A Survey of Teenagers' Attitudes Toward Moving Oral Contraceptives Over the Counter Open Access

Manski, Ruth (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/ht24wj99c?locale=en


Introduction: Evidence suggests that over-the-counter access to oral contraceptives may improve contraceptive access and use among adult women. Teenagers may particularly benefit from over-the-counter access, as they experience disproportionately high rates of unintended pregnancy and face unique challenges accessing contraception. However, limited research has explored teenagers' attitudes toward over-the-counter access.

Methodology: During September 2014, 348 females aged 14-17 were recruited via Facebook advertisements to participate in an online survey to assess teenagers' attitudes toward over-the-counter access and understanding of how to use oral contraceptives based on reading a prototype over-the-counter product label. Descriptive statistics and bivariate analyses were conducted using SPSS; Pearson chi-square and Fisher's exact tests were conducted for categorical outcomes and independent t-tests and one-way ANOVA for continuous outcomes.

Results: Seventy-three percent of participants reported being in favor of over-the-counter access and 61% reported that they would be likely to use oral contraceptives through over-the-counter access. Participants who had sex were significantly more likely to be interested in using over-the-counter access (77%) compared to participants who had not had sex (48%). Participants understood an average of 7.1 of 8 key concepts that the prototype over-the-counter product label was intended to convey; no significant differences were found among subgroups.

Discussion: Participants in this sample are interested in using oral contraceptives over the counter and can understand how to use an over-the-counter product. These findings, in combination with evidence documenting the safety and effectiveness of over-the-counter access, support continued exploration of reclassification of oral contraceptives to over-the-counter status without age restriction.

Table of Contents

Chapter 1: Introduction. 1

Introduction and Rationale. 1

Problem Statement. 1

Purpose Statement. 3

Significance Statement. 3

Definition of Terms. 5

Chapter 2: Comprehensive Review of the Literature. 7

Unintended Pregnancy and Contraceptive Use Among Teenagers. 7

Over-the-Counter Access to Oral Contraceptive Pills. 8

Safety of Over-the-Counter Access to Oral Contraceptive Pills. 10

Contraceptive Continuation Among Over-the-Counter Users. 14

Attitudes Toward Over-the-Counter Access to Oral Contraceptive Pills. 14

Over-the-Counter Access to Oral Contraceptive Pills under the Affordable Care Act. 19

Chapter 3: Manuscript. 22

Introduction. 26

Methods. 28

Results. 32

Discussion. 35

Tables. 41

Chapter 4: Conclusions and Implications. 47

References. 51

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