title: "I'll see what I can do": What adolescents experience when requesting emergency contraception.
abstract: OBJECTIVE
  To understand the experiences of adolescent females when they try to obtain emergency contraception (EC) from pharmacies.
  
  
  METHODS
  Female callers, posing as 17-year-old adolescents, used standardized scripts to telephone 943 pharmacies in five United States cities. Two investigators independently coded qualitative data from these calls. Codes were discussed and a thematic analysis was conducted. Investigator, expert, and informant triangulation were used to ensure data credibility.
  
  
  RESULTS
  Four major themes emerged. First, ethical terms (personal or religious) were used to explain institutional pharmacy policies on EC availability. Second, there was confusion about the dispensing regulations regarding EC, given recent changes in United States policies. Third, pharmacy staff often introduced false barriers to EC access. In some cases, pharmacy staff used these barriers as justification for refusing to dispense EC; however, in other cases, pharmacy staff helped the adolescents overcome these false barriers. Finally, the degree of confidentiality in providing EC was unpredictable, with some pharmacies guaranteeing strict confidentiality and others explicitly telling adolescents, incorrectly, that their parents had to be informed.
  
  
  CONCLUSIONS
  Adolescents requesting EC from pharmacies are often explained pharmacy policies in ethics-laden terms, and confidentiality is not always guaranteed. They are told of false barriers to EC access, and there is confusion concerning the evolving policies regarding EC dispensing. It is important for clinicians, pharmacy staff and others to be aware of these experiences as they work to help improve adolescents' access to EC.
authors.affiliation: Department of Pediatrics, Keck School of Medicine/Children's Hospital of Los Angeles, Los Angeles, California. Electronic address: twilkinson@chla.usc.edu.
authors.forename: Tracey A
authors.initials: TA
authors.lastname: Wilkinson
authors.affiliation: Brown University, Hasbro Children's Hospital, Providence, Rhode Island.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Vargas
authors.affiliation: Des Moines University, Des Moines, Iowa.
authors.forename: Nisha
authors.initials: N
authors.lastname: Fahey
authors.affiliation: University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Emily
authors.initials: E
authors.lastname: Suther
authors.affiliation: Department of Pediatrics, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts.
authors.forename: Michael
authors.initials: M
authors.lastname: Silverstein
mesh_terms: D000293:Adolescent; D026688:Bioethical Issues; D003219:Confidentiality; D003281:Contraceptives, Postcoital; D004994:Ethics, Pharmacy; D005260:Female; D033161:Government Regulation; D006297:Health Services Accessibility; D006801:Humans; D007880:Legislation, Drug; D010594:Pharmacies; D014481:United States
chemical_list: D003281:Contraceptives, Postcoital
keywords: Adolescent medicine; Adolescent pregnancy; Adolescent sexual behavior; Adolescents; Contraceptive agents