Assessing attitudes about emergency contraception among urban, minority adolescent girls: an in-depth interview study.
OBJECTIVE
The purpose of this work was to explore the knowledge, attitudes, and beliefs of urban, minority adolescent girls about intention to use emergency contraception pills and to identify barriers to emergency contraception pill use.


METHODS
We conducted an in-depth, semistructured interview study of healthy, urban-dwelling, English-speaking 15- to 19-year-old black adolescents seeking care in a children's hospital emergency department. Purposive sampling was used to recruit sexually active and nonsexually active adolescents and those with and without a history of pregnancy. Enrollment continued until saturation of key themes was achieved. Participants returned after their emergency department visit for a 1-hour interview. The interview consisted of semistructured questions based on the theory of planned behavior constructs: attitudes (including knowledge), subjective norms, and perceived behavioral control, as well as demographic data collection. Interviews were recorded and transcribed. Transcripts were coded by 2 members of the study team by using a modified grounded-theory method.


RESULTS
Thirty interviews were required for saturation. Mean participant age was 16.4 years; 53% reported being sexually active, and 17% reported a history of pregnancy. Specific knowledge gaps exist about emergency contraception pills, including misconceptions about the recommended time frame for taking the medication. Several major themes were noted for each of the constructs. Intention to use emergency contraception pills is affected by the conflicting attitudes that the emergency contraception pill works faster than birth control pills and that those who use emergency contraception pills are irresponsible; family and friends are important influences and have uninformed but generally supportive opinions; and adolescents have a perception of limited behavioral control because of their young age and concerns about confidentiality.


CONCLUSIONS
Urban, minority adolescent girls have misconceptions about emergency contraception pills, are affected by the opinions of those close to them, and express concern about specific barriers. These findings can inform specific interventions aimed at addressing the barriers to emergency contraception pill use that are of most importance to this population of young women.
Mollen
Cynthia J
CJ
Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. mollenc@email.chop.edu
Barg
Frances K
FK
Hayes
Katie L
KL
Gotcsik
Marah
M
Blades
Nakeisha M
NM
Schwarz
Donald F
DF
D000293:Adolescent; D001294:Attitude to Health; D003268:Contraception Behavior; D044363:Contraception, Postcoital / Q000523:psychology* / Q000706:statistics & numerical data*; D004522:Educational Status; D004636:Emergency Service, Hospital; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008913:Minority Groups; D010414:Pennsylvania; D011247:Pregnancy / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population