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Chan YYS, Wan SFR, Li HWR, Lo SST. A revisit of knowledge, attitude and practice of emergency contraception in Hong Kong. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024:bmjsrh-2024-202331. [PMID: 39271236 DOI: 10.1136/bmjsrh-2024-202331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 08/22/2024] [Indexed: 09/15/2024]
Abstract
OBJECTIVES To revisit women's knowledge, attitudes and practices (KAP) regarding emergency contraception (EC) in Hong Kong. The research sought to provide insights for improving the accessibility and quality of EC services. STUDY DESIGN A cross-sectional study, where self-administered questionnaires were distributed at a major community sexual and reproductive health service in Hong Kong over a 3-month period between July 2023 and October 2023. Descriptive and regression analyses were used. RESULTS Of 1127 respondents, the majority (n=1057, 93.8%) reported using contraception and 513 (45.6%) had used EC. The main contraceptive methods used were male condoms and oral contraceptive pills. The majority (n=1035, 91.8%) of respondents demonstrated awareness about EC and 938 (83.2%) participants correctly reported the timeframe for oral EC. Around two-thirds reported the internet as being their leading source of EC knowledge. Over 93% of respondents advocated for enhancing public awareness. Acceptance of non-traditional means of obtaining EC, such as over-the-counter provision (51.3%), pharmacy provision (49.8%) and telemedicine consultation (43.1%), were higher than face-to-face EC consultations (32.9%). CONCLUSIONS Family planning service users' characteristics and KAP regarding EC have significantly changed over the last 20 years. Women now demonstrate greater awareness, knowledge and openness regarding EC, indicating improved readiness for more liberal delivery of EC nowadays. This study highlights the need for restructuring EC service provision in Hong Kong to address women's changing preferences and contraceptive needs, and to minimise barriers to EC access. We recommend reclassifying emergency contraceptive pills as non-prescription drugs in Hong Kong to align with international practice.
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Affiliation(s)
- Yat Yee Shizuka Chan
- Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Hong Kong
| | - Siu Fan Rebecca Wan
- Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Hong Kong
| | - Hang Wun Raymond Li
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, Hong Kong
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Hägglund S, Andtfolk M, Rosenberg S, Wingren M, Andersson S, Nyholm L. Do you wanna dance? Tales of trust and driving trust factors in robot medication counseling in the pharmacy context. Front Robot AI 2024; 11:1332110. [PMID: 39170902 PMCID: PMC11336249 DOI: 10.3389/frobt.2024.1332110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 07/12/2024] [Indexed: 08/23/2024] Open
Abstract
Introduction: The sustainable implementation of socially assistive robots in a pharmacy setting requires that customers trust the robot. Our aim was to explore young adults' anticipations of and motives for trusting robot medication counseling in a high-stakes scenario. Methods: Through a co-creation approach, we co-designed a prototype application for the Furhat platform together with young adults. In-lab testing of a pharmacy scenario, where the robot provides medication counseling related to emergency contraceptive pills, was conducted to deepen our understanding of some factors driving young adults' initial trust establishment and anticipations of interacting with a robot in a high-stakes scenario. Qualitative data from interviews with six study participants were analyzed using inductive, reflexive thematic analysis and are presented through a narrative approach. Results: We outline five tales of trust characterized by personas. A continuum of different anticipations for consulting a robot in medication counseling is presented, ranging from low to high expectations of use. Driving factors in the initial trust establishment process are position, autonomy, boundaries, shame, gaze, and alignment. Discussion: The article adds to the understanding of the dimensions of the multifaceted trust concept, of driving trust factors, and of the subsequent anticipation to trust robots in a high-stakes pharmacy context.
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Affiliation(s)
- Susanne Hägglund
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
| | - Malin Andtfolk
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
| | - Sara Rosenberg
- Pharmaceutical Sciences Laboratory, Faculty of Science and Engineering, Åbo Akademi University, Turku, Finland
| | - Mattias Wingren
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
| | - Sören Andersson
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
| | - Linda Nyholm
- Department of Caring and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Contraception and Abortion. Nurs Womens Health 2024; 28:e13-e16. [PMID: 38573275 DOI: 10.1016/j.nwh.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
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Contraception and Abortion. J Obstet Gynecol Neonatal Nurs 2024; 53:e1-e4. [PMID: 38573294 DOI: 10.1016/j.jogn.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
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Narasimhan M, Hargreaves JR, Logie CH, Abdool-Karim Q, Aujla M, Hopkins J, Cover J, Sentumbwe-Mugisa O, Maleche A, Gilmore K. Self-care interventions for women's health and well-being. Nat Med 2024; 30:660-669. [PMID: 38454127 DOI: 10.1038/s41591-024-02844-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024]
Abstract
The human right to health is universal and non-exclusionary, supporting health in full, and for all. Despite advances in health systems globally, 3.6 billion people lack access to essential health services. Women and girls are disadvantaged when it comes to benefiting from quality health services, owing to social norms, unequal power in relationships, lack of consideration beyond their reproductive roles and poverty. Self-care interventions, including medicines and diagnostics, which offer an additional option to facility-based care, can improve the autonomy and agency of women in managing their own health. However, tackling challenges such as stigma is essential to avoid scenarios in which self-care interventions provide more choice for those who already benefit from access to quality healthcare, and leave behind those with the greatest need. This Perspective explores the opportunities that self-care interventions offer to advance the health and well-being of women with an approach grounded in human rights, gender equality and equity.
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Affiliation(s)
- Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, including the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
| | - James R Hargreaves
- Center for Evaluation, London School of Hygiene and Tropical Medicine, London, UK
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | - Mandip Aujla
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Jane Cover
- Sexual and Reproductive Health Program, PATH, Seattle, WA, USA
| | | | - Allan Maleche
- Kenya Legal & Ethical Issues Network on HIV and AIDS (KELIN), Nairobi, Kenya
| | - Kate Gilmore
- Department of International Development, London School of Economics and Political Science, London, UK
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6
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Vogt EL, Chibber S, Jiang C, Owda R, Caldwell MT, Harris LH, Marsh EE. Trends in Encounters for Emergency Contraception in US Emergency Departments, 2006-2020. JAMA Netw Open 2024; 7:e2353672. [PMID: 38277150 PMCID: PMC10818211 DOI: 10.1001/jamanetworkopen.2023.53672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 12/06/2023] [Indexed: 01/27/2024] Open
Abstract
This cross-sectional study of female emergency contraception users examines emergency contraception–related emergency department use disparities and associations with policy changes.
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Affiliation(s)
- Emily L. Vogt
- University of Michigan Medical School, Ann Arbor
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
| | - Shani Chibber
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
- Department of Obstetrics and Gynecology, University of Texas Southwestern, Dallas
| | - Charley Jiang
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
| | - Rieham Owda
- Complex Family Planning Section, Division of Gynecology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
| | | | - Lisa H. Harris
- Complex Family Planning Section, Division of Gynecology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- Department of Women’s and Gender Studies, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor
| | - Erica E. Marsh
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
- Department of Women’s and Gender Studies, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor
- Michigan Institute of Clinical and Health Research, University of Michigan, Ann Arbor
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Gonsalves L, Kamuyango A, Chandra-Mouli V. Pharmacies: an important source of contraception for some adolescents, but not a panacea for all. Sex Reprod Health Matters 2023; 31:2221883. [PMID: 37417799 PMCID: PMC10332186 DOI: 10.1080/26410397.2023.2221883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Affiliation(s)
- Lianne Gonsalves
- Scientist, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Asantesana Kamuyango
- Technical Officer, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Venkatraman Chandra-Mouli
- Scientist, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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8
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Choi YJ, Lee SH, Yi J, Nho WY. Emergency contraceptive provision in the emergency department and risk analysis for delayed utilization in South Korea. Medicine (Baltimore) 2023; 102:e36195. [PMID: 38013329 PMCID: PMC10681593 DOI: 10.1097/md.0000000000036195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/27/2023] [Indexed: 11/29/2023] Open
Abstract
In certain nations, the emergency department (ED) has been designated as the primary center to provide emergency contraception (EC). However, analyses of ED visits for EC are limited. Moreover, ED-based research that focuses on time is limited to only a few surveys. The aims of this study were to examine the characteristics of ED visitors for EC and the interval between the coitus and arrival at the ED, and to analyze the factors associated with delays in visiting the ED. This retrospective cohort study involved patients at 2 urban tertiary academic hospitals in South Korea. All patients who presented to the ED for EC between January 2019 and December 2021 were analyzed. The median age of the participants was 26 years. The most common variables were age of 20 to 29 years (42.0%), evening visits (34.9%), weekends or public holidays (62.6%), single status (89.2%), and visits after contraceptive failure (79.1%). The mean time interval was 7.49 hours, and 77.4% of all patients visited the ED within 12 hours. Patients who received public sex education presented earlier (P < .001). ED visits after nonconsensual sexual incidents represented significantly delayed presentations (P < .001). Regression analysis revealed that both the lack of public education and the occurrence of nonconsensual coitus were associated with incident-to-ED visit intervals of >12 hours. Most patients received emergency contraceptive pill (ECP) within the recommended timeframe. In particular, nationwide school-based public sex education positively affected early ECP access. In contrast, ECP provision was delayed for patients who experienced nonconsensual coitus. Strategies for timely ECP access should account for possible concerns about stigmatization and privacy.
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Affiliation(s)
- Yoon Jung Choi
- Department of Emergency Medicine, CHA Gumi Medical Center, Gumi, Republic of Korea
| | - Soo Hyung Lee
- Department of Emergency Medicine, CHA Gumi Medical Center, Gumi, Republic of Korea
- Department of Emergency Medicine, School of Medicine, CHA University, Pocheon, Republic of Korea
| | - Jeongsik Yi
- Department of Emergency Medicine, CHA Gumi Medical Center, Gumi, Republic of Korea
- Department of Emergency Medicine, School of Medicine, CHA University, Pocheon, Republic of Korea
| | - Woo Young Nho
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Tavares AI, Ferreira PL, Raposo V, Quintal C. Consumption of Non-Prescribed Drugs in Portugal During the Pandemic in 2021. Int J Public Health 2023; 68:1606021. [PMID: 37546350 PMCID: PMC10397401 DOI: 10.3389/ijph.2023.1606021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives: Portugal liberalised the over-the-counter drugs market in 2005 and provides universal healthcare coverage in a mainly Beveridge-type health system. However, the COVID-19 pandemic has forced healthcare to change how services were delivered, especially increasing remote consultations in primary care. This analysis aims to find the drivers for taking non-prescribed drugs during the pandemic in Portugal. Specifically, it seeks to understand the role of taking prescribed drugs and attending remote medical appointments in the self-medication decision. Methods: In this observational study, we used data collected during the pandemic in Centre Region of Portugal and estimated logistic regression for the whole sample and stratified by sex. Results: The main findings show that people taking prescribed medications and attending a remote consultation are more likely to take non-prescribed drugs. Also, reporting unmet healthcare needs seems to motivate people to choose self-medication. Conclusion: Policy implications are pointed out concerning the health risks raised from self-medication, the role of the pharmacist advising non-prescribed drugs, and the related health risks arising from unmet healthcare needs.
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Affiliation(s)
- Aida Isabel Tavares
- ISEG, UL - Lisbon School of Economics and Management, University of Lisbon, Lisbon, Portugal
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
| | - Pedro Lopes Ferreira
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- FEUC - Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Vitor Raposo
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- FEUC - Faculty of Economics, University of Coimbra, Coimbra, Portugal
- CEBER - Centre for Business and Economics Research, University of Coimbra, Coimbra, Portugal
| | - Carlota Quintal
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- FEUC - Faculty of Economics, University of Coimbra, Coimbra, Portugal
- CEBER - Centre for Business and Economics Research, University of Coimbra, Coimbra, Portugal
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Tavares AI, Ferreira PL, Cavadas V. Factors Contributing to Self-Medication and Consumption of Non-Prescribed Drugs in Portugal. Int J Public Health 2022; 67:1604852. [PMID: 36419733 PMCID: PMC9676243 DOI: 10.3389/ijph.2022.1604852] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 10/17/2022] [Indexed: 08/08/2023] Open
Abstract
Objectives: This work sets out to find the relationship between taking non-prescribed drugs and predisposing, enabling and need factors. Specifically, our main aim is to find the relationship between taking non-prescribed drugs and the lack of health care. Methods: We used data from the last 2019 National Health Survey and estimate logistic regressions for the whole sample and stratified by sex. Results: The most striking finding is that people self-medicating with non-prescribed drugs seem to be replacing health care when this is not used because of financial constraints or distance from provider. This suggests that non-prescribed drugs are a fast, affordable, alternative to health care. Other findings show that income and the financial resources to cope with unexpected expenditure are considerations in taking these drugs. Health and needs are other factors triggering their consumption. Conclusion: Policy measures need to be aimed at improving access to medical care, providing responses to health needs such as those arising from chronic pain, and improving health literacy.
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Affiliation(s)
- Aida Isabel Tavares
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- ISEG, UL - Lisbon School of Economics and Management, University of Lisbon, Lisbon, Portugal
| | - Pedro Lopes Ferreira
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- FEUC - Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Veronica Cavadas
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- USF Marquês de Marialva, ACES Baixo Mondego, Coimbra, Portugal
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