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Contraceptive knowledge assessment: validity and reliability of a novel contraceptive research tool
ABSTRACTS / Contraception 92 (2015) 359–414
P177 Using the theory of planned behavior to influence resident physician emergency contraception prescribing patterns Brant A Baystate Medical Center, Springfield, MA, USA White K, St. Marie P Objectives: Physician knowledge, attitudes and values regarding emergency contraception (EC) correlate with willingness to prescribe it. We performed a prospective single-arm cohort study to determine if an educational intervention would influence EC attitudes, intent to prescribe and prescribing patterns among resident physicians. Methods: We administered a 30-min interactive presentation based on the theory of planned behavior to resident physicians in medicine, medicinepediatrics, pediatrics, emergency medicine and obstetrics–gynecology at an academic medical center. Participants completed questionnaires immediately before and after the intervention; items were scored from − 3 to + 3. From the electronic medical record, we obtained the number of EC prescriptions written by participants in the 6 months surrounding the intervention. Results: Most residents (n= 79) had positive attitudes regarding EC (baseline median score +3) and reported high intention to prescribe it in multiple clinical scenarios (median score +3 both pre- and postintervention). Only 13% of residents reported prescribing EC in the 3 months before the intervention, though 21% had actually prescribed it. The number of residents who prescribed EC increased by 28% during the follow-up period, from 14 to 18. The total number of EC prescriptions increased by 94%, from 18 in the 3 months preintervention to 35 in the 3 months postintervention. Outcomes: Despite positive attitudes and intent to prescribe EC, few residents had prescribed EC during the study period. A behavioral theory-based intervention can result in an increase in EC prescriptions provided for patients. Future efforts should focus on helping residents identify patients who would benefit from EC prescriptions. http://dx.doi.org/10.1016/j.contraception.2015.06.218
P178 A survey of pharmacists on contraceptive counseling McCarthy HC Teva US and Global Medical Affairs, Frazer, PA, USA Tang B, D’Angelo CM, Masonis AE, Howard B Objectives: We aimed to assess pharmacists' education and comfort level with respect to contraception counseling, the frequency and types of questions received and the characteristics of individuals requesting information. Methods: A survey regarding contraception counseling was distributed to 16,000 pharmacists selected by proportionate quota sampling from a mailing list of US-based retail and hospital pharmacists. The online survey was conducted via an HIPAA-compliant platform and included an opt-in/opt-out portal. Results: Some 131 pharmacists responded. Of the 118 who reported coming into regular contact with patients (2–3 times/week), 94% reported receiving questions on contraception. The majority of respondents (62%) reported receiving only “one or two lectures” on contraceptive agents in pharmacy school, while 30% had received “a full section of a course.” Thirty-three percent of respondents reported that they rarely or never referred patients to other healthcare providers, such as gynecologists, when asked about contraception. Most pharmacists indicated a high level of comfort (responding 5/6, 0–6 scale) in answering questions on oral contraceptives, emergency contraceptives and over-the-counter contraceptives (76%, 62%
413
and 56%, respectively) but were less likely to report high comfort with diaphragms, IUDs and vaginal rings (11%, 13% and 35%, respectively). Nearly 45% of respondents reported that all of those asking questions regarding contraception were female, and approximately half estimated that 50% or more were in their 20s. Counseling topics varied by contraceptive type. The most common topics across contraceptive types included side-effects, efficacy, timing/administration and safety. Outcomes: Despite reporting limited education on contraception, pharmacists frequently receive questions and provide contraceptive counseling. http://dx.doi.org/10.1016/j.contraception.2015.06.219
P179 Contraceptive knowledge assessment: validity and reliability of a novel contraceptive research tool Campol Haynes M New York University School of Medicine, New York, NY, USA Saleh M, Ryan N, Winkel A, Ades V Objectives: To develop effective teaching methods for contraceptive education, researchers require a validated, reliable tool to measure subjects' contraceptive knowledge. However, most widely used indices are outdated. We aimed to create and assess the validity and reliability of a novel assessment tool for measuring contraceptive knowledge. Methods: The study tool was validated using both qualitative and quantitative methods. The tool was developed by the research team and reviewed by a group of experts. Testing participants included English-speaking men and women aged 15–45 at one institution. Structured interviews were conducted with a randomly selected group of patients for qualitative feedback. Quantitative tests included comparison with gold standard, test–retest reliability and comparison between groups with low and high contraceptive knowledge. Results: Qualitative feedback was obtained on the 25-question study tool from six experts and seven patients. The tool was administered to 102 patients, with a mean score of 9.0. Compared with the gold standard, the mean score was significantly higher (tool 9.1 vs. gold standard 5.8, pb.001). Test–Retest reliability was demonstrated via repeat testing within 2–4 weeks, demonstrating no difference between test/retest among the same subjects (p=.667). Compared with those of medical students, patients' mean scores were significantly lower (patients 9.1 vs. students 19.4, pb.005). Outcomes: We have designed a valid and reliable study tool to measure a person's level of contraceptive knowledge. This tool will allow the assessment of baseline knowledge, educational gaps and posteducational knowledge achievements after an intervention. http://dx.doi.org/10.1016/j.contraception.2015.06.220
P180 Evaluation of a simulation-based curriculum to improve resident performance in medical emergencies in the outpatient setting Espey E University of New Mexico, Albuquerque, NM, USA Baty G, Rask J, Chungtuyco M, Pereda B, Leeman L Objectives: Emergency response skills are essential when complications occur in the outpatient setting. Physicians must have optimal training to manage such complications. We sought to evaluate the impact of a simulation-based curriculum on both self-efficacy and objective performance. Methods: This study enrolled OB-GYN and family medicine trainees in a program of simulation-based, outpatient emergency training activities. Subjects
P177 Using the theory of planned behavior to influence resident physician emergency contraception prescribing patterns Brant A Baystate Medical Center, Springfield, MA, USA White K, St. Marie P Objectives: Physician knowledge, attitudes and values regarding emergency contraception (EC) correlate with willingness to prescribe it. We performed a prospective single-arm cohort study to determine if an educational intervention would influence EC attitudes, intent to prescribe and prescribing patterns among resident physicians. Methods: We administered a 30-min interactive presentation based on the theory of planned behavior to resident physicians in medicine, medicinepediatrics, pediatrics, emergency medicine and obstetrics–gynecology at an academic medical center. Participants completed questionnaires immediately before and after the intervention; items were scored from − 3 to + 3. From the electronic medical record, we obtained the number of EC prescriptions written by participants in the 6 months surrounding the intervention. Results: Most residents (n= 79) had positive attitudes regarding EC (baseline median score +3) and reported high intention to prescribe it in multiple clinical scenarios (median score +3 both pre- and postintervention). Only 13% of residents reported prescribing EC in the 3 months before the intervention, though 21% had actually prescribed it. The number of residents who prescribed EC increased by 28% during the follow-up period, from 14 to 18. The total number of EC prescriptions increased by 94%, from 18 in the 3 months preintervention to 35 in the 3 months postintervention. Outcomes: Despite positive attitudes and intent to prescribe EC, few residents had prescribed EC during the study period. A behavioral theory-based intervention can result in an increase in EC prescriptions provided for patients. Future efforts should focus on helping residents identify patients who would benefit from EC prescriptions. http://dx.doi.org/10.1016/j.contraception.2015.06.218
P178 A survey of pharmacists on contraceptive counseling McCarthy HC Teva US and Global Medical Affairs, Frazer, PA, USA Tang B, D’Angelo CM, Masonis AE, Howard B Objectives: We aimed to assess pharmacists' education and comfort level with respect to contraception counseling, the frequency and types of questions received and the characteristics of individuals requesting information. Methods: A survey regarding contraception counseling was distributed to 16,000 pharmacists selected by proportionate quota sampling from a mailing list of US-based retail and hospital pharmacists. The online survey was conducted via an HIPAA-compliant platform and included an opt-in/opt-out portal. Results: Some 131 pharmacists responded. Of the 118 who reported coming into regular contact with patients (2–3 times/week), 94% reported receiving questions on contraception. The majority of respondents (62%) reported receiving only “one or two lectures” on contraceptive agents in pharmacy school, while 30% had received “a full section of a course.” Thirty-three percent of respondents reported that they rarely or never referred patients to other healthcare providers, such as gynecologists, when asked about contraception. Most pharmacists indicated a high level of comfort (responding 5/6, 0–6 scale) in answering questions on oral contraceptives, emergency contraceptives and over-the-counter contraceptives (76%, 62%
413
and 56%, respectively) but were less likely to report high comfort with diaphragms, IUDs and vaginal rings (11%, 13% and 35%, respectively). Nearly 45% of respondents reported that all of those asking questions regarding contraception were female, and approximately half estimated that 50% or more were in their 20s. Counseling topics varied by contraceptive type. The most common topics across contraceptive types included side-effects, efficacy, timing/administration and safety. Outcomes: Despite reporting limited education on contraception, pharmacists frequently receive questions and provide contraceptive counseling. http://dx.doi.org/10.1016/j.contraception.2015.06.219
P179 Contraceptive knowledge assessment: validity and reliability of a novel contraceptive research tool Campol Haynes M New York University School of Medicine, New York, NY, USA Saleh M, Ryan N, Winkel A, Ades V Objectives: To develop effective teaching methods for contraceptive education, researchers require a validated, reliable tool to measure subjects' contraceptive knowledge. However, most widely used indices are outdated. We aimed to create and assess the validity and reliability of a novel assessment tool for measuring contraceptive knowledge. Methods: The study tool was validated using both qualitative and quantitative methods. The tool was developed by the research team and reviewed by a group of experts. Testing participants included English-speaking men and women aged 15–45 at one institution. Structured interviews were conducted with a randomly selected group of patients for qualitative feedback. Quantitative tests included comparison with gold standard, test–retest reliability and comparison between groups with low and high contraceptive knowledge. Results: Qualitative feedback was obtained on the 25-question study tool from six experts and seven patients. The tool was administered to 102 patients, with a mean score of 9.0. Compared with the gold standard, the mean score was significantly higher (tool 9.1 vs. gold standard 5.8, pb.001). Test–Retest reliability was demonstrated via repeat testing within 2–4 weeks, demonstrating no difference between test/retest among the same subjects (p=.667). Compared with those of medical students, patients' mean scores were significantly lower (patients 9.1 vs. students 19.4, pb.005). Outcomes: We have designed a valid and reliable study tool to measure a person's level of contraceptive knowledge. This tool will allow the assessment of baseline knowledge, educational gaps and posteducational knowledge achievements after an intervention. http://dx.doi.org/10.1016/j.contraception.2015.06.220
P180 Evaluation of a simulation-based curriculum to improve resident performance in medical emergencies in the outpatient setting Espey E University of New Mexico, Albuquerque, NM, USA Baty G, Rask J, Chungtuyco M, Pereda B, Leeman L Objectives: Emergency response skills are essential when complications occur in the outpatient setting. Physicians must have optimal training to manage such complications. We sought to evaluate the impact of a simulation-based curriculum on both self-efficacy and objective performance. Methods: This study enrolled OB-GYN and family medicine trainees in a program of simulation-based, outpatient emergency training activities. Subjects