Abstract
Improved access to effective contraceptive methods is needed in Canada, particularly in rural areas, where unintended pregnancy rates are high and specific sexual health services may be further away. A rural pharmacist may be the most accessible health care professional. Pharmacy practice increasingly incorporates cognitive services. In Canada many provinces allow pharmacists to independently prescribe for some indications, but not for hormonal contraception. To assess the acceptability for the implementation of this innovative practice in Canada, we developed and piloted a survey instrument. We chose questions to address the components for adoption and change described in Rogers’ “diffusion of innovations” theory. The proposed instrument was iteratively reviewed by 12 experts, then focus group tested among eight pharmacists or students to improve the instrument for face validity, readability, consistency and relevancy to community pharmacists in the Canadian context. We then pilot tested the survey among urban and rural pharmacies. 4% of urban and 35% of rural pharmacies returned pilot surveys. Internal consistency on repeated re-phrased questions was high (Cronbach’s Alpha = 0.901). We present our process for the development of a survey instrument to assess the acceptability and feasibility among Canadian community pharmacists for the innovative practice of the independent prescribing of hormonal contraception.
Highlights
Contraception use and access remain an important concern for women wanting to prevent unintended pregnancies [1,2,3,4,5,6]
The draft questionnaires were reviewed by all team investigators, as well as by 12 expert volunteers from a wide variety of fields, including physicians, medical students, nurses, pharmacists and university and hospital-based researchers
Comparison of the responses on these identically themed questions from different parts of the survey yielded a Cronbach’s Alpha of 0.901, indicating a high degree of internal reliability. This survey development and pilot study provided insight into the feasibility of sampling among urban compared to rural pharmacists, as well as demonstrating the internal reliability of the questions, reflecting self-assessed readiness to adopt an innovation within this survey instrument
Summary
Contraception use and access remain an important concern for women wanting to prevent unintended pregnancies [1,2,3,4,5,6]. Canadian surveys on contraception completed from 1993–2002 have found that oral contraception and condoms are the most common contraception methods used to prevent unintended pregnancies [2,3,4,5,6]. Rural access to effective methods of contraception remains an important issue to address. In a 2010 survey of Canadian pharmacists’ perceptions on the future of pharmacy, over 62% of respondents believed that pharmacists need to accept new roles and responsibilities within the healthcare system [10].
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