| 1. Title: Plan B for 17-year olds. Source: Medical Letter On Drugs and Therapeutics. 2009 May 18;51(1312):40. Abstract: The FDA has announced that it will lower the age for over-the-counter access to the emergency contraceptive Plan B from 18 to 17 years old. In a randomized, controlled trial, the two 0.75-mg levonorgestrel tablets in Plan B, taken 12 hours apart beginning within 72 hours after unprotected intercourse, decreased the overall pregnancy rate to 1.1% (11/976) of women who requested emergency contraception. The sooner the drug is taken after coitus, the more effective it is. Nausea and vomiting can occur with Plan B. Fetal malformations have not been associated with pregnancies that occurred despite use of levonorgestrel-only emergency contraception. (full-text) Language: English Keywords: UNITED STATES OF AMERICA | USFDA | ADOLESCENTS | EMERGENCY CONTRACEPTION | ADMINISTRATION AND DOSAGE | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration Document Number: 341625 |
2.  Title: Quick reference guide to family planning research. Author: Family Health International [FHI] Source: [Research Triangle Park, North Carolina], FHI, 2009 Jan. 51 p. (Research to Practice) Abstract: This document is a summary of research and program findings that FHI believes could improve family planning and reproductive health services if they were more widely incorporated into policies and programs. The following topics are covered: Preventing Mother-to-Child Transmission of HIV through Family Planning; Integrating HIV Voluntary Testing and Counseling and Family Planning Services; Intrauterine Devices; Emergency Contraceptive Pills; Vasectomy; Male Condoms; Female Condoms; Standard Days Method; Eligibility Screening and Provider Checklists; Community-Based Services and Distribution; Youth (ages 10-24); Implants; Contraceptive Continuation; Male Circumcision and HIV; Contraceptive Counseling and Job Aids; Healthy Timing and Spacing of Pregnancies; Postpartum Family Planning. Language: English Keywords: GLOBAL | CATALOG | RESEARCH ACTIVITIES | FAMILY PLANNING POLICY | CONTRACEPTIVE METHODS | HIV/FP INTEGRATION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | EMERGENCY CONTRACEPTION | CONTRACEPTION CONTINUATION | MALE CIRCUMCISION | COMMUNITY-BASED DISTRIBUTION | COUNSELING | YOUTH PROGRAMS | POSTPARTUM PROGRAMS | Research Methodology | Population Policy | Social Policy | Policy | Political Factors | Sociocultural Factors | Family Planning | Contraception | Programs | Organization and Administration | Disease Transmission Control | Prevention and Control | Diseases | Contraceptive Usage | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Clinic Activities | Family Planning Programs Document Number: 331689 |
| 3. Peer Reviewed Title: Emergency contraception: knowledge and attitudes of family physicians of a teaching hospital, Karachi, Pakistan. Author: Abdulghani HM; Karim SI; Irfan F Source: Journal of Health, Population, and Nutrition. 2009 Jun;27(3):339-44. Abstract: This study was conducted to assess the knowledge of family medicine providers and their attitudes towards emergency contraception in a teaching hospital in Karachi, Pakistan. A 21-item questionnaire containing the demographic profile of respondents and questions concerning knowledge of and attitudes towards emergency contraception was distributed among participants. In total, 45 interviews were conducted, with a response rate of 100%, with faculty physicians (33%), residents (27%), medical officers (40%), 36% male and 64% female physicians; of them, the majority (64%) were married. Although the large majority (71%) of the respondents reported considerable familiarity with emergency contraception, objective assessment revealed deficiencies in their knowledge. About 38% of the participants incorrectly chose menstrual irregularity as the most common side-effect of progestin-only emergency contraception pills, and only 33% answered that emergency contraception was not an abortifacient while 42% were unsure. Forty percent of the physicians prescribed emergency contraception in the past. The large majority (71%) of the physicians were familiar with emergency contraception, yet deficiencies in knowledge inaccuracies were identified. Barriers to its use were identified as 'it will promote promiscuity' (31%), religious/ethical reasons (27%), liability (40%), teratogenicity (44%), and inexperience (40%). Overall attitudes regarding emergency contraception were positive; however, most (82%) physicians were unsatisfied with their current knowledge of emergency contraception, and there was a discrepancy between perceptions of physicians and actual knowledge. Interventions providing education to family physicians regarding emergency contraception is strongly recommended. Language: English Keywords: PAKISTAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PHYSICIANS | EMERGENCY CONTRACEPTION | ATTITUDES | KNOWLEDGE | PERCEPTION | FAMILY PLANNING | Developing Countries | Asia, Southern | Asia | Research Methodology | Health Personnel | Delivery of Health Care | Health | Contraception | Psychological Factors | Behavior | Sociocultural Factors Document Number: 341579 |
4.  Title: The morning-after pill [letter] Author: Abell S Source: Clinical Pediatrics. 2009 Apr;48(3):341-2; discussion 342. Abstract: This is a question from a reader to the journal's Medical Doctor about the morning-after pill. The Dr. clearly confirms that the morning-after pill is not causing abortion. Her description helps us better understand how this pill (usually levonorgestrel), a progestin, works in preventing a pregnancy. This approach, which is now known as Plan B™, has received strong support in the prevention of unplanned pregnancies from both the American College of Obstetrics and Gynecology and the American Academy of Pediatrics in also circumventing the need for abortions in women of all ages, especially in adolescent girls. Some pharmacists have resisted filling these Plan B prescriptions, so it will be important for pediatricians to know which pharmacies in your community will accept your Plan B™ prescriptions. Sadly, teenage pregnancies continue to have a major impact on disadvantaged teenagers. This group of individuals also may have limited access to Plan B prescriptions, which requires that they should be taken within 5 days of unprotected intercourse in order for them to be effective in preventing unwanted pregnancies. Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | EVALUATION | WOMEN | EMERGENCY CONTRACEPTION | CONTRACEPTIVE MODE OF ACTION | ABORTION | CONTRACEPTIVE SAFETY | CONTRACEPTIVE AVAILABILITY | PHARMACY DISTRIBUTION | ORAL CONTRACEPTIVES, SIDE EFFECTS | NAUSEA | VOMITING | Developed Countries | North America | Americas | Demographic Factors | Population | Contraception | Family Planning | Fertility Control, Postconception | Safety | Public Health | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Signs and Symptoms | Diseases Document Number: 331244 Notification |
| 5. Title: Knowledge, practices, and attitudes regarding emergency contraception among students at a university in Ghana. Author: Addo VN; Tagoe-Darko ED Source: International Journal of Gynaecology and Obstetrics. 2009 Jun;105(3):206-209. Abstract: An anonymous, self-administered, 39-item questionnaire was sent to 3,200 students. The sample size was stratified, and 2,292 students were randomly selected. Of the 71.6% of students who responded, 51.4% had heard of emergency contraception (EC). Among those, 19.4% thought EC consisted of contraceptive pills, 19.1% of "morning-after pills," and 12.8% of an intrauterine device. Only 4.2% had ever used EC, but 73.9% wished it were provided on campus. Of all the respondents, 90.9% called for the establishment of a reproductive health counseling center on campus. Language: English Keywords: GHANA | RESEARCH REPORT | KAP SURVEYS | CONTRACEPTIVE PREVALENCE SURVEYS | STUDENTS | UNIVERSITIES | EMERGENCY CONTRACEPTION | KNOWLEDGE | CONTRACEPTIVE USAGE | ATTITUDES | IUD | CONTRACEPTIVE PREVALENCE | COUNSELING | FAMILY PLANNING EDUCATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Family Planning Surveys | Family Planning | Education | Schools | Contraception | Sociocultural Factors | Psychological Factors | Behavior | Contraceptive Methods | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 330422 |
| 6. Peer Reviewed Title: Factors affecting awareness of emergency contraception among college students in Kathmandu, Nepal. Author: Adhikari R Source: BMC Women's Health. 2009 Sep 17;9(1):27. Abstract: ABSTRACT: BACKGROUND: In Nepal, Emergency Contraception (EC) could play a critical role in reducing unintended pregnancies, but very few people aware about it. This paper aims to investigate the level of awareness and factors influencing awareness of EC among college students. METHODS: A cross-sectional study was carried out in April-May 2006. Structured self-administered questionnaires were administered to 1,137 college students (573 males and 564 females) in Kathmandu district. The association between awareness of EC and the explanatory variables were first assessed in bivariate analysis using the Chi-square test. The associations were further explored using a multivariate logistic analysis. RESULTS: Only about two-thirds of college students (68%) had ever heard about EC. Bivariate analysis shows that males were more aware (72%) of EC than were females (64%). Similarly, the awareness level was significantly higher among younger, unmarried youth who were from outside Kathmandu Valley, who lived with friends, and who had received reproductive health (RH) education in school/college. The study also found that students' sex, permanent place of residence (district), and RH education are significant predictors of awareness of EC. Males are 1.5 times more likely to be aware of EC compared to females. Furthermore, students who lived in Kathmandu Valley were 41% less likely to be aware of EC than were students from outside Kathmandu Valley. On the other hand, those students who received RH education in school/college were almost nine times more likely to be aware of EC compared to those who did not receive such education. CONCLUSIONS: Awareness of the EC is low among college students in Nepal. Health education initiatives should target students as they are more likely to be sexually active. There is a need to further educate students about EC which can help to reduce unintended pregnancies, many of which result in unsafe abortion and take a large toll on women's health. Language: English Keywords: NEPAL | RESEARCH REPORT | STUDENTS | EMERGENCY CONTRACEPTION | AWARENESS | QUESTIONNAIRES | LIVING ARRANGEMENTS | SEX FACTORS | AGE FACTORS | SEX EDUCATION | PREGNANCY, UNPLANNED | Developing Countries | Asia, Southern | Asia | Education | Contraception | Family Planning | Knowledge | Sociocultural Factors | Residence Characteristics | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Reproductive Behavior | Fertility | Population Dynamics Document Number: 342836 |
| 7. Title: Catching up on contraception. Author: Allen K Source: Australian Family Physician. 2009 Jun;38(6):380-2. Abstract: BACKGROUND: Providing contraceptive advice is a core activity in general practice. There have been numerous changes to the contraceptive options available in Australia over the past 10 years. It is important that general practitioners are aware of these changes so that they can advise patients appropriately. OBJECTIVE: This article examines the changes that have occurred in contraception over the past decade and discusses the implications of these changes to clinical practice. DISCUSSION: Up-to-date knowledge about how the combined oral contraceptive pill works is reflected in changes to packaging and formulations, with varying success. Other changes include the over-the-counter availability of emergency contraceptive pills and the new combined hormonal vaginal ring. There has been a resurgence in intrauterine device use and their insertion has Level 1 (nonprocedural) indemnity status in most medical defence organisations. Bleeding with long acting progestogen only contraception remains a problem and management options include antiprostaglandins, tranexamic acid, doxycycline, the combined oral contraceptive pill and removal of the device. Sterilisation remains an option for older men and women and newer methods are available. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | KNOWLEDGE | ORAL CONTRACEPTIVES, COMBINED | EMERGENCY CONTRACEPTION | SATISFACTION | VAGINAL RING | STERILIZATION, SEXUAL | INFORMED CHOICE | Oceania | Developed Countries | Sociocultural Factors | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Psychological Factors | Behavior | Contraceptive Usage Document Number: 341574 |
| 8. Peer Reviewed Title: [Sexual behavior and emergency contraception among adolescents from public schools in Pernambuco State, Brazil] Comportamento sexual e contracepcao de emergencia entre adolescentes de escolas Author: Araujo MS; Costa LO Source: Cadernos de Saude Publica. 2009 Mar;25(3):551-62. Abstract: This study examined knowledge and use of emergency contraception among 4,210 adolescents (14-19 years) enrolled in public schools in Pernambuco State, Brazil. The authors collected information with the Global School-Based Student Health Survey, previously validated. Knowledge, frequency, and form of use of emergency contraception were investigated. Independent variables were classified as sociodemographic and those related to sexual behavior. Most adolescents reported knowing and having received information about the method, but among those who had already used it, only 22.1% had done so correctly. Adjusted regression analysis showed greater likelihood of knowledge about the method among girls and the sexually initiated, while rural residents were 68% less knowledgeable. Rural residents showed 1.68 times higher odds of incorrect use, while girls showed 71% lower likelihood of incorrect use. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | SURVEYS | RURAL POPULATION | ADOLESCENTS | KNOWLEDGE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE USAGE | SEX EDUCATION | NEEDS ASSESSMENT | South America, Eastern | South America | Latin America | Americas | Developing Countries | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Sociocultural Factors | Contraception | Family Planning | Education | Evaluation Document Number: 330737 |
| 9. Peer Reviewed Title: Increased access to emergency contraception: why it may fail. Author: Baecher L; Weaver MA; Raymond EG Source: Human Reproduction. 2009 Apr;24(4):815-9. Abstract: BACKGROUND: To explore why increased access to emergency contraception (EC) failed to reduce pregnancies in a recent randomized controlled trial. METHODS: We used multivariable logistic regression to identify risk factors for unintended pregnancy using data from a trial involving sexually active women (n = 1490, aged 14-24 years) randomly assigned to either increased access or standard access to EC. We used predictive modeling to generate estimated pregnancy risk scores for each participant. We then examined EC use among women at low or high baseline risk of pregnancy. RESULTS: Gravidity, recent history of unprotected sex (within 14 days of enrollment to study) and lower aversion to pregnancy predicted unintended pregnancy. Women in the increased access group were more likely than women in the standard access group to use EC repeatedly. This difference was significantly stronger (P = 0.03) among low risk women than high risk women [Relative risk (RR) 10.0, 95% confidence interval (CI) 6.5-15.4 and RR 5.5, 95% CI 3.8-7.9, respectively]. CONCLUSIONS: Increased access to EC had a greater impact on women who were at lower baseline risk of pregnancy. This may explain in part why increased access to EC has had no measurable benefit in clinical trials. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | STATISTICAL REGRESSION | WOMEN | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | PREGNANCY, UNPLANNED | INCIDENCE | RISK FACTORS | PSYCHOSOCIAL FACTORS | Developed Countries | North America | Americas | Data Analysis | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Measurement | Health | Behavior Document Number: 341661 |
| 10. Title: Emergency contraception: how does it work? Author: Baird DT Source: Reproductive Biomedicine Online. 2009;18 Suppl 1:32-6. Abstract: Emergency (or post-coital) contraception is any substance or device that is used to prevent pregnancy after unprotected intercourse. Currently used hormonal methods of emergency contraception (high-dose combined oral contraceptive pill or levonorgestrel) prevent about 50-80% of pregnancies. Research has demonstrated that these methods inhibit the midcycle surge of LH from the pituitary and, if given at least 2 days before ovulation, ovulation is delayed or prevented. Ovulation still occurs if administration is delayed until ovulation is imminent. Biological data that suggest that the most likely mode of action is by preventing fertilization are supported by the clinical observation that the greater the interval between coitus and administration the greater the chance of pregnancy. There are no data supporting the view that levonorgestrel can impair the development of the embryo or prevent implantation. In contrast, other very effective methods of emergency contraception, such as mifepristone and intrauterine devices, can also inhibit implantation. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | EMERGENCY CONTRACEPTION | IUD | RU-486 | LEVONORGESTREL | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Contraception | Family Planning | Contraceptive Methods | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents Document Number: 330739 |
| 11. Peer Reviewed Title: Teenagers and emergency contraception in the UK: a focus group study of salient beliefs using concepts from the Theory of Planned Behaviour. Author: Bayley J; Brown K; Wallace L Source: European Journal of Contraception and Reproductive Health Care. 2009 Jun;14(3):196-206. Abstract: OBJECTIVES: To explore teenagers' beliefs about emergency contraception (EC) within a Theory of Planned Behaviour (TPB) framework. METHODS: Six single sex focus groups comprising a total of 25 female and 23 male pupils aged 13-16 years conducted in schools in Central England. RESULTS: Attitudes to emergency contraception (EC) were mainly positive about the rewards of avoiding teenage pregnancy. Participants had positive beliefs about the effectiveness of EC, although knowledge of crucial time limits varied. EC use was more socially acceptable than teenage pregnancy, yet both outcomes were perceived negatively. Motivation to comply with social pressure was influenced by the appraisal of individuals' intentions. Participants reported high self efficacy in accessing EC, but had concerns over confidentiality and access. CONCLUSIONS: Desire to avoid pregnancy was high in this group, but practical factors and attitudes may be more important for those ambivalent about pregnancy. Adolescents perceive accessing EC as difficult, are concerned about confidentiality, and anticipate negative reactions from staff. Data support the TPB as a suitable framework for understanding attitudes to EC use. Further research should apply quantitative TPB measures to EC use in a wider teenage sample in order to identify potential psychological factors to target in an intervention. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | FOCUS GROUPS | ADOLESCENTS | STUDENTS | EMERGENCY CONTRACEPTION | ATTITUDES | BELIEFS | KNOWLEDGE | PEER PRESSURE | MOTIVATION | CONTRACEPTIVE USAGE | Developed Countries | Europe, Western | Europe | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Contraception | Family Planning | Psychological Factors | Behavior | Culture | Sociocultural Factors | Psychosocial Factors Document Number: 341801 |
| 12. Title: Perception and practice of emergency contraception among female undergraduates of the University of Ibadan, Nigeria. Author: Bello FA; Olayemi O; Fawole AO; Ogunbode OO; Sobukunola T Source: Journal of Reproduction and Contraception. 2009 Jun;20(2):113-121. Abstract: The authors performed a cross-sectional questionnaire study with 383 female undergraduates in Nigeria in June 2006 to assess their perceptions about and proper use of emergency contraception (EC). One hundred and five (48.2%) of the students had been sexually exposed. Only 32 (30.5%) used regular contraception. Seventy-three (24.3%) female undergraduates were aware of EC. Only 29 (7.6%) had used EC before. Most would not use EC drugs in the future due to lack of awareness (64.8%), fear for future fertility, and fear that EC was injurious to health. Use of EC was associated with awareness of correct interval for use. The authors concluded that there was poor knowledge about EC and poor use. Most knowledge was acquired from peers and was inaccurate. Language: English Keywords: NIGERIA | RESEARCH REPORT | DATA ANALYSIS | YOUTH | STUDENTS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AGENTS, POSTCOITAL | KNOWLEDGE | PEER EDUCATORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Adolescents | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Sociocultural Factors Document Number: 339903 |
| 13. Peer Reviewed Title: Involving pharmacists in sexual health research: experience from an emergency contraception study. Author: Black K; Anderson C; Kubba A; Wellings K Source: Journal of Family Planning and Reproductive Health Care. 2009 Jan;35(1):41-3. Abstract: BACKGROUND: Community pharmacists are expanding their sphere of activity within primary health care, increasing their role not only in health care but also research. METHODS AND RESULTS: We describe the challenges encountered in carrying out a pilot study of women obtaining emergency hormonal contraception through different providers, including pharmacies, highlighting deficiencies in understanding and experience of the research process, which impacted on the study in substantial ways. CONCLUSIONS: As pharmacists expand their role, training and professional development will need to be enhanced to support them in their contribution to health care and research. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | EMERGENCY CONTRACEPTION | PHARMACISTS | EDUCATION | HOME CARE | PHARMACY DISTRIBUTION | SEX EDUCATION | HEALTH | RESEARCH AND DEVELOPMENT | Developed Countries | Europe, Western | Europe | Contraception | Family Planning | Health Personnel | Delivery of Health Care | Care and Support | Health Services | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Technology | Economic Factors Document Number: 329636 |
| 14. Peer Reviewed Title: Developments and challenges in emergency contraception. Author: Black KI Source: Best Practice and Research: Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):221-231. Abstract: Emergency contraception (EC) methods, available in oral and intrauterine forms, seek to prevent pregnancy after unprotected intercourse or contraceptive failure. Levonorgestrel EC is more effective and has fewer side effects than the previously used combined oral hormonal method; the Yuzpe regimen. In recent years, levonorgestrel has increased in use, and has become available over the counter in pharmacies in many countries. compared with oral methods, the copper intra-uterine device offers greater protection against unplanned pregnancy but requires a clinical consultation. The much hoped for potential of EC methods to reduce unintended pregnancy is yet to be demonstrated at population level. Language: English Keywords: GLOBAL | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | EMERGENCY CONTRACEPTION | LEVONORGESTREL | RU-486 | IUD | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, SIDE EFFECTS | PHARMACY DISTRIBUTION | IUD, COPPER RELEASING | NAUSEA | VOMITING | FATIGUE | PAIN | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Contraceptive Methods | Oral Contraceptives | Contraceptive Safety | Safety | Public Health | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Signs and Symptoms | Diseases Document Number: 341506 |
| 15. Peer Reviewed Title: Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK : a prospective study. Author: Brabin L; Thomas G; Hopkins M; O'Brien K; Roberts SA Source: BMC Women's Health. 2009 Mar 26;9(1):7. Abstract: ABSTRACT: BACKGROUND: More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. METHODS: Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers ([greater than or equal to] 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. RESULTS: 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348 /2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015). CONCLUSIONS: Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | YOUTH | SCREENING | EMERGENCY CONTRACEPTION | CHLAMYDIA | PHARMACY DISTRIBUTION | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Age Factors | Population Characteristics | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 330849 |
| 16. Peer Reviewed Title: Effect of sexual intercourse on the absorption of levonorgestrel after vaginal administration of 0.75 mg in Carraguard gel: a randomized, cross-over, pharmacokinetic study. Author: Brache V; Croxatto H; Kumar N; Sitruk-Ware R; Cochon L; Schiappacasse V; Sivin I; Munoz C; Maguire R; Faundes A Source: Contraception. 2009 Feb;79(2):150-4. Abstract: BACKGROUND: The Population Council studied a pre-coital contraceptive microbicide vaginal product containing levonorgestrel (LNG) as active component and Carraguard gel as a vehicle (Carra/LNG gel) for couples who engage in occasional unplanned intercourse. The objective of this study was to evaluate the effect of sexual intercourse after vaginal application of Carra/LNG gel on serum levels of LNG in women and to assess LNG absorption by the male partner. STUDY DESIGN: This was a randomized, cross-over, pharmacokinetic study including an abstinence arm and an arm in which couples engaged in sexual intercourse between 2 and 4 h after gel application. In each study arm, each woman received a single application of Carra/LNG gel (0.75 mg in 4 mL gel) followed by serial blood samples taken at 0, 1, 2, 4, 8, 24 and 48 h after gel application for LNG measurements. In the intercourse arm, LNG was measured in blood samples taken from the male partner before intercourse and at 4, 8 and 24 h after gel application in the female partner. RESULTS: Time concentration curves for serum LNG levels showed a mean C(max) of 7.8+/-5.5 and 8.3+/-5.7 nmol/L, a mean T(max) of 6.2+/-5.9 and 7.5+/-5.7, and comparable area under the curve for the intercourse and abstinence arm, respectively. Pharmacokinetic parameters presented large variability between subjects, but excellent reproducibility within each subject. LNG was undetectable in 10 out of 12 male partners. CONCLUSION: Sexual intercourse does not appear to interfere with vaginal absorption of LNG after application of a Carra/LNG gel. A vaginal pre-coital contraceptive gel is feasible. Language: English Keywords: DOMINICAN REPUBLIC | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | SEXUAL PARTNERS | SEXUAL INTERCOURSE | PHYSIOLOGY | LEVONORGESTREL | VAGINAL GEL | MICROBICIDES | TIME FACTORS | CONTRACEPTIVE EFFECTIVENESS | EMERGENCY CONTRACEPTION | Developing Countries | Caribbean | Americas | Research Methodology | Economic Development | Economic Factors | Sex Behavior | Behavior | Reproduction | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Vaginal Spermicides | Contraceptive Methods | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Demographic Factors | Population Document Number: 331015 |
| 17. Title: Emergency contraception, efficacy and public health impact. Author: Broekhuizen FF Source: Current Opinion In Obstetrics and Gynecology. 2009 May 30; Abstract: PURPOSE OF REVIEW: Emergency contraception in the past two decades had been proven to be effective and well tolerated. Counseling and advance provision and prescription of emergency contraception have been embraced by professional organizations in practice guidelines for its potential to reduce the number of unintended pregnancies and abortions. Has emergency contraception lived up to that promise? RECENT FINDINGS: Mifepristone (not available in the USA) is the agent of choice. Emergency contraception has not reduced the number of unintended pregnancies. Acceptance by healthcare providers and the public has not been optimal, and multiple financial and healthcare system barriers to use emergency contraception continue to exist. The public health impact of emergency contraception has been disappointing. SUMMARY: Although emergency contraception may continue to be an important component of contraceptive practice, only increased access to more effective methods of contraception will change unintended pregnancy rates. The use of mifepristone for emergency contraception in the USA must be considered. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | EMERGENCY CONTRACEPTION | PREGNANCY, UNPLANNED | RU-486 | PUBLIC HEALTH | Developed Countries | North America | Americas | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Health Document Number: 341569 |
| 19. Title: Emergency contraception - knowledge and attitudes in a group of Australian university students. Author: Calabretto H Source: Australian and New Zealand Journal of Public Health. 2009 Jun;33(3):234-9. Abstract: OBJECTIVE: To explore first year Australian university students' knowledge and attitudes about emergency contraception and their understanding of the risk for pregnancy. METHOD: A self-report questionnaire was completed by a convenience sample of 627 first year on-campus students from both health and non-health disciplines. RESULTS: Knowledge about emergency contraception (EC) was generally poor including misunderstanding that it can only be used the 'morning after', as well as where it may be accessed. Its potential use was, however, more highly accepted as a preventative measure after unprotected sexual intercourse than abortion in the event of unplanned pregnancy. Women had better knowledge than men, and on a number of measures there were significant differences between these groups. CONCLUSIONS: Poor knowledge about the timing, accessibility, action and side effects of EC may act as a barrier to its use in the event of unprotected sexual intercourse. Although EC has been available in Australia as a Schedule 3 medication since 2004, its availability from pharmacies is not well known, nor is access from other primary health care providers. Implications: The lack of knowledge about EC may lead to its underutilisation and underlines the need for future educational strategies about EC as well as the need for health professionals who provide contraceptive services to discuss EC with clients. Health promotion campaigns which are both general as well as gender-specific may improve overall community knowledge about this method of contraception. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | SAMPLING STUDIES | STUDENTS | UNIVERSITIES | EMERGENCY CONTRACEPTION | KNOWLEDGE | ATTITUDES | ABORTION | QUESTIONNAIRES | CONTRACEPTIVE METHOD ACCEPTABILITY | Oceania | Developed Countries | Studies | Research Methodology | Education | Schools | Contraception | Family Planning | Sociocultural Factors | Psychological Factors | Behavior | Fertility Control, Postconception | Contraceptive Usage Document Number: 342310 Notification |
| 20. Title: Emergency contraception: have we come full circle? [editorial] Author: Coeytaux F; Wells ES; Westley E Source: Contraception. 2009 Jul;80(1):1-3. Abstract: Two decades ago, Dr. Felicia Stewart, then serving as Medical Director of the Planned Parenthood affiliate in Sacramento, CA, began her campaign to let out of the closet "America's best-kept secret" - emergency contraception (EC). The method had been suppressed because many providers thought the method was "not effective enough" or would lead women to use it "too much" (in place of using other more effective methods). Advocates disagreed, believing that EC could help some women prevent pregnancy, that women could learn to use the method appropriately, and that women had the right to this important option. When Dr. Stewart and other women's health advocates pushed to move EC "from secret to shelf," they had women's needs in mind - in particular the need for a method that, unlike others, could be used after sex and one that was safe enough to provide without the barrier of a medical interface. The success of this 20-year effort is evident in the many dedicated EC products now available worldwide, the increase in women's awareness and use of EC, and, in the United States, the full-on direct to consumer marketing of EC by a pharmaceutical company, not to mention the popularity of the method among women. Today, in the midst of this forward trajectory of increased access and awareness, we have encountered a curve ball that has us circling back to where we started. Recent analyses suggesting that EC is not as effective in reducing unwanted pregnancy rates at a population level as we once hoped seem to have put the brakes on funding and have revived the original arguments that EC is "not effective enough" to be promoted as an option and that women are "abusing" it, using it repeatedly instead of using other more effective methods. Some in the field have also again voiced concerns that by providing it directly to women we are missing opportunities to provide women with a full range of reproductive health services. Our response to this recent round of questioning is that EC still fills a unique and important role in the mix of available contraceptive methods, that it is effective enough to be promoted as a contraceptive option and that women's use of the method does not constitute a problem (in terms of lower effectiveness) but rather contributes in a positive way to every woman's significant challenge of how to avoid unplanned pregnancies over her lengthy fertile years. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | WOMEN | EMERGENCY CONTRACEPTION | AWARENESS | FERTILITY CONTROL, POSTCOITAL | CONTRACEPTIVE EFFECTIVENESS | INFORMED CHOICE | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | Demographic Factors | Population | Contraception | Family Planning | Knowledge | Sociocultural Factors | Contraceptive Usage | Program Evaluation | Programs | Organization and Administration Document Number: 341588 |
| 21. Peer Reviewed Title: Adolescent Comprehension of Emergency Contraception in New York City. Author: Cremer M; Holland E; Adams B; Klausner D; Nichols S; Scott Ram R; Alonzo TA Source: Obstetrics and Gynecology. 2009 Apr;113(4):840-844. Abstract: OBJECTIVE:: To estimate comprehension of the over-the-counter emergency contraception label among female adolescents aged 12 through 17 years, and to compare the results with a similar study that focused on adults. METHODS:: Surveys were administered to female adolescents in New York City in public venues such as malls, movie theaters, and parks. Participants were asked to read the emergency contraception (levonorgestrel) label before answering survey questions. Comparisons were made in SPSS version 13.0 using chi tests of independence and Fisher exact tests for sparse data. RESULTS:: One thousand eighty-five girls between the ages of 12 and 17 participated in the study. Overall, adolescents demonstrated high comprehension of the key points of emergency contraception: (1) that it is a method of preventing pregnancy 92% (confidence interval [CI] 91-94%); (2) that it has to be taken within the first 72 hours after unprotected intercourse 83% (CI 83-87%); (3) that if you are already pregnant emergency contraception will not be effective 87% (CI 85-89%); (4) that emergency contraception will not protect against human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) 95% (CI 94-96%); and (5) that emergency contraception should not be used as a method of long-term birth control 85% (CI 83-87%). CONCLUSION:: After reading the emergency contraception (levonorgestrel) label, female adolescents aged 12 to 17 understood the information necessary to use emergency contraception safely and effectively as well as their adult counterparts. LEVEL OF EVIDENCE:: III. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | SURVEYS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | INFORMATION | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning Document Number: 330854 |
| 22. Peer Reviewed Title: Repeat abortion: facts and issues. Author: Das S; Adegbenro A; Ray S; Amu O Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):93-5. Abstract: BACKGROUND: The commonest reason for undertaking termination of pregnancy (TOP) in the UK is as defined by Clause 2 of the Abortion Act. There are no agreed criteria for defining 'recurrent abortion seekers'. We aimed to review the characteristics of women requesting termination of at least two consecutive pregnancies within 24 months of the first and to identify any factors for seeking repeat TOP. METHODS: The database of patients that attended our Fertility Control Services from 2001 to 2006 was evaluated. Demographic data, contraceptive use in the cycle of conception and reasons for request were assessed for possible associations with repeat TOP. RESULTS: The incidence was 2.3% as defined by our criteria. Financial circumstances was the commonest reason for seeking TOP (75%). The combined oral contraceptive pill and condom were the commonest forms of contraception in these patients before the first TOP (35% and 38%, respectively). Long-acting reversible contraception (LARC) was used by only 8% of women before their TOP. Although 58% accepted LARC following TOP, only 2% continued its use thereafter and 50% of women were not using any contraception at the time of the repeat TOP. CONCLUSION: This study suggests that social workers and perhaps psychologists should be part of the peri-abortion counselling team. Contraceptive counselling should emphasise the side effects of LARC to improve compliance. Follow-up to ensure compliance and involvement of partners in decision-making could help to reduce the incidence of repeat TOP. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | RETROSPECTIVE STUDIES | ABORTION | CONTRACEPTION TERMINATION | USER COMPLIANCE | EMERGENCY CONTRACEPTION | COUNSELING | PSYCHOLOGICAL FACTORS | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Contraception | Behavior | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 341653 |
| 23. Title: Adolescent contraceptive care for the practicing pediatrician. Author: Duffy K; Wimberly Y; Brooks C Source: Adolescent Medicine. 2009 Apr;20(1):168-87, x. Abstract: Improved use of contraception has been intrinsic in the decline of teenaged pregnancies in the United States. Recent advances in contraception, including the development of new progestins and longer-acting reversible methods, have greatly increased the options available for adolescents. By frankly discussing adverse effects, offering clear explanations of noncontraceptive benefits, and developing strategies for improving compliance, providers can play a key role in facilitating successful contraceptive use in young patients. Language: English Keywords: GEORGIA | UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS | HEALTH PERSONNEL | ADOLESCENT HEALTH | HEALTH SERVICES | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONTRACEPTION | CONFIDENTIAL INFORMATION | EMERGENCY CONTRACEPTION | ORAL CONTRACEPTIVES | PHYSICIAN-PATIENT RELATIONS | VAGINAL RING | INJECTABLES | IUD | COUNSELING | Developing Countries | Asia, Southwestern | Asia | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Family Planning | Ethics | Sociocultural Factors | Contraceptive Methods | Interpersonal Relations | Behavior | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 341530 |
| 24. Title: Compliance with mandated emergency contraception in New Mexico emergency departments. Author: Espey E; Ogburn T; Leeman L; Buchen E; Angeli E; Qualls C Source: Journal of Women's Health. 2009 May;18(5):619-23. Abstract: OBJECTIVE: New Mexico enacted a law in 2003 requiring that emergency departments (EDs) offer emergency contraception (EC) to survivors of sexual assault and that both doses be administered in the ED. This investigation sought to examine practices and knowledge of ED providers about EC in the setting of sexual assault. METHODS: We visited hospitals in New Mexico from July 2005 to December 2005 and administered an 18-item questionnaire to three providers-a physician, a nurse, and a clerk-in the ED. The questionnaire included items related to characteristics of the hospital, knowledge of providers about EC and the law, and ED practices relevant to EC for sexual assault survivors as well as for women who had consensual unprotected intercourse. RESULTS: Surveys were completed at 33 of 38 hospitals (87%). Overall, 52% of respondents reported that EC was routinely offered to sexual assault survivors, and 33% reported that both doses were administered in the ED. Forty-one percent of RNs, MDs, and clerks reported that EC was offered to sexual assault survivors who were minors regardless of age. Overall, 64% of respondents knew that EC may prevent pregnancy up to 72 hours after unprotected intercourse, and only 12% of respondents reported awareness of any requirements to offer EC to sexual assault survivors. Respondents reported that physicians in the ED more often routinely offered EC to sexual assault survivors (52%) than to women who requested it after consensual sex (20%). Thirty-three percent of respondents indicated parental consent was necessary for minors in the setting of sexual assault, although there is no requirement for parental notification in New Mexico. CONCLUSIONS: EDs in New Mexico are not universally complying with the law. Better dissemination of the law and education about EC could improve care of sexual assault survivors in New Mexico. Language: English Keywords: NEW MEXICO | UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | WOMEN | EMERGENCY SERVICES | SEXUAL ABUSE | RAPE | HEALTH SERVICES | EMERGENCY CONTRACEPTION | HEALTH EDUCATION | NEEDS | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Delivery of Health Care | Health | Crime | Social Problems | Sociocultural Factors | Contraception | Family Planning | Education | Economic Factors Document Number: 342561 |
| 25. Peer Reviewed Title: Adolescent access to emergency contraception: a comment on the UK context. Author: Fallon D Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):120-6. Abstract: The provision of emergency contraception (EC) in the United Kingdom (UK) has been transformed over the past decade through advances in pharmacology and the implementation of governmental measures to reduce teenage pregnancy rates. This paper considers how these issues have developed in the current social and political context with specific reference to adolescent access to EC in the UK. It highlights the concerns caused by increased availability of EC and the tension between adolescent rights to confidential treatment and advice, and professional anxiety about encouraging secrecy or parental deception. It concludes that adolescents, whilst benefiting from increased access to EC may also face a series of challenges as a result. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | CLINICAL RESEARCH | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | GOVERNMENT PROGRAMS | ADOLESCENT PREGNANCY | PREVENTION AND CONTROL | POLITICAL FACTORS | CONFIDENTIAL INFORMATION | FAMILY PLANNING EDUCATION | PARENTAL CONSENT | Developed Countries | Europe, Western | Europe | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Programs | Organization and Administration | Reproductive Behavior | Fertility | Population Dynamics | Diseases | Sociocultural Factors | Ethics | Education Document Number: 330933 |
| 26. Title: Knowledge, attitudes, and use of emergency contraception among Hispanic women of North Carolina. Author: Galvin SL; Fagan EB Source: Southern Medical Journal. 2009 Jan;102(1):17-20. Abstract: INTRODUCTION: This project was designed to determine the knowledge, attitudes and self-reported use of emergency contraception (EC) of Spanish-speaking women of western North Carolina. MATERIALS AND METHODS: Using a cross-sectional survey, a convenience sample of patients completed the survey in exam or interview rooms of an obstetric and gynecology residency program in western North Carolina. Participants included 213 Spanish-speaking women of childbearing age (18 to 44-years-old) presenting for routine care between August 2004 and October 2006. RESULTS: Seventy percent of the sexually active respondents (N = 196) reported inconsistent use of birth control. Only 22% reporting knowing about EC; an additional 26% knew about the morning after pill. Overall, 12% reported previous use of EC. Very few (15%) reported a moral or religious objection to EC. Only 21% reported having discussed EC with a care provider. DISCUSSION: Considerable opportunity exists to expand patient education about all contraceptive options, including EC with Hispanic women of western North Carolina. Language: English Keywords: UNITED STATES OF AMERICA | NORTH CAROLINA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | HISPANICS | EMERGENCY CONTRACEPTION | ATTITUDES | USER COMPLIANCE | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Contraception | Family Planning | Psychological Factors | Behavior Document Number: 330064 |
| 27. Peer Reviewed Title: Ectopic pregnancy following levonorgestrel emergency contraception: a case report. Author: Ghosh B; Dadhwal V; Deka D; Ramesan CK; Mittal S Source: Contraception. 2009 Feb;79(2):155-7. Abstract: Use of levonorgestrel as emergency contraception is a safe and effective measure to prevent unwanted pregnancy. However, ectopic gestation in case of failure is a known risk. Access to levonorgestrel without a prescription in many countries has made it impossible to estimate the exact incidence of this potential adverse event. Thus, spontaneous reporting of cases serves to alert physicians to this possibility. We present a case of ectopic pregnancy following use of levonorgestrel emergency contraception. To our knowledge, this is the first case report from India following introduction of levonorgestrel emergency contraception in 2001. Language: English Keywords: INDIA | RESEARCH REPORT | EMERGENCY CONTRACEPTION | LEVONORGESTREL | CONTRACEPTIVE SAFETY | PREGNANCY, ECTOPIC | PREGNANCY, UNWANTED | Developing Countries | Asia, Southern | Asia | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Safety | Public Health | Health | Pregnancy Complications | Diseases | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population Document Number: 329608 |
| 28. Title: Contraceptive attitudes among inner-city African American female adolescents: Barriers to effective hormonal contraceptive use. Author: Gilliam ML; Davis SD; Neustadt AB; Levey EJ Source: Journal of Pediatric and Adolescent Gynecology. 2009 Apr;22(2):97-104. Abstract: STUDY OBJECTIVE: To better understand the contraceptive attitudes of low-income, inner-city African American female adolescents. DESIGN: We conducted four focus group sessions with African American female adolescents. SETTING: An urban, community health clinic serving low-income patients on Chicago's south side. PARTICIPANTS: African American female adolescents (n = 15) between 14 and 19 years of age. INTERVENTIONS: Focus group sessions lasting approximately 90 minutes in length were conducted using a pre-determined script with set probes and open-ended questions. MAIN OUTCOME MEASURES: Qualitative analysis was conducted to identify major themes related to adolescents' contraceptive attitudes. RESULTS: Six themes related to the contraceptive attitudes of these adolescents emerged: Concerns About Hormones, Concerns About Privacy, Concerns About Compliance, Limited Awareness of New Methods of Hormonal Contraception (HC), Preference for Condoms, and Acceptability of Emergency Contraception (EC). Overall, adolescents in these sessions expressed skepticism and unwillingness to use continuous methods of HC. For some adolescents, concerns about hormones, privacy, and compliance outweighed their concerns about pregnancy. CONCLUSION: Concerns about perceived side effects and long-term health risks associated HC and privacy in obtaining contraception and reproductive health care, as well as concerns about ability to comply with daily and weekly HC regimens are common among African American female adolescents and may deter consistent HC use. Although condoms and EC appear to be highly acceptable among this group, adolescents also report a number of barriers to their consistent use. Efforts to reduce early, unintended pregnancy among African American youth should focus on addressing adolescents' HC-related concerns, improving access to EC, and helping female adolescents effectively negotiate condom use. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | FOCUS GROUPS | BLACKS | LOW INCOME POPULATION | ADOLESCENTS, FEMALE | URBAN POPULATION | ATTITUDES | CONTRACEPTIVE SAFETY | PRIVACY | CONTRACEPTION CONTINUATION | CONDOM USE | CONTRACEPTIVE METHODS | KNOWLEDGE | EMERGENCY CONTRACEPTION | Developed Countries | North America | Americas | Data Collection | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Adolescents | Youth | Age Factors | Psychological Factors | Behavior | Safety | Public Health | Health | Contraceptive Usage | Contraception | Family Planning | Risk Reduction Behavior | Sociocultural Factors Document Number: 330953 |
| 29. Peer Reviewed Title: Exploring emergency contraception knowledge, prescription practices, and barriers to prescription for adolescents in the emergency department. Author: Goyal M; Zhao H; Mollen C Source: Pediatrics. 2009 Mar;123(3):765-70. Abstract: OBJECTIVE: The objective of this study was to assess the proportion of emergency medicine physicians who had prescribed emergency contraception pills to adolescents, to identify potential barriers to emergency contraception pill prescription for adolescents, and to assess physician knowledge of emergency contraception pills. PARTICIPANTS AND METHODS: A cross-sectional, anonymous, Internet-based survey of members of the American Academy of Pediatrics Section of Emergency Medicine was conducted. Providers were included in analysis if they were attending physicians caring for children (<22 years of age) in the emergency department setting >30% of the time. Survey questions included demographics, emergency contraception pill prescription rates for adolescents, attitudes toward emergency contraception pills for adolescents, and emergency contraception pill knowledge questions. RESULTS: A total of 1005 Section of Emergency Medicine members were contacted; 424 (42%) responded, and 133 did not meet inclusion criteria. Of the 291 eligible respondents, 282 had complete surveys. Eighty-five percent of the respondents stated that they had prescribed emergency contraception pills to adolescents, 71% within the previous year. Of those, 81% prescribed emergency contraception pills <5 times. The 5 most frequently cited barriers were concern for lack of follow-up (72%), time constraints (40%), lack of clinical resources (33%), discouraging regular contraceptive use (29%), and concern about birth defects (27%). Thirty-nine percent of respondents identified >/=5 barriers to emergency contraception pill prescriptions for adolescents. Forty-three percent incorrectly answered >50% of the questions. Physicians were more likely to report prescribing emergency contraception pills if they had answered >3 of the knowledge-based questions correctly and were less likely to report prescribing if they identified >5 barriers. CONCLUSIONS: Although a large proportion of emergency department physicians reported prescribing emergency contraception pills to adolescents, the pills were prescribed infrequently. Factors associated with nonprescription were decreased knowledge of emergency contraception pills and identifying >5 barriers. Identification of these potential barriers and education regarding emergency contraception pills may ultimately improve adolescent access to emergency contraception pills in the emergency department. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS | EMERGENCY CONTRACEPTION | PRESCRIPTIONS | FERTILITY CONTROL, POSTCOITAL | CONTRACEPTION | KNOWLEDGE | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Planning | Distributional Activities | Program Activities | Programs | Organization and Administration | Sociocultural Factors Document Number: 330466 |
| 30. Title: [Providing emergency contraceptive pills in pharmacies] Author: Heidarsdottir ML; Almarsdottir AB; Geirsson RT Source: Laeknabladid. 2009 May;95(5):343-347. Abstract: Objective: Use of the levonorgestrel emergency contraception (EC) pill has become more common after being made formally available in pharmacies without prescription. It was investigated how pharmacists in the capital area of Reykjavik supply EC to clients. Material and methods: A total of 46 pharmacists of all working ages and both genders were asked to answer a questionnaire concerning how they sold the emergency contraception pill over the counter (84.8% reply rate). Results: Four of five used <5 minutes to discuss emergency contraception with the client, but almost all enquired about time from intercourse. While only 20% asked about the woman s health, most considered concomitant drug use and potential interaction with levonorgestrel. Only about 50% pointed out that EC did not protect against sexually transmitted disease, (3/4) pointed out the need for permanent contraceptive use, 95% asked about previous EC use, but only 30% would provide EC again in the same menstrual cycle. One half of the pharmacists sold EC to men/teenage boys and wished to assist them with taking responsibility, while the others only sold the drug to the woman. Of those prepared to give the drug to the men, 55% asked to speak over the telephone with the woman to ensure correct prescription and information. Nearly a third would never or rarely provide consultation in private. Conclusions: Pharmacists agree mostly about main points in supplying EC, but not as regards provision to women through their male partners. Provisons for consultation can be improved. Key words: Key contraception, emergency contraception, pregnancy. Correspondence: Reynir Tomas Geirsson, reynirg@landspitali.is. Language: Icelandic Keywords: RUSSIA | RESEARCH REPORT | QUESTIONNAIRES | WOMEN | SEXUAL PARTNERS | EMERGENCY CONTRACEPTION | PREGNANCY | PHARMACY DISTRIBUTION | Developing Countries | Asia, Northern | Asia | Demographic Factors | Population | Sex Behavior | Behavior | Contraception | Family Planning | Reproduction | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 341070 |
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