P129 Feasibility of Implementing Emergency Contraception in Chicago Municipal Sexually Transmitted Infection Clinics: A Focus Group Study

Tuesday, March 9, 2010
Pre-Function Lobby & Grand Ballroom D2/E (M4) (Omni Hotel)
Santina Wheat, BA1, Corinne Blum, MD2, William Wong, MD3, Amit Nathani, BS, MSc4 and Emily Godfrey, MD, MPH1, 1Department of Family Medicine, University of Illinois College of Medicine, Chicago, IL, 2Division of STI/HIV/AIDS, STI/HIV Prevention & Control Services, Chicago Department of Public Health, Chicago, IL, 3STI/HIV Prevention and Control Services Section, Division of STI/HIV/AIDS, Chicago Department of Public Health, Chicago, IL, 4College of Medicine, University of Illinois College of Medicine, Chicago, IL

Background: Women at risk for sexually transmitted infections (STI) are also at risk for unintended pregnancies. Since many high-risk women attend STI clinics for clinical services, CDC recommends counseling and provision of emergency contraception pills (ECP) by STI practitioners.

Objectives: (1) To assess barriers among clinical staff at municipal STI clinics regarding ECP implementation for women seeking services; (2) To develop recommendations for ECP implementation within public STI clinics.

Methods: A focus group of staff from four Chicago Department of Public Health (CDPH) STI Clinics was conducted to assess perceived barriers, benefits, and disadvantages to ECP implementation. Common themes from transcripts were identified and compared to recent major newsprint media articles discussing ECPs.

Results: Four CDPH staff attended the focus group. All (100%) participants were female, including two (50%) nurse practitioners, one (25%) physician, and one (25%) clinic supervisor. Potential implementation barriers included: limited clinician time, ECP supply, and whether ECP provision is within the clinical mission. Implementation recommendations included: needed policies, protocols, and staff training. Respondents identified the major benefit of ECP implementation as increased access (and thus greater prevention of unwanted pregnancy) for patients, particularly teenagers. Recent news articles discussing ECPs frequently contained information about morality and federal ECP policies, which contrasted themes identified within the focus group.

Conclusions: STI staff reported concerns about policies and procedures regarding ECP implementation, rather than specific objections to ECPs. This study suggests staff members are receptive to ECP implementation if procedural barriers are addressed. Unlike the media themes, staff did not focus on moral concerns and controversies in federal ECP policies.

Implications for Programs, Policy, and/or Research: A comprehensive administrative implementation plan may allow for successful ECP provision within public STI clinics. ECP provision within STI clinics may have a public health impact on unintended pregnancy in high-risk populations.

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