Graduation Year

2008

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Community and Family Health

Major Professor

Ellen Daley, Ph.D.

Keywords

Plan B, Theory of Planned Behavior, Subjective Norms, Perceived Behavioral Control, Intention to Dispense

Abstract

Emergency contraception is a safe and effective form of contraception that is 75%-89% effective in preventing pregnancies within 120 hours of unprotected intercourse. Emergency contraception is a type of hormonal contraception, containing high doses of estrogen and progestin (ethinyl estradiol plus levonorgestrel) or progestin only (levonorgestrel). Wider access to emergency contraception has the potential to decrease the number of unintended pregnancies and abortions in the U.S. The Food and Drug Administration (FDA) has previously denied any over-the-counter (OTC) access to emergency contraception and only recently approved it for OTC status for women 18 years old and over; therefore, pharmacists continue to play a critical role in providing access to emergency contraception. For example, pharmacists can answer women's questions, dispel misconceptions, advise medical colleagues, and provide important information about the medication to clients.

Although emergency contraception is a safe and effective medication, many pharmacists and pharmacies throughout the U.S. have either refused to fill prescriptions of emergency contraception or have refused to carry and stock emergency contraception. Pharmacists' perceptions and practice affect whether women have access to this form of contraception and whether pharmacies carry this medication. In addition, pharmacists' behavior, professional conduct, and ethical practice and training have major implications for public health and access to care for women, children, and families. This study has two purposes: First, because the attitudes and dispensing practices among pharmacists may be related to their understanding of the medication, a review of pharmacy school curricula in the U.S. was conducted, and involved (a) an assessment of course content related to emergency contraception and (b) an analysis of how this content is perceived by pharmacy students.

The second purpose of the study is to assess emergency contraception knowledge, attitudes, subjective norms, perceived behavioral control, and dispensing practices of pharmacists and to determine if pharmacists' emergency contraception knowledge, attitudes, subjective norms, and perceived behavioral control are predictive of their dispensing practices. To reach these ends, a mixed-methods study design was employed using mixed methods data analysis techniques including coding methods, univariate, bivariate, and logistic regression.

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