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Pathways of Choice (CHOICES)

Pathways of Choice (CHOICES)


1995 - 2000 

Christina Mitchell, Ph.D.

Christina Mitchell, Ph.D., Ellen Keane, MSPH; Lorette Yazzie; Nichole Cottier; CeCe Big Crow


The Pathways of Choice project was designed to gather information from a group of approximately 1300 American Indian youth and young adults during the period when they are making the transition from adolescence to adulthood.   This project had a special focus on issues surrounding early and unintended pregnancies and how that might influence other life choices.   In addition, predictors of unintended pregnancies were examined.   The project has the following Specific Aims.

  1. to explore the nature and meaning of pregnancy intentionality in this population through the use of ethnographic methods;
  2. to develop and/or adapt measures of pregnancy intentionality and its determinants that will measure these concepts in a manner that is both relevant and psychometrically sound within these 2 populations;
  3. to determine differences in intention by tribe, age, gender, and contraceptive use, as well as to contrast these estimates with those for the general U.S. population; and
  4. to assess prospectively the determinants of unintended pregnancy, sexual activity, and various forms of contraceptive use.



Each year of data collection was divided into 2 phases:   1) annual survey data collection, when everyone who attended 1 of 3 American Indian high schools during the 1993-94 school year is asked to fill out a survey, and 2) the interview data collection, when a subsample of those who filled out a survey are asked to participate in an interview.   Each phase was repeated 4 times over a 4-year period.



The Pathways of Choice project was a longitudinal study that built upon the work conducted during the Voices of Indian Teens project by continuing to survey and monitor the development of those who participated in this previous study.   In Spring 1996, the 1292 participants ranged in age from 15-24 years old, with the majority ranging in age from 16-20 years old.   Participation was voluntary and informed consent is obtained from each participant.   Guardian permission has been obtained for any participant under 18 years of age.


CHOICES Longitudinal Data Set
# of annual survey data points # of participants (%)
# with 1 data point 78 ( 6%)
# with 2 data points 138 (11%)
# with 3 data points 314 (24%)
# with 4 data points 774 (59%)
Total 1304




  1. Depression   (CES-D).
  2. Anxiety (CIDI).
  3. Antisocial (CIDI).
  4. Substance Abuse.
  5. Competencies.
  6. Community-mindedness.
  7. Developmental markers of adulthood.
  8. Life stressors.
  9. Risk/protective factors.
  10. Coping.
  11. Social support.
  12. Self-esteem.
  13. Harm-avoidance.
  14. Ethnic identity.
  15. HIV/AIDS.



The CHOICES SURVEY and the CHOICES CODEBOOK are in PDF format and can only be viewed with a Reader, as described below.

The PDF format is modeled after the PostScript language and is device and resolution independent. Publications in the PDF format can be viewed, navigated and printed from a workstation using the freely available Acrobat Reader software from Adobe Systems Inc. Versions of Acrobat Reader run on Dos, Windows, Macintosh, and Unix systems.

Click Here to View the CHOICES SURVEY in PDF Format
Click Here to View the CHOICES CODEBOOK in PDF Format (large file - 8.9 Mb)



Mitchell, C. M., & Kaufman, C. E. (2002). Structure of HIV knowledge, attitudes, and behaviors among American Indian young adults. AIDS Education and Prevention, 14, 381-398.

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