Pharmacy staff perceptions and self-reported behaviors related to providing contraceptive information and counseling.

OBJECTIVE: To evaluate pharmacy staff perspectives of a 2-year pharmacy intervention aimed at reducing unintended pregnancy in 18- to 30-year-old women. DESIGN: Pharmacy staff completed a 48-item, self-administered paper survey consisting of scaled and open-ended questions. SETTING: 55 community pharmacies in 12 Iowa counties. PARTICIPANTS: All pharmacy staff participated, including pharmacists, pharmacy technicians, and other pharmacy employees. INTERVENTION: Online continuing education (CE) training was made available to all pharmacy staff. Promotional materials including posters, brochures, and shelf talkers were displayed in all of the pharmacies. MAIN OUTCOME MEASURES: Pharmacy staff perceptions and self-reported behaviors related to displaying posters, brochures, and shelf talkers in their pharmacies and providing contraceptive information and counseling to patients/customers. RESULTS: A total of 192 (43% return rate) pharmacy staff responded. Only 44% of respondents consistently provided contraceptive information and counseling, yet more than 90% felt that talking with patients/customers about contraceptives was easy, and more than 50% could do so privately. The study showed increased pharmacy staff desire to make this topic a priority. CONCLUSION: Community pharmacy staff can play a key role in educating and counseling young adult women about contraceptive health and pregnancy planning. This study indicates that staff are comfortable providing this service and that patients/customers are open to receiving guidance from pharmacists. However, pharmacy staff are missing additional opportunities to provide information and counseling. There is also a need for greater attention to provision of nonprescription contraceptive education.

Impact of a passive social marketing intervention in community pharmacies on oral contraceptive and condom sales: a quasi-experimental study.

BACKGROUND: Almost 50% of pregnancies in the United States are unwanted or mistimed. Notably, just over one-half of unintended pregnancies occurred when birth control was being used, suggesting inappropriate or poor use or contraceptive failure. About two-thirds of all women who are of reproductive age use contraceptives, and oral hormonal contraceptives remain the most common contraceptive method. Often, contraceptive products are obtained in community pharmacies. The purpose of this study was to determine whether a pharmacy-based intervention would impact sales of contraceptive products in pharmacies. METHODS: This study was conducted in Iowa and used a quasi-experimental design including 55 community pharmacies (independent and grocery) in 12 counties as the intervention and 32 grocery pharmacies in 10 counties as a comparison group. The passive intervention was focused towards 18-30 year old women who visited community pharmacies and prompted those of childbearing age to "plan your pregnancy" and "consider using birth control". The intervention was delivered via educational tri-fold brochures, posters and 'shelf talkers.' Data sources for evaluation were contraceptive sales from intervention and comparison pharmacies, and a mixed negative binomial regression was used with study group*time interactions to examine the impact of the intervention on oral contraceptive and condom sales. Data from 2009 were considered baseline sales. RESULTS: From 2009 to 2011, condom sales decreased over time and oral contraceptives sales showed no change. Overall, the units sold were significantly higher in grocery pharmacies than in independent pharmacies for both contraceptive types. In the negative binomial regression for condoms, there was an overall significant interaction between the study group and time variables (p = 0.003), indicating an effect of the intervention, and there was a significant slowing in the drop of sales at time 3 in comparison with time 1 (p < 0.001). There was a statistically significant association between pharmacy type and study group, where the independent intervention pharmacies had a higher proportion of stores with increases in condom sales compared to grocery pharmacies in the intervention or comparison group. CONCLUSIONS: A passive community pharmacy-based public health intervention appeared to reduce the decrease in condom sales from baseline, particularly in independent pharmacies, but it did not impact oral contraceptive sales.

Unlocking the condoms: the effect on sales and theft / Liberando los condones: el efecto en ventas y robos

Community pharmacies may place condoms in locked displays or behind glass, thereby reducing access and consequent use. Objective: Quantify sales and theft of condoms when condoms were unlocked and removed from behind glass in grocery pharmacies Methods: Design. In this pilot study, condom displays were unlocked in selected pharmacies for three months. Participants. Eight grocery pharmacies in central Iowa agreed to participate. Intervention. Stores provided inventory at baseline, sales/theft thereafter in three monthly reports and sales for the same period one-year earlier. Outcome measures. Descriptive statistics quantified condom theft and sales. Number of pharmacies leaving condoms unlocked after the intervention was determined. Results: Theft varied by pharmacy and ranged from an average of 1.33 boxes (units) per month to 27.33 per month. All stores experienced some increase in sales during the intervention. Two locations decided to re-lock their displays, only one indicated theft as the reason. Conclusion: After removing condoms from locked displays, more condoms were purchased and stolen from the study pharmacies. Sales outweighed theft in all pharmacies (AU)

Las farmacias comunitarias pueden situar los condones en estanterías cerradas o detrás de un cristal, reduciendo así el acceso y consiguientemente el uso. Objetivo: Cuantificar las ventas y el robo de condones cuando están libres y retirados de detrás de un cristal en las farmacias. Métodos: Diseño. En este estudio piloto, se abrieron las estanterías de los condones en unas farmacias seleccionadas durante tres meses. Participantes. Ocho farmacias en el centro de Iowa aceptaron participar. Intervención. Las farmacias proporcionaron el inventario al principio, informes de las ventas/robos en los tres meses posteriores y las ventas para ese mismo periodo de un año antes. Medidas de resultados. La estadística descriptiva cuantificó las ventas y robos de condones. Se determinó el número de farmacias que dejaron los condones abiertos después de la intervención. Resultados: Los robos variaron por farmacia y oscilaron entre una media de 1,33 cajas (unidades) por mes a 27,33 por mes. Todas las farmacias experimentaron algún aumento en las ventas durante la intervención. Dos establecimientos decidieron volver a cerrar los expositores de condones, y sólo uno indicó el robo como causa. Conclusión: Después de retirar los condones de los expositores cerrados, se vendieron y robaron más condones en las farmacias estudiadas. Las ventas sobrepasaron los robos en todas las farmacias (AU)

Unlocking the condoms: The effect on sales and theft.

UNLABELLED: Community pharmacies may place condoms in locked displays or behind glass, thereby reducing access and consequent use. OBJECTIVE: Quantify sales and theft of condoms when condoms were unlocked and removed from behind glass in grocery pharmacies. METHODS: Design. In this pilot study, condom displays were unlocked in selected pharmacies for three months. Participants. Eight grocery pharmacies in central Iowa agreed to participate. Intervention. Stores provided inventory at baseline, sales/theft thereafter in three monthly reports and sales for the same period one-year earlier. Outcome measures. Descriptive statistics quantified condom theft and sales. Number of pharmacies leaving condoms unlocked after the intervention was determined. RESULTS: Theft varied by pharmacy and ranged from an average of 1.33 boxes (units) per month to 27.33 per month. All stores experienced some increase in sales during the intervention. Two locations decided to re-lock their displays, only one indicated theft as the reason. CONCLUSION: After removing condoms from locked displays, more condoms were purchased and stolen from the study pharmacies. Sales outweighed theft in all pharmacies.

Fourth-year dental students' perceived barriers to providing tobacco intervention services.

In order to facilitate effective tobacco cessation services within dental school clinics, it is necessary to understand the perceived barriers encountered by dental students while providing these services. The aim of this study was to identify which factors fourth-year dental students perceive to be associated with barriers to providing tobacco intervention services. A written survey was developed and completed by incoming fourth-year dental students (a convenience sample of seventy students) at the University of Iowa College of Dentistry in 2008. The survey assessed the perceived barriers to providing tobacco intervention services and related factors. Descriptive, bivariate, and linear regression analyses were conducted. The response rate was 97 percent. The most frequently reported barriers were patients' resistance to tobacco intervention services (96 percent), inadequate time available for tobacco intervention services (96 percent), and forgetting to give tobacco intervention advice (91 percent). The following variables were significantly (p<0.05) related to greater perceived barriers in providing tobacco intervention services: lower "adequacy of tobacco intervention curriculum coverage of specific topics covered over the previous three years" and greater "perceived importance of incorporating objective structured clinical examination teaching method for learning tobacco intervention." Students probably could benefit from additional didactic training, but most important may be enhanced clinical experiences and faculty reinforcement to facilitate effective practical student learning and adaptation for future delivery of intervention services in private practice settings.

The cooperative University of Iowa / Iowa State University MPH program.

Public health is an important component of veterinary medicine. In the last 10 years, there has been growing recognition of the need to increase the number of veterinarians trained in public health. The Center for Food Security and Public Health (CFSPH) at Iowa State University (ISU), College of Veterinary Medicine, received a grant from the Centers for Disease Control and Prevention (CDC) to support veterinarians working at CFSPH while pursuing the Master of Public Health degree. CFSPH and ISU administrators worked with the University of Iowa (UI) College of Public Health to establish three cooperative programs for veterinarians to earn the MPH degree. This article describes how these programs were developed and how they operate. (1) Between 2002 and 2005, CFSPH used funds provided by the CDC to support 15 veterinarians as they worked for CFSPH and toward the MPH degree. As the program grew, distance-education methods such as the Internet, Polycom videoconferencing, and the Iowa Communications Network (ICN) were incorporated. (2) A concurrent DVM/MPH degree is now offered; students can complete both degrees in four years. As of January 2008, three students have received their DVM and MPH degrees and 16 students are enrolled in the program. (3) In June 2007, the UI and ISU launched a distance MPH program for veterinarians working in private practice, industry, and government. Eight veterinarians are participating in the program, which includes two two-week, in-person summer sessions, with the remainder of the coursework taken at a distance via the Internet.

Barriers to children having a medical home in Johnson County, Iowa: notes from the field.

BACKGROUND: In Iowa 70.7% of children who qualify for Title XIX and/or Title V services have a medical home, but in Johnson County, Iowa only 54.0% of such children have one. Objectives Identify barriers to access to a medical home for children who use Johnson County Public Health (JCPH) services and recommend strategies to overcome these barriers. METHODS: Families with children attending JCPH well-child and WIC clinics were randomly selected to be interviewed using a semi-structured, 38-item questionnaire. Data analysis used qualitative and quantitative methodologies. RESULTS: Among 71 families interviewed, 41 had children without a medical home and 85% of these families cited financial barriers. Lack of U.S. citizenship accounted for 59% without health insurance. A recent move contributed to 29% not having medical homes. Nine different languages were spoken among the 41 families without a medical home. Forty-one percent of all parents interviewed had never had a medical home themselves. Many parents perceived emergency departments as more convenient than doctors' offices. CONCLUSIONS: Lack of health insurance, due primarily to citizenship status, is the greatest barrier to access to a medical home in this population. The migratory nature of the U.S. population, marked cultural diversity, and parental attitudes were additional barriers to children's access to a medical home. Strategies to overcome these barriers are discussed.

Predicting tobacco sales in community pharmacies using population demographics and pharmacy type.

OBJECTIVE: To determine whether the population demographics of the location of pharmacies were associated with tobacco sales in pharmacies, when controlling for pharmacy type. DESIGN: Retrospective analysis. SETTING: Iowa. PARTICIPANTS: All retailers in Iowa that obtained tobacco licenses and all pharmacies registered with the Iowa Board of Pharmacy in 2003. MAIN OUTCOME MEASURE AND INTERVENTIONS: Percentage of pharmacies selling tobacco (examined by pharmacy type using chi-square analysis); median income and distribution of race/ethnicity in the county for pharmacies that did or did not sell tobacco (t tests); predictors of whether a pharmacy sold tobacco (logistic regression using the independent variables county-level demographic variables and pharmacy characteristics). RESULTS: County gender composition, race/ethnicity make-up, and income levels were different for tobacco-selling and -nonselling pharmacies. Logistic regression showed that whether a pharmacy sold tobacco was strongly dependent on the type of pharmacy; compared with independent pharmacies (of which only 5% sold tobacco products), chain pharmacies were 34 times more likely to sell tobacco products, mass merchandiser outlets were 47 times more likely to stock these goods, and grocery stores were 378 times more likely to do so. Pharmacies selling tobacco were more likely to be located in counties with significantly higher numbers of multiracial groups. CONCLUSION: The best predictor of whether an Iowa pharmacy sells tobacco products is type of pharmacy. In multivariable analyses, population demographics of the county in which pharmacies were located were generally not predictive of whether a pharmacy sold tobacco.

Knowledge and attitudes about smoking cessation among pharmacy technicians.

OBJECTIVE: To evaluate the knowledge and attitudes of pharmacy technicians before and after attending a continuing education program about smoking cessation. DESIGN: A pre/post survey of a single group. SETTING: Two statewide meetings of the Iowa Pharmacy Association. PARTICIPANTS: Pharmacy technicians. INTERVENTION: One 2-hour continuing education (CE) course about smoking cessation for pharmacy technicians. MAIN OUTCOME MEASURES: Changes in scores before and after the CE sessions among three domains (knowledge, efficacy, and outcome) of a validated survey instrument. RESULTS: Fifty-one technicians completed both the presession and postsession questionnaire. For the three survey domains, technicians' knowledge (P = .034), efficacy (P < .001), and outcome (P < .001) showed significant improvement between the presession and postsession surveys (Wilcoxon signed rank test). CONCLUSION: Pharmacy technicians who attended a CE program on smoking cessation improved their knowledge, attitudes, and self-confidence in helping smokers quit. Additional research should be conducted to test the role of pharmacy technicians in smoking cessation promotion.

Smoking-cessation services in Iowa community pharmacies.

STUDY OBJECTIVE: To examine community pharmacy practice with regard to providing smoking-cessation counseling. DESIGN: Mailed survey. SETTING: Iowa community pharmacies. PARTICIPANTS: A stratified random sample of pharmacists statewide. MEASUREMENTS AND MAIN RESULTS: Descriptive statistics were computed for all study variables. Fisher exact test or chi2 analysis was performed on selected variables to determine the relationship of each item with pharmacists routinely offering smokers suggestions for quitting. Responses from 129 (38.2%) of 338 pharmacists indicated that although most felt it is important to offer smoking-cessation counseling, about half actually offer this service. Most pharmacists indicated they are prepared to provide counseling, but fewer than 25% had received formal training or were aware of national clinical practice guidelines. Those who had received specific training (p=0.020) or recently attended an educational program (p=0.014) on smoking cessation were more likely to counsel smokers. Primary barriers to providing counseling were lack of time, inability to identify smokers, low patient demand, and lack of reimbursement. CONCLUSION: Our findings suggest that opportunities exist for improving pharmacist education and reducing practice barriers in order to bridge the gap between pharmacists' knowledge and attitudes related to smoking-cessation counseling and their provision of patient counseling in community pharmacy practice.