Unintended pregnancy is a major public health problem in the United States. Half of all pregnancies are unintended with severe economic and social costs. Current contraception education and methods are not adequately addressing the problem of unintended pregnancy. Emergency contraception is a clinical practice of utilizing hormone therapy shortly after sexual intercourse to prevent pregnancy. It is safe, effective, and inexpensive, with pregnancy prevention rates of up to 74%. A pregnancy prevention rate of 74% in the United States would result in one million less abortions a year. Although widely utilized in Europe and Asia for more than twenty years, this practice has been slow to win adoption in the United States. In the last two years there has been considerable effort to promote the provision of emergency contraception in the United States. Quantitative studies have looked at provider and consumer knowledge and utilization of emergency contraception. This presentation explores the barriers and facilitating factors in a large HMO setting affecting the provision of emergency contraception. Providers who have had extensive inservice and organizational support to provide emergency contraception are interviewed to discover what affects their clinical decision-making patterns related to offering or declining to offer information and therapy related to emergency contraception. Diffusion of Innovation Theory and Grounded Theory are the foundation of this study design. Evaluation of provider and consumer education programs including mass media and use of interpersonal communication channels will be discussed. Gaps in current information and future research strategies will be explored.
Learning Objectives: Recognize barriers to obtaining emergency contraception in an HMO setting. Identify provider concerns in providing emergency contraception. Evaluate HMO organizational efforts to educate and influence providers in providing emergency contraception. Discuss how clinical care innovations become a part of the clinical decision-making patterns of health care providers
Keywords: Access to Health Care, Contraception
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.