open. 2022 07 01; 5(7):e2220093. Rocca CH, Parra M, Muñoz I, Foster DG, Boscardin WJ, Ralph LJ. PMID: 35788671; PMCID: PMC9257576.
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Systematic Review of Interventions Addressing Food Insecurity in Pregnant Women and New Mothers. Curr Nutr Rep. 2022 09; 11(3):486-499. McKay FH, Spiteri S, Zinga J, Sulemani K, Jacobs SE, Ranjan N, Ralph L, Raeburn E, Threlfall S, Bergmeier ML, van der Pligt P. PMID: 35501553; PMCID: PMC9381473.
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Comprehension of an Over-the-Counter Drug Facts Label Prototype for a Mifepristone and Misoprostol Medication Abortion Product. Obstet Gynecol. 2022 06 01; 139(6):1111-1122. Biggs MA, Ehrenreich K, Morris N, Blanchard K, Bustamante CK, Choimorrow SY, Hauser D, Hernandez Y, Kapp N, Kromenaker T, Moayedi G, Perritt JB, Ralph L, Raymond EG, Valladares ES, White K, Grossman D. PMID: 35675608; PMCID: PMC9202002.
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Comprehension of an Over-the-counter Drug Facts Label Prototype for a Mifepristone and Misoprostol Medication Abortion Product. Contraception. 2022 May 1; 109:86. Biggs BM, Ehrenreich EK, Morris MN, Blanchard BK, Bustamante BC, Choimorrow CS, Hauser HD, Hernandez HY, Kapp KN, Kromenaker KT, Moayedi MG, Perritt PJ, Ralph RL, Raymond RE, Valladares VE, White WK, Grossman GD. .View in: Publisher Site Mentions:
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A cross-sectional survey of U.S. abortion patients' interest in obtaining medication abortion over the counter. Contraception. 2022 05; 109:25-31. Biggs MA, Ralph L, Morris N, Ehrenreich K, Perritt J, Kapp N, Blanchard K, White K, Barar R, Grossman D. PMID: 35081391.
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Accuracy of self-assessment of gestational duration among people seeking abortion. Am J Obstet Gynecol. 2022 05; 226(5):710.e1-710.e21. Ralph LJ, Ehrenreich K, Barar R, Biggs MA, Morris N, Blanchard K, Kapp N, Moayedi G, Perritt J, Raymond EG, White K, Grossman D. PMID: 34922922.
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The relationship between hormonal contraception and cervical dysplasia/cancer controlling for human papillomavirus infection: A systematic review. Contraception. 2022 03; 107:1-9. Anastasiou E, McCarthy KJ, Gollub EL, Ralph L, van de Wijgert JHHM, Jones HE. PMID: 34752778; PMCID: PMC8837691.
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POSTER ABSTRACTS P24 ABORTION TERMINOLOGY PREFERENCES AMONG PEOPLE ACCESSING ABORTION CARE. Contraception. 2021 Oct 1; 104(4):458. Kaller KS, Ralph RL, Wingo WE, Biggs BM. .View in: Publisher Site Mentions:
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ORAL ABSTRACTS O4 IMPACT OF THE COVID-19 PANDEMIC ON PREGNANCY PREFERENCES: A LONGITUDINAL INTERRUPTED TIME-SERIES STUDY. Contraception. 2021 Sep 6; 104(4):451. Rocca RC, Parra PM, Munoz MI, Foster FD, Boscardin BW, Ralph RL. .View in: Publisher Site Mentions:
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"I'll just deal with this on my own": a qualitative exploration of experiences with self-managed abortion in the United States. Reprod Health. 2021 May 04; 18(1):91. Raifman S, Ralph L, Biggs MA, Grossman D. PMID: 33947413; PMCID: PMC8093912.
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Exploring Attitudes About the Legality of Self-Managed Abortion in the US: Results from a Nationally Representative Survey. Sexuality Research and Social Policy. 2021 Apr 1; 1-14. Raifman RS, Biggs BM, Ralph RL, Ehrenreich EK, Grossman GD. .View in: Publisher Site Mentions:
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Abortion Waiting Periods and Decision Certainty Among People Searching Online for Abortion Care. Obstet Gynecol. 2021 04 01; 137(4):597-605. Jovel I, Cartwright AF, Ralph L, Upadhyay UD. PMID: 33706354; PMCID: PMC7984762.
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Developing and validating the Psychosocial Burden among people Seeking Abortion Scale (PB-SAS). PLoS One. 2020; 15(12):e0242463. Biggs MA, Neilands TB, Kaller S, Wingo E, Ralph LJ. PMID: 33301480; PMCID: PMC7728247.
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Prevalence of Self-Managed Abortion Among Women of Reproductive Age in the United States. JAMA Netw Open. 2020 12 01; 3(12):e2029245. Ralph L, Foster DG, Raifman S, Biggs MA, Samari G, Upadhyay U, Gerdts C, Grossman D. PMID: 33337493; PMCID: PMC7749440.
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Certainty and intention in pregnancy decision-making: An exploratory study. Contraception. 2021 02; 103(2):80-85. Rowland BB, Rocca CH, Ralph LJ. PMID: 33189708; PMCID: PMC8186868.
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Reasons for and Logistical Burdens of Judicial Bypass for Abortion in Illinois. J Adolesc Health. 2021 01; 68(1):71-78. Ralph LJ, Chaiten L, Werth E, Daniel S, Brindis CD, Biggs MA. PMID: 33041202.
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P35 Consideration of self-managed abortion among people seeking facility-based care in three haven states. Contraception. 2020 Oct 1; 102(4):288. Ralph RL, Wingo WE, Kaller KS, Biggs BM. .View in: Publisher Site Mentions:
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P8 ‘Abortion patients’ interest in obtaining medication abortion over-the-counter (OTC). Contraception. 2020 Oct 1; 102(4):280. Biggs BM, Ralph RL, Morris MN, Ehrenreich EK, Perritt PJ, Kapp KN, Raymond RE, Grossman GD. .View in: Publisher Site Mentions:
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P4 Development and validation of a new scale to measure the psychosocial burden of accessing abortion care. Contraception. 2020 Oct 1; 102(4):279. Biggs BM, Neilands NT, Kaller KS, Wingo WE, Ralph RL. .View in: Publisher Site Mentions:
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Chapter 5. The Sexual and Reproductive Health of Young Latino Males Living in the United States. . 2020 May 28; 83-98. Biggs BM, Brindis BC, Ralph RL, Santelli SJ. .View in: Publisher Site Mentions:
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Certainty and Intention in Pregnancy Decision-making: an exploratory study. Contraception. 2020 May 1; 101(5):357-358. Rowland RB, Rocca RC, Ralph RL. .View in: Publisher Site Mentions:
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Barriers accessing abortion care and their association with psychological well-being. Contraception. 2020 May 1; 101(5):355. Biggs BM, Kaller KS, Ralph RL. .View in: Publisher Site Mentions:
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Comparing Prospective and Retrospective Reports of Pregnancy Intention in a Longitudinal Cohort of U.S. Women. Perspect Sex Reprod Health. 2020 03; 52(1):39-48. Ralph LJ, Foster DG, Rocca CH. PMID: 32189427; PMCID: PMC8126343.
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The effect of receiving versus being denied an abortion on making and achieving aspirational 5-year life plans. BMJ Sex Reprod Health. 2020 07; 46(3):177-183. McCarthy MA, Upadhyay U, Ralph L, Biggs MA, Foster DG. PMID: 32098771.
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ECHO: context and limitations. Lancet. 2020 02 08; 395(10222):e24. Gollub EL, Stein Z, van de Wijgert JHHM, Jones H, Ralph L, Padian N. PMID: 32035560.
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ECHO: context and limitations. Lancet. 2020 02 08; 395(10222):e25-e26. Jewell BL, Smith JA, Padian NS, van de Wijgert JHHM, Gollub EL, Jones HE, Ralph LJ, Hallett TB. PMID: 32035561.
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Physical Health of Women After Seeking Abortion Services. Ann Intern Med. 2020 01 21; 172(2):164-165. Ralph LJ, Schwarz EB, Grossman D, Foster DG. PMID: 31958829.
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Pregnancy preferences and contraceptive use among US women. Contraception. 2020 02; 101(2):79-85. Samari G, Foster DG, Ralph LJ, Rocca CH. PMID: 31805265; PMCID: PMC7028518.
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A Prospective Cohort Study of the Effect of Receiving versus Being Denied an Abortion on Educational Attainment. Womens Health Issues. 2019 Nov - Dec; 29(6):455-464. Ralph LJ, Mauldon J, Biggs MA, Foster DG. PMID: 31708341.
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Self-reported Physical Health of Women Who Did and Did Not Terminate Pregnancy After Seeking Abortion Services: A Cohort Study. Ann Intern Med. 2019 08 20; 171(4):238-247. Ralph LJ, Schwarz EB, Grossman D, Foster DG. PMID: 31181576.
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Hormonal Contraceptives and the Acquisition of Sexually Transmitted Infections: An Updated Systematic Review. Sex Transm Dis. 2019 05; 46(5):290-296. McCarthy KJ, Gollub EL, Ralph L, van de Wijgert J, Jones HE. PMID: 30628946.
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Psychometric Evaluation of an Instrument to Measure Prospective Pregnancy Preferences: The Desire to Avoid Pregnancy Scale. Med Care. 2019 02; 57(2):152-158. Rocca CH, Ralph LJ, Wilson M, Gould H, Foster DG. PMID: 30550399; PMCID: PMC6331264.
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The Need for Policy Change Regarding Progestin-Only Injectable Contraceptives. J Womens Health (Larchmt). 2019 09; 28(9):1180-1184. Gollub EL, Jones HE, Ralph LJ, van de Wijgert JHHM, Padian N, Stein Z. PMID: 30576259; PMCID: PMC6909683.
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Unintended pregnancy and subsequent postpartum long-acting reversible contraceptive use in Zimbabwe. BMC Womens Health. 2018 11 26; 18(1):193. Nance N, Ralph L, Padian N, Cowan F, Buzdugan R, Mushavi A, Mahomva A, McCoy SI. PMID: 30477497; PMCID: PMC6258256.
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Support for and interest in alternative models of medication abortion provision among a national probability sample of U.S. women. Contraception. 2019 02; 99(2):118-124. Biggs MA, Ralph L, Raifman S, Foster DG, Grossman D. PMID: 30448203.
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Interest in and support for alternative models of medication abortion provision according to a U.S. national probability sample. Contraception. 2018 Oct 1; 98(4):344. Biggs BM, Ralph RL, Raifman RS, Foster FD, Grossman GD. .View in: Publisher Site Mentions:
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Pregnancy preferences and contraceptive use among U.S. women: new insights using a validated prospective instrument. Contraception. 2018 Oct 1; 98(4):355. Samari SG, Foster FD, Ralph RL, Rocca RC. .View in: Publisher Site Mentions:
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Lifetime prevalence of self-induced abortion among a nationally representative sample of U.S. women. Contraception. 2018 May 1; 97(5):460. Grossman GD, Ralph RL, Raifman RS, Upadhyay UU, Gerdts GC, Biggs BA, Foster FD. .View in: Publisher Site Mentions:
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Socioeconomic Outcomes of Women Who Receive and Women Who Are Denied Wanted Abortions in the United States. Am J Public Health. 2018 03; 108(3):407-413. Foster DG, Biggs MA, Ralph L, Gerdts C, Roberts S, Glymour MM. PMID: 29345993; PMCID: PMC5803812.
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The Impact of a Parental Notification Requirement on Illinois Minors' Access to and Decision-Making Around Abortion. J Adolesc Health. 2018 03; 62(3):281-287. Ralph LJ, King E, Belusa E, Foster DG, Brindis CD, Biggs MA. PMID: 29248391.
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Do 72-Hour Waiting Periods and Two-Visit Requirements for Abortion Affect Women's Certainty? A Prospective Cohort Study. Womens Health Issues. 2017 Jul - Aug; 27(4):400-406. Roberts SCM, Belusa E, Turok DK, Combellick S, Ralph L. PMID: 28391971.
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Adoption Decision Making among Women Seeking Abortion. Womens Health Issues. 2017 Mar - Apr; 27(2):136-144. Sisson G, Ralph L, Gould H, Foster DG. PMID: 28153742.
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Measuring decisional certainty among women seeking abortion. Contraception. 2017 Mar; 95(3):269-278. Ralph LJ, Foster DG, Kimport K, Turok D, Roberts SCM. PMID: 27745910.
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Operationalizing pregnancy preferences: development of a new instrument to measure strength of desire to avoid pregnancy. Contraception. 2016 Oct 1; 94(4):423. Rocca RC, Gould GH, Barar BR, Ralph RL, Rowlan RB, Foster FD. .View in: Publisher Site Mentions:
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Adoption decision making after being denied a wanted abortion. Contraception. 2016 Oct 1; 94(4):400. Sisson SG, Gould GH, Ralph RL, Foster FD. .View in: Publisher Site Mentions:
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Which women are missed by primary health-care based interventions for alcohol and drug use? Addict Behav. 2016 Apr; 55:32-7. Roberts SC, Ralph LJ, Wilsnack SC, Foster DG. PMID: 26774493; PMCID: PMC4721246.
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Hormonal contraceptive use and women's risk of HIV acquisition: priorities emerging from recent data. Curr Opin Obstet Gynecol. 2015 Dec; 27(6):487-95. Ralph LJ, Gollub EL, Jones HE. PMID: 26536211.
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Evaluating the psychometric properties of two decisional conflict scales among women seeking abortion in Utah. Contraception. 2015 Oct 1; 92(4):368-369. Ralph RL, Foster FD, Turok TD, Roberts RS. .View in: Publisher Site Mentions:
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Hormonal contraceptive use and women's risk of HIV acquisition: a meta-analysis of observational studies. Lancet Infect Dis. 2015 Feb; 15(2):181-9. Ralph LJ, McCoy SI, Shiu K, Padian NS. PMID: 25578825; PMCID: PMC4526270.
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Are hormonal contraceptive users more likely to misreport unprotected sex? Evidence from a biomarker validation study in Zimbabwe. AIDS Behav. 2014 Dec; 18(12):2259-64. McCoy SI, Ralph LJ, Padian NS, Minnis AM. PMID: 24619603; PMCID: PMC4162861.
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Unmet need for family planning, contraceptive failure, and unintended pregnancy among HIV-infected and HIV-uninfected women in Zimbabwe. PLoS One. 2014; 9(8):e105320. McCoy SI, Buzdugan R, Ralph LJ, Mushavi A, Mahomva A, Hakobyan A, Watadzaushe C, Dirawo J, Cowan FM, Padian NS. PMID: 25144229; PMCID: PMC4140753.
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Food insecurity, socioeconomic status, and HIV-related risk behavior among women in farming households in Tanzania. AIDS Behav. 2014 Jul; 18(7):1224-36. McCoy SI, Ralph LJ, Njau PF, Msolla MM, Padian NS. PMID: 24097335; PMCID: PMC3977025.
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Research on hormonal contraception and HIV - Authors' reply. Lancet. 2014 Jan 25; 383(9914):305-6. Ralph L, McCoy S, Hallett T, Padian N. PMID: 24461119.
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The role of parents and partners in minors' decisions to have an abortion and anticipated coping after abortion. J Adolesc Health. 2014 Apr; 54(4):428-34. Ralph L, Gould H, Baker A, Foster DG. PMID: 24332398.
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Next steps for research on hormonal contraception and HIV. Lancet. 2013 Nov 02; 382(9903):1467-9. Ralph LJ, McCoy SI, Hallett T, Padian N. PMID: 23810224.
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Limited socioeconomic opportunities and Latina teen childbearing: a qualitative study of family and structural factors affecting future expectations. J Immigr Minor Health. 2013 Apr; 15(2):334-40. Minnis AM, Marchi K, Ralph L, Biggs MA, Combellick S, Arons A, Brindis CD, Braveman P. PMID: 22678305; PMCID: PMC3479330.
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Alcohol production as an adaptive livelihood strategy for women farmers in Tanzania and its potential for unintended consequences on women's reproductive health. PLoS One. 2013; 8(3):e59343. McCoy SI, Ralph LJ, Wilson W, Padian NS. PMID: 23527167; PMCID: PMC3601967.
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Critical junctures: assuring healthy outcomes for adolescents in the new millennium. Adolesc Med State Art Rev. 2011 Dec; 22(3):341-66, ix. Brindis CD, Ralph LJ. PMID: 22423455.
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Latina adolescents' perceptions of their male partners' influences on childbearing: findings from a qualitative study in California. Cult Health Sex. 2011 Sep; 13(8):873-86. Schwartz SL, Brindis CD, Ralph LJ, Biggs MA. PMID: 21707264.
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Finding Teens in TheirSpace: Using Social Networking Sites to Connect Youth to Sexual Health Services. Sexuality Research and Social Policy. 2011 Mar 1; 8(1):38-49. Ralph RL, Berglas BN, Schwartz SS, Brindis BC. .View in: Publisher Site Mentions:
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Access to reproductive healthcare for adolescents: establishing healthy behaviors at a critical juncture in the lifecourse. Curr Opin Obstet Gynecol. 2010 Oct; 22(5):369-74. Ralph LJ, Brindis CD. PMID: 20733485.
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Factors Associated With Delayed Childbearing: From the Voices of Expectant Latina Adults and Teens in California. Hispanic Journal of Behavioral Sciences. 2010 Feb 1; 32(1):77-103. Biggs BM, Ralph RL, Minnis MA, Arons AA, Marchi MK, Lehrer LJ, Braveman BP, Brindis BC. .View in: Publisher Site Mentions:
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Family planning and life planning reproductive intentions among individuals seeking reproductive health care. Womens Health Issues. 2008 Sep-Oct; 18(5):351-9. Foster DG, Biggs MA, Ralph LJ, Arons A, Brindis CD. PMID: 18485738.
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Trends in knowledge of emergency contraception among women in California, 1999-2004. Womens Health Issues. 2007 Jan-Feb; 17(1):22-8. Foster DG, Ralph LJ, Arons A, Brindis CD, Harper CC. PMID: 17321944.
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Mandating parental involvement in adolescents' abortion: implications of a short-sighted policy. Contraception. 2006 Feb; 73(2):211-3. Ralph L, Brindis C, Shields WC. PMID: 16413852.
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Critical Junctures. . 2005 Jul 4; 341-366. Brindis BC, Ralph RL. .View in: Publisher Site Mentions: