Physicians' intention to educate about emergency contraception.

BACKGROUND AND OBJECTIVES: Our objective was to examine the intention of academic primary care physicians to educate women about emergency contraception (EC) and whether differences in their intention varies with patient situation, knowledge and attitudes about EC, gender, or specialty. METHODS: As part of a larger cross-sectional survey about intention to prescribe EC with 96 faculty physicians from one Southern and three Midwestern universities, we analyzed factors associated with intention to educate patients about EC. Physicians were from departments of family medicine, obstetrics-gynecology, and pediatrics. RESULTS: The main outcome variable was intention to educate about EC. Attitudes and perceived peer expectations on educating about EC predicted physicians' intentions to provide EC education to their patients. Neither knowledge about EC nor physician demographics predicted intention to educate. Almost one in five respondents were reluctant to provide education to sexually active adolescents. Physicians who had high intention to educate were more likely than others to believe that educating about EC enhances a woman's reproductive options and that EC education reduces unintended pregnancy and abortion. Providers with low intention to educate were more likely to consider EC education to be inconvenient and to take too much clinic time. CONCLUSIONS: To maximize training programs, physicians' attitudes, beliefs, and professional expectations should be examined when designing and initiating educational interventions.

Using Photovoice to improve family planning services for immigrant Hispanics.

In a participatory action research program called Photovoice, Hispanic immigrants in a Midwestern community took photographs to provide researchers with insight regarding family planning. This report describes the Photovoice approach, why the researchers chose it, how they implemented it, what they learned, and the benefits derived for a larger service project.

Abstinence-only programs as a violation of adolescents' reproductive rights.

For most young women and young men throughout the world, adolescence is a time for the discovery and expression of sexuality. The process of this essential human behavior often occurs without accurate information about normal development, physiological processes, and the potential physical, social, and psychological results of sexual exploration. Much of the insufficient information available to adolescents in the United States and elsewhere is not accidental, but can be directly attributed to U.S. government policies, some of which infringe upon the human and reproductive rights of adolescents. Established U.S. policy that promotes abstinence-only programming through selective funding is a violation of adolescent reproductive rights, both at home and abroad. The authors explore why receiving accurate and appropriate sex education is a basic human right for adolescents, and provide suggestions about effective ways to address violations of this right.

Social well-being in pregnant women: intended versus unintended pregnancies.

The relationship between pregnancy intention (unintended versus intended pregnancy) and social well-being was examined in a sample of 72 pregnant, mostly low-income women attending Women, Infants, and Children programs and prenatal clinics in a midwestern community. Feelings of happiness about giving birth and the extent to which having a baby would fill a void in one's life were also examined. Pregnancy intention was significantly associated with reduced social support. Feelings of happiness about having the baby positively correlated with all domains of social support and negatively correlated with loneliness and family relationship problems. The belief that having a baby could fill a void in a woman's life was strongly correlated with perceived loneliness. Interventions to increase social support and to address areas of stress for women whose pregnancies are unintended are recommended. Future research in larger random samples is needed to better test these associations and to make recommendations for specific practice interventions to increase social well-being.

Using the theory of reasoned action to explain physician intention to prescribe emergency contraception.

CONTEXT: Although research has examined providers' knowledge, attitudes and prescribing behaviors with regard to emergency contraception, none has used a theory-based approach to understanding the interplay of these factors. METHODS: A cross-sectional survey of 96 faculty physicians from one Southern and three Midwestern universities was conducted in 2004 to assess factors associated with intention to prescribe emergency contraception. The theory of reasoned action guided the study hypotheses and survey design. Correlation and regression analyses were used to examine the data. RESULTS: Only 42% of respondents strongly intended to prescribe emergency contraception for teenagers, but 65-77% intended to do so for all other specified groups (women who ask for the method, who have had a method problem, who have experienced rape or incest, and who have had unprotected sex). Consistent with the theory of reasoned action, high intention to prescribe emergency contraception was associated with positive attitudes toward doing so and with the perception that specific colleagues or professional groups support prescribing it; however, the perception of support by colleagues or professional groups in general did not predict intention. Also consistent with the theory, physicians' knowledge about emergency contraception and their demographic characteristics were not significant. CONCLUSIONS: Interventions to encourage physicians to provide emergency contraception should take into account their attitudes toward the method and the components of those attitudes.