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Knowledge and attitudes of pharmacists regarding emergency contraception in an urban health system
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Abstracts / Contraception 74 (2006) 178 – 197
choose to have an abortion, 73% responded that they would prefer to have it done by their PCP in the primary care office, whereas 25% would prefer it at a freestanding high-volume abortion clinic. The most commonly cited reason for choosing abortion with their PCP was comfort. Expertise of the physician was the reason most often cited for choosing to have an abortion at an abortion clinic. Conclusions: The majority of women surveyed are interested in having early abortion available at their primary care office site. The most important factor influencing women’s interest is comfort with their provider. Women favored their clinic offering medical abortion over surgical abortion. Increasing options for abortion provision, with integration of abortion services in the primary care setting, appears acceptable to the majority of female patients. 40 KNOWLEDGE AND ATTITUDES OF PHARMACISTS REGARDING EMERGENCY CONTRACEPTION IN AN URBAN HEALTH SYSTEM Harwood B, Nguyen DK. Introduction: Pharmacists are pivotal to access to emergency contraception (EC). Materials and Methods: In October 2005, pharmacists at the University of Pittsburgh Medical Center Health System (UPMCHS) completed surveys by telephone or by facsimile. In this descriptive study, 21 questions addressed experience with, knowledge on and attitudes towards EC. Results: Twenty pharmacists representing each of the 16 UPMCHS pharmacies completed the survey. Sixty percent (12/20) were female, and 35% (7/20) routinely provided EC. Eighty percent (16/20) worked for extended hours in pharmacies that routinely stocked EC. Overall, 65% (13/20) correctly answered at least 50% (5/6) of knowledge questions. Most respondents correctly answered questions regarding mechanism of action, interval of administration and maternal and fetal safety. However, only 10% (2/20) correctly answered that EC was effective beyond 72 h after unprotected intercourse. Sixty-five percent (13/20) felt comfortable counseling women regarding EC. The majority disapproved of EC nonprescription status; 70% (14/20) disagreed that EC should be available without a prescription, and 80% (18/20) disagreed that EC should be available over-the-counter. Most respondents participated in continuing education, and 95% (19/20) used web-based programs. Conclusions: Despite good general knowledge, comfort with counseling and EC availability, pharmacists in an urban health care system rarely dispense EC and do not support access to EC without a prescription. Access to EC will rely more heavily on pharmacists if it has nonprescription status. Interventions to improve access should address pharmacists’ concerns on utilizing web-based methods. 41 KNOWLEDGE AND BELIEFS ABOUT PAP SMEARS AND COLPOSCOPY AMONG LOW-INCOME WOMEN ATTENDING UNIVERSITY-BASED COLPOSCOPY CLINICS Fortner KB, Zite NB, Young V, Wallace LS. Introduction: Many women undergoing routine health screening lack appropriate understanding of the annual gynecological exam,
including the Pap test. Additionally, women fail to understand the evaluation and causality of abnormal Pap results. This study examined women’s comprehension and beliefs regarding the purposes of the Pap test and of colposcopy. Materials and Methods: Women aged z 18 years (n = 100) were recruited from university-based colposcopy clinics. Via structured interviews, we evaluated sociodemographic characteristics, health literacy skills, situational anxiety and emotional distress using valid and reliable tools. Using four open-ended questions, we assessed women’s knowledge of Pap smears, including the purpose of screening, beliefs regarding abnormal results and risk factors and the purpose of colposcopy. Open-ended questions were independently scored by two investigators, discordant scores were discussed and a final score was agreed on. Results: Forty-one percent of women (mean age = 28.5F9.4 years; 92% were Caucasian and 17% had health literacy skills at less than the eighth-grade level) interviewed reported having had no colposcopy in the past. Women reported high levels of anxiety prior to colposcopy (mean anxiety = 45.7F5.5). Overall, women demonstrated a poor understanding of Pap tests, abnormal results and the causality of abnormal results. Of 73% reporting current smoking behavior, one woman identified smoking as a risk factor for dysplasia. Conclusions: Remarkably few patients understood the purpose of screening and the meaning of abnormal results. Limited understanding persisted among women who reported having had prior colposcopy and among those with adequate health literacy skills. There is a need for effective patient education to address persistent misconceptions and to increase knowledge. 42 LATINA AND AFRICAN AMERICAN YOUNG WOMEN’S EXPERIENCES ACCESSING EMERGENCY CONTRACEPTION Dries-Daffner I, Landau SC, Taylor-McGhee B, Marques M, Gerdts C, Fosse I. Introduction: Despite progress made to date, certain communities remain unaware of emergency contraception (EC) or its availability directly in California pharmacies, contributing to significant delays some women experience obtaining EC. In particular, many African American and Latina teens do not currently seek EC in pharmacies due to lack of information and awareness about its availability. Materials and Methods: Pharmacy Access Partnership and the Pacific Institute for Women’s Health (PIWH) collaborated on an initiative to increase access to and awareness of EC among California’s Latina and African American youth. Strategies included conducting statewide focus groups and community dialogues to assess Latina and African American adolescents’ experiences accessing EC and to identify their pharmacy access needs. Results: Statewide focus groups conducted with African American and Latina youth revealed while more than half of adolescents visit a pharmacy regularly, most adolescents have limited knowledge that they may access EC at a pharmacy without a doctor’s prescription; that EC is safe and legal; and that EC is not an abortifacient. Latinas were less informed and less empowered to seek information about EC than African Americans. Barriers include concerns about privacy, the provider’s gender, and fear of discriminatory public perceptions of teens’ sexual and contraceptive behaviors. Results guided the development and launch of a
Abstracts / Contraception 74 (2006) 178 – 197
choose to have an abortion, 73% responded that they would prefer to have it done by their PCP in the primary care office, whereas 25% would prefer it at a freestanding high-volume abortion clinic. The most commonly cited reason for choosing abortion with their PCP was comfort. Expertise of the physician was the reason most often cited for choosing to have an abortion at an abortion clinic. Conclusions: The majority of women surveyed are interested in having early abortion available at their primary care office site. The most important factor influencing women’s interest is comfort with their provider. Women favored their clinic offering medical abortion over surgical abortion. Increasing options for abortion provision, with integration of abortion services in the primary care setting, appears acceptable to the majority of female patients. 40 KNOWLEDGE AND ATTITUDES OF PHARMACISTS REGARDING EMERGENCY CONTRACEPTION IN AN URBAN HEALTH SYSTEM Harwood B, Nguyen DK. Introduction: Pharmacists are pivotal to access to emergency contraception (EC). Materials and Methods: In October 2005, pharmacists at the University of Pittsburgh Medical Center Health System (UPMCHS) completed surveys by telephone or by facsimile. In this descriptive study, 21 questions addressed experience with, knowledge on and attitudes towards EC. Results: Twenty pharmacists representing each of the 16 UPMCHS pharmacies completed the survey. Sixty percent (12/20) were female, and 35% (7/20) routinely provided EC. Eighty percent (16/20) worked for extended hours in pharmacies that routinely stocked EC. Overall, 65% (13/20) correctly answered at least 50% (5/6) of knowledge questions. Most respondents correctly answered questions regarding mechanism of action, interval of administration and maternal and fetal safety. However, only 10% (2/20) correctly answered that EC was effective beyond 72 h after unprotected intercourse. Sixty-five percent (13/20) felt comfortable counseling women regarding EC. The majority disapproved of EC nonprescription status; 70% (14/20) disagreed that EC should be available without a prescription, and 80% (18/20) disagreed that EC should be available over-the-counter. Most respondents participated in continuing education, and 95% (19/20) used web-based programs. Conclusions: Despite good general knowledge, comfort with counseling and EC availability, pharmacists in an urban health care system rarely dispense EC and do not support access to EC without a prescription. Access to EC will rely more heavily on pharmacists if it has nonprescription status. Interventions to improve access should address pharmacists’ concerns on utilizing web-based methods. 41 KNOWLEDGE AND BELIEFS ABOUT PAP SMEARS AND COLPOSCOPY AMONG LOW-INCOME WOMEN ATTENDING UNIVERSITY-BASED COLPOSCOPY CLINICS Fortner KB, Zite NB, Young V, Wallace LS. Introduction: Many women undergoing routine health screening lack appropriate understanding of the annual gynecological exam,
including the Pap test. Additionally, women fail to understand the evaluation and causality of abnormal Pap results. This study examined women’s comprehension and beliefs regarding the purposes of the Pap test and of colposcopy. Materials and Methods: Women aged z 18 years (n = 100) were recruited from university-based colposcopy clinics. Via structured interviews, we evaluated sociodemographic characteristics, health literacy skills, situational anxiety and emotional distress using valid and reliable tools. Using four open-ended questions, we assessed women’s knowledge of Pap smears, including the purpose of screening, beliefs regarding abnormal results and risk factors and the purpose of colposcopy. Open-ended questions were independently scored by two investigators, discordant scores were discussed and a final score was agreed on. Results: Forty-one percent of women (mean age = 28.5F9.4 years; 92% were Caucasian and 17% had health literacy skills at less than the eighth-grade level) interviewed reported having had no colposcopy in the past. Women reported high levels of anxiety prior to colposcopy (mean anxiety = 45.7F5.5). Overall, women demonstrated a poor understanding of Pap tests, abnormal results and the causality of abnormal results. Of 73% reporting current smoking behavior, one woman identified smoking as a risk factor for dysplasia. Conclusions: Remarkably few patients understood the purpose of screening and the meaning of abnormal results. Limited understanding persisted among women who reported having had prior colposcopy and among those with adequate health literacy skills. There is a need for effective patient education to address persistent misconceptions and to increase knowledge. 42 LATINA AND AFRICAN AMERICAN YOUNG WOMEN’S EXPERIENCES ACCESSING EMERGENCY CONTRACEPTION Dries-Daffner I, Landau SC, Taylor-McGhee B, Marques M, Gerdts C, Fosse I. Introduction: Despite progress made to date, certain communities remain unaware of emergency contraception (EC) or its availability directly in California pharmacies, contributing to significant delays some women experience obtaining EC. In particular, many African American and Latina teens do not currently seek EC in pharmacies due to lack of information and awareness about its availability. Materials and Methods: Pharmacy Access Partnership and the Pacific Institute for Women’s Health (PIWH) collaborated on an initiative to increase access to and awareness of EC among California’s Latina and African American youth. Strategies included conducting statewide focus groups and community dialogues to assess Latina and African American adolescents’ experiences accessing EC and to identify their pharmacy access needs. Results: Statewide focus groups conducted with African American and Latina youth revealed while more than half of adolescents visit a pharmacy regularly, most adolescents have limited knowledge that they may access EC at a pharmacy without a doctor’s prescription; that EC is safe and legal; and that EC is not an abortifacient. Latinas were less informed and less empowered to seek information about EC than African Americans. Barriers include concerns about privacy, the provider’s gender, and fear of discriminatory public perceptions of teens’ sexual and contraceptive behaviors. Results guided the development and launch of a