Practice Of Emergency Contraception Research Articles

Impact of Individual Values on Adherence to Emergency Contraception Practice Guidelines Among Pediatric Residents

To evaluate the impact of individual, system, and interpersonal factors on emergency contraception practices. We hypothesized that abortion attitudes and attitudes toward teen sex would be significant individual factors influencing emergency contraception practices. This was a cross-sectional, anonymous Internet survey. Four pediatric residency programs in the Baltimore, Maryland-Washington, DC, metropolitan area during April to June 2007. One hundred forty-one pediatric residents completed the survey. Abortion attitudes were assessed by participants' level of agreement with abortion in 7 scenarios. Attitudes toward teen sex were assessed by participants' level of agreement with 5 statements about the acceptability of teens having sex. Emergency contraceptive counseling behavior was assessed by reported frequency of including emergency contraception in routine contraceptive counseling. Intention to prescribe emergency contraception was assessed by reported likelihood of prescribing in 5 scenarios. When controlling for demographics and other predictors, residents with less favorable abortion attitudes were more likely to have the lowest intention to prescribe emergency contraception. Residents with more positive attitudes toward teen sex and who had a preceptor encourage emergency contraception prescription were more likely to include emergency contraception in routine contraceptive counseling most/all the time and to have the highest intention to prescribe. Efforts to challenge and affect attitudes toward teen sex and to prompt residents to prescribe emergency contraception in clinical settings may be needed to encourage more proactive emergency contraceptive practice in accordance with national practice guidelines.

O409 Knowledge, attitude and practice of emergency contraception in women requesting termination of pregnancy

O409 Knowledge, attitude and practice of emergency contraception in women requesting termination of pregnancy

Perception and Practice of Emergency Contraception among Female Undergraduates of the University of Ibadan, Nigeria

Objective To assess perception and level of proper utilization of emergency contraception (EC) among female undergraduates. Methods Cross-sectional questionnaire study was performed on 383 female undergraduates in Nigeria in June 2006. Data analysis was with χ-square test and logistic regressions (P Results One hundred and five (48.2%) 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 emergency contraceptive drugs in future due to lack of awareness (64.8%), and fear for future fertility and of drugs being injurious to health. Use of EC was associated with awareness of correct interval for use (OR=9.1; 95%CI: 2.1-39.9). Conclusion There is poor knowledge about EC and poor use, while significant need remains. Most knowledge was acquired from peers and inaccurate. Peer educators are important and professionals' knowledge needs improvement.

Predicting Certified Nurse-Midwives' Counseling and Prescribing Practices of Emergency Contraception

Purpose: Test the adequacy of the theory of planned behavior (TPB) to explain the influences that attitudes and beliefs, subjective norm, and perceived behavioral control have on certified nurse-midwives' (CNMs') intentions to counsel and prescribe emergency contraception (EC) to women; examine EC knowledge, counseling, and prescribing practices of CNMs. Research Question: What is the effect of attitudes and beliefs, subjective norms, and perceived behavioral control on CNMs' intentions to counsel women about and prescribe EC? Hypothesis: Midwives' prescribing and counseling practices will be influenced by constructs of the TPB. Significance/Background: EC is a safe and effective method to reduce unintended pregnancy. Few studies have been dedicated to understanding CNMs' prescribing and counseling patterns of EC. Methods: This study was guided by a descriptive correlational design and used an electronic survey for data collection. Structural equation modeling was used to test the adequacy of the TPB to explain CNMs' intentions to counsel and prescribe EC. Findings: The TPB was found to be a valid theoretical framework for predicting intention of CNMs to counsel and prescribe EC to women and provided insights to the multiple influences on CNMs' intention to counsel and prescribe EC to women. CNMs are overwhelmingly in favor of EC as a means to reduce unintended pregnancy. Discussion: Policies within CNM practice settings such as those requiring a provider visit may reduce access to EC for women.

Emergency Contraception for Sexual Assault Victims in North Carolina Emergency Departments

One in 5 women is a victim of sexual assault. This study examines the administration of emergency contraception to victims of sexual assault in North Carolina hospital emergency departments. One hundred seventeen surveys were mailed to hospital emergency departments across the state to determine their emergency contraception practices for victims ofsexual assault. The survey contained 11 questions about emergency contraception practices for victims. Of the 117 surveys, 103 were returned revealing that just over 50% of the hospitals in North Carolina treated victims with emergency contraception without exception. Both dispensing emergency contraception and providing information about emergency contraception were significantly associated with having a sexual assault nurse examiner program. Results from this study demonstrate inconsistent provision of emergency contraception to victims of sexual assault; however, there is greater consistency of emergency contraception use by emergency departments using sexual assault nurse examiners.

A survey of knowledge, attitudes and practice of emergency contraception among university students in Cameroon.

BackgroundUnsafe abortion is a major public health problem in low-and-middle income countries. Young and unmarried women constitute a high risk group for unsafe abortions. It has been estimated that widespread use of emergency contraception may significantly reduce the number of abortion-related morbidity and mortality. The purpose of this study was to evaluate the knowledge, attitudes and experiences on emergency contraceptive pills by the university students in Cameroon in order to develop and refine a national health programme for reducing unwanted pregnancies and their associated morbidity and mortality.MethodsA convenient sample of 700 students of the University of Buea (Cameroon) was selected for the study. Data was collected by a self-administered, anonymous and pre-tested questionnaire.ResultsThe response rate was 94.9% (664/700). General level of awareness of emergency contraceptive pills was 63.0% (418/664). However, knowledge of the general features of emergency contraceptive pills was low and misinformation was high among these students. Knowledge differed according to the source of information: informal source was associated with misinformation, while medical and informational sources were associated with better knowledge. Although the students generally had positive attitudes regarding emergency contraceptive pills, up to 65.0% (465/664) believed that emergency contraceptive pills were unsafe. Those with adequate knowledge generally showed favourable attitudes with regards to emergency contraceptive pills (Mann-Whitney U = 2592.5, p = 0.000). Forty-nine students (7.4%) had used emergency contraceptive pills themselves or had a partner who had used them.ConclusionAwareness of emergency contraception pills by Cameroonian students is low and the method is still underused. Strategies to promote use of emergency contraception should be focused on spreading accurate information through medical and informational sources, which have been found to be reliable and associated with good knowledge on emergency contraceptive pills.

Misconception of emergency contraception among tertiary school students in Akwa Ibom State, South-south, Nigeria.

To assess the degree of awareness and use of emergency contraception among tertiary school students inAkwa Ibom State, Nigeria. A self-administered questionnaire survey. The Akwa Ibom State Polytechnic, Ikot Osurua, located on the outskirts of Ikot Ekpene local government area between 1stApril 2002 and 31st April 2002. 1,000 randomly selected female students ofthe Akwa Ibom State polytechnic, Ikot Osurua The students were aged between 16 and 43 years. Five hundred and eighty-nine (68.5%) of the respondents had heard of products that could be used as emergency contraceptives. However, only 49 (5.7%) of the respondents had practised some form of emergency contraception, which was most commonly practised by those between 16 and 25 years (71.4%). Menstrogen (30.6%), gynaecosid (24.5%), and quinine (14.3%) were the most common medications used for emergency contraception. Patent medicine dealers (40.9%) and friends/course mates (29.7%) were the most common sources of knowledge about emergency contraception. This study shows that awareness and use of emergency contraception by our youths is low. Community enlightenment about emergency contraception using specifically designed programmes, the formation of reproductive health clubs in our tertiary institutions and training of peer group educators in all our communities are advocated. Patent medicine dealers in our communities should have basic training in modern contraceptive methods and periodic evaluation should be carried out to assess their knowledge and practice of emergency contraception.

Knowledge and practice of emergency contraception among female undergraduates in the University of Lagos, Nigeria

To assess the level of knowledge and practice of emergency contraception among female undergraduates in University of Lagos and to determine the factors that influence knowledge and practice of emergency contraception among female undergraduates. Cross-sectional descriptive study. The University of Lagos, Lagos, South-West, Nigeria between August 2003 and March 2004. Four hundred and eighty randomly selected female undergraduate students. The findings revealed that 67.8% of the respondents reported knowing about emergency contraception. More than half (56.1%) were sexually active and of this group, 96.8% had ever practiced contraception with only 33.9% having ever practiced emergency contraception. However, only 37.8% and 36.3% of respondents who had reported knowing about emergency contraception knew the correct time frame for effective use, and correctly identified emergency contraceptives respectively. Among those who were aware of, and had used emergency contraception, 34.1% obtained their information from health care providers, while the larger majority obtained from friends. Knowledge and practice of emergency contraception was found to be directly related to age, level of study, medical education, marital status, sexual activity, previous history of use of contraceptives and previous history of induced abortion. Education efforts that focus on the training of health care providers and young adults on emergency contraception with regards to available methods and correct timing of use would greatly improve women's access to and effective use of this method in Nigeria.

Providers' knowledge of, attitude to and practice of emergency contraception

Objectives Barriers to widespread use of hormonal emergency contraceptives (EC), such as lack of knowledge and prejudices held by health-care providers, still exist today. This study was initiated to evaluate the knowledge, attitudes and prejudices of family-planning (FP) providers.Methods This survey was conducted in FP units of primary-health-care centers in Istanbul. A total of 180 providers were interviewed in 80 units to whom a questionnaire was administered by face-to-face technique.Results One-hundred and fifty-two of the providers stated that they had heard of EC. The correct timing and dose interval of EC were known by 50% of them. The participants held the belief that EC caused abortion (39.4%), and that it was harmful for the fetus (31.1%). Other prejudices were the possibility of increased unprotected sexual intercourse (78.9%) and a tendency for men to give up condom use (75%); female providers were more prejudiced concerning these statements. The providers' tendency towards the provision of counseling was significantly related to their prejudices (p = 0.011, p = 0.033) and to the application rate (p = 0.000).Conclusion Providers need more detailed information about EC. During FP training courses, the providers should be encouraged towards counseling EC which would increase the application rate of the users and decrease their own prejudices.

Knowledge and attitudes towards emergency contraception of health-care providers in a region with a high birth rate

Objective To assess the knowledge of, attitude towards and practices of emergency contraception among health-care providers at a university hospital located in a region with a high birth rate.Methods The survey was conducted among 214 health-care providers working at a university hospital located in eastern Turkey.Results Two hundred participants completed the questionnaire. Of the respondents, 26.0% said that they did not know anything about emergency contraception, while the remaining 74.0% said that they knew about at least one of the methods of emergency contraception. But among these, the knowledge of 38.5% of the participants about emergency contraception was accurate and that of 61.5% was inaccurate. Thirty-four percent of the respondents stated that they had previously required personally to use emergency contraceptive methods. The most commonly used emergency contraceptive methods were oral contraceptives (69.1%) and intrauterine device (14.7%). None of the respondents knew anything about mifepristone and levonorgestrel.Conclusion There is a knowledge deficit among health-care providers who play a significant role in the dissemination of the information about emergency contraception.

Emergency Contraception: A Global Overview of Knowledge, Attitudes and Practices Among Providers

Context: Recent concerns over teenage pregnancy, abortion and sexuality have pushed emergency contraceptive methods to the fore once again. The studies on knowledge and attitudes of providers are of particular importance, as they will have direct effects on potential users of emergency contraception. Aim/Method: This paper is a critical and systematic review of available literature relevant to knowledge, attitude and practice of emergency contraception among providers. Literature was reviewed from the late 1980s to date, with articles accessed using PUBMED and MEDLINE through the Internet. Relevant references from published articles were also used to source more information. All articles were published in English. It summarises the work done so far in this area, with indications for future research. Result: Most of the studies are in developed countries with very little research in developing countries. Most studies undertaken have been through telephone interviews, postal surveys, and focus group discussions. Some provider studies are targeted at a specific subtype of health professionals or different clinic settings. Majority of studies, however, point to the fact that knowledge of emergency contraception is poor among family planning service providers. Conclusion: Women must know that it is possible to prevent pregnancy after an unprotected intercourse before they can look for this service. Knowledge of emergency contraception is therefore crucial for its use. Training and re-training of health professionals is needed to improve knowledge and increase awareness. Emergency contraception is financially, psychologically and physically less burdensome than abortion. Key Words: Post-Coital, Contraception, Family Planning Services. [Trop J Obstet Gynaecol, 2003, 20: 153-158]

Emergency contraception: knowledge, attitude, and practices among health care providers in North India.

The present study was conducted to assess knowledge, attitude, and practice of emergency contraception in health care providers and users in North India. A survey was carried out with the help of a predesigned questionnaire comprising of two groups of clients (abortion seekers at Family Welfare center, and non-medical college students (prospective clients)); and 4 groups of health care providers (gynecologists, general practitioners, paramedical workers, and medical students). Practically none of the clients were familiar with the concept of emergency contraception and so the rest of the information could not be obtained from them and hence this was excluded from further analysis. Many providers (84.8% gynecologists, 41.0% general practitioners, 2.7% paramedical workers, and 64.4% medical students) were vaguely familiar with the concept of emergency contraception, very few knew accurately about timing and doses. The majority of these thought it to be an essential component of contraceptive services but preferred distribution through health care providers only. The practice of emergency contraception as reported in the present survey was inconsistent. Yuzpe regimen was the most commonly used method and nausea/vomiting were the commonest side-effects. The question of efficacy of emergency contraception was not answered reliably by the health care providers. Awareness about emergency contraception among the general population and paramedical workers studied is practically nonexistent. Precise knowledge about emergency contraception among doctors (both gynecologists and general practitioners) is also inadequate. Prescription practices can improve by generating demand and training of health care providers.

Perception and Practice of Emergency Contraception by Post-Secondary School Students in Southwest Nigeria

A survey of 1500 students in post-secondary institutions in southwest Nigeria showed that the concept of emergency contraception (EC) was well known. Respectively, 32.4%, 20.4% and 19.8% knew that combined pills, progesterone only pills and intrauterine contraceptive device (IUCD) were usable for EC, while 56.7% mentioned the use of traditional methods. Only 11.8% had ever used either pills or IUCD and 10.7% had used a traditional method. Few students (11.5% and 2.3% respectively) knew the correct timing of EC pills and IUCD. The respondents reported varying circumstances under which EC was indicated but the majority cited condom breakage and sexual assault. The popular media represent the commonest source of information while hospitals/clinics were the commonest sources of procurement. About 37% of the respondents planned to use EC in future while 58% would not and 4.7% were uncertain. Reasons for these responses were explored.

Knowledge and practice of emergency contraception among Nigerian youths

The knowledge and use of regular or emergency contraceptives (ECs) among Nigerian youths were assessed by a survey conducted among students with previous clandestine abortions in five higher institutions in Southwest Nigeria. 1000 questionnaires were distributed with a response rate of 75.8%. Analysis was made of the records of 166 respondents with previous clandestine abortions. Sexual intercourse was first experienced at a mean age of 15.7 +or- 3.6 years (range 11-24 years) while the mean number of induced abortions was 2.2 +or- 1.8 (range 1-14). Although most of the respondents were aware of the concept of EC only 30.1% knew about emergency contraceptive pills (ECPs) and 10.2% knew about the IUD. The percentage of those knowledgeable about ECPs and the IUD was highest among student nurse/midwives students in 26-30 years age group single respondents and Protestants. These results suggest that awareness and use of ECPs and the IUD by the respondents are inadequate but could be improved through readily available information.