Adolescent perceptions of facilitators and barriers to emergency contraception access

BACKGROUND:  Understanding teens’ perceptions of emergency contraception (EC) is critical to increasing appropriate EC use.

METHODS:  This mixed-methods study used data from 72 teens (ages 14-18, 89% female, 60% non-Hispanic white) in Minnesota who participated in TeensTalkHealth, a web-based sexual health intervention, during 2011-2012. Teens watched a video vignette about EC, then completed a brief survey and message-board discussion. We used an inductive approach to identify themes in qualitative data and multivariable logistic regression for quantitative data.

RESULTS: Almost half of teens (46%) reported having either used EC at least once or wanting to use EC and not being able. Key themes in teens’ message-board comments included perceived barriers to EC access (limited knowledge and misconceptions, young age, timing) and social influences (parents, peers, partners). Teens described peers as key supports but felt that parents could be facilitators or barriers to EC. Survey data indicated that two-thirds of teens (66%) were very confident that they could access EC and almost half (47%) thought parents would facilitate access in a way that made them feel good. In multivariable analyses, teens with higher levels of peer support had greater confidence that they could access EC (OR=3.9) and teens with higher levels of family support had greater odds of thinking parents would positively facilitate access (OR=3.5)(both p<.05).

CONCLUSION:  While recent regulations make EC available without a prescription to teens under age 17, our findings point to other factors that will be important to address if expanded access is to lead to increased use.