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The Role of Pharmacists and Emergency Contraception: an Assessment of Pharmacy School Curricula in the U.S. and the Knowledge, A

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The Role of Pharmacists and Emergency Contraception: an Assessment of Pharmacy School Curricula in the U.S. and the Knowledge, A University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School 10-15-2008 The Role of Pharmacists and Emergency Contraception: An Assessment of Pharmacy School Curricula in the U.S. and the Knowledge, Attitudes, and Dispensing Practices of Florida Pharmacists. Alice R. Richman University of South Florida Follow this and additional works at: https://scholarcommons.usf.edu/etd Part of the American Studies Commons Scholar Commons Citation Richman, Alice R., "The Role of Pharmacists and Emergency Contraception: An Assessment of Pharmacy School Curricula in the U.S. and the Knowledge, Attitudes, and Dispensing Practices of Florida Pharmacists." (2008). Graduate Theses and Dissertations. https://scholarcommons.usf.edu/etd/476 This Dissertation is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. The Role of Pharmacists and Emergency Contraception: An Assessment of Pharmacy School Curricula in the U.S. and the Knowledge, Attitudes, and Dispensing Practices of Florida Pharmacists. by Alice R. Richman A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Community and Family Health College of Public Health University of South Florida Major Professor: Ellen Daley, Ph.D. Julie Baldwin, Ph.D. Jeffrey Kromrey, Ph.D. Kathleen O’Rourke, Ph.D. Kay Perrin, Ph.D. Date of Approval: October 15, 2008 Keywords: Plan B, Theory of Planned Behavior, Subjective Norms, Perceived Behavioral Control, Intention to Dispense, Mixed Methods © Copyright 2008, Alice R. Richman Dedication To those in the past, present, and future working for reproductive health and freedom. Acknowledgments There are many people who have guided and supported me throughout this process. Dr. Ellen Daley, thank you for being my chair and for your endless support and guidance throughout my doctoral program and in the writing of this dissertation, for being a role model, a friend, for always lifting me up, for believing in me, and for understanding that work should be peppered with laughter. Dr. Julie Baldwin, thank you for your heartfelt support and encouragement throughout my doctoral education and research. Dr. Jeffery Kromrey, thank you for countless hours of statistical guidance, emails on weekends, and for your uncanny ability to make difficult concepts understandable. Dr. Kathleen O’Rourke, thank you for your unswerving support and friendship over the years, your critical eye, and your ability to get me to think critically about methodology and statistics. Dr. Kay Perrin, thank you for your support, your continuous expert advice and feedback on all aspects of my dissertation, and for never being too busy to talk. My parents, Jack and Carol Richman, thank you for your unwavering, unconditional love and support in my academic endeavors and with any life choice I’ve made. I am who I am because of you. My sister, Erica Richman, thank you for your statistical advice and for always being my biggest advocate. Thank you to my grandparents, Sol and Elizabeth Richman, who taught me the value of education and family. And last but not least, thank you to friends and colleagues who provided both emotional and tangible support throughout this journey: Debbie Gulick, Duane Olivier, Lawrence Rosenfeld, Lisa Nugent, Tom Ross, Karissa Morton, and Linda Simkin. Table of Contents List of Tables .......................................................................................................................v List of Figures .................................................................................................................... ix Abstract ................................................................................................................................x Chapter One: Introduction .................................................................................................1 Statement of the Problem .........................................................................................1 History of Emergency Contraception ......................................................................8 Need for the Study .................................................................................................12 Purpose of the Study ..............................................................................................13 Research Questions ................................................................................................14 Assumptions ...........................................................................................................15 Delimitations ..........................................................................................................16 Limitations .............................................................................................................16 Definitions of Relevant Terms ...............................................................................16 Chapter Two: Literature Review .....................................................................................20 Review of Related Research ..................................................................................20 Overview of Emergency Contraception .................................................................21 Epidemiology: Knowledge & Attitudes of Emergency Contraception .................24 Women’s Knowledge.................................................................................24 Women’s Attitudes ....................................................................................27 Health Care Professionals’ Knowledge, Attitudes, & Practice of Emergency Contraception ...................................................................................................30 Provider Knowledge ..................................................................................31 Provider Attitudes ......................................................................................33 Provider Prescribing Practices ...................................................................34 Pharmacists’ Knowledge, Attitudes, & Dispensing Practices of Emergency Contraception ...................................................................................................37 New Literature .......................................................................................................42 Summary & Recommendations for Future Research ............................................43 Women’s Knowledge & Attitudes .............................................................43 Health Care Professionals’ Knowledge, Attitudes, & Practice..................44 Pharmacists’ Knowledge, Attitudes, & Dispensing Practices ...................46 The Theory of Reasoned Action ............................................................................48 The Theory of Planned Behavior ...........................................................................50 i Chapter Three: Methods ...................................................................................................55 Purpose of the Study ..............................................................................................55 Research Questions ................................................................................................56 Overview of Study Design .....................................................................................58 Pharmacy School Curricula Review ......................................................................59 Target Population & Sampling Frame .......................................................59 Sampling Plan ............................................................................................59 Pharmacy Student Focus Groups ...........................................................................62 Target Population & Sampling Frame .......................................................62 Focus Group Discussion Guide .................................................................62 Sampling Plan ............................................................................................64 Pharmacist Questionnaire ......................................................................................67 Target Population & Sampling Frame .......................................................67 Power Analysis—Sample Size ..................................................................68 Sampling Plan ............................................................................................71 Data Collection ......................................................................................................75 Instrument Development ............................................................................75 Measures ....................................................................................................79 Reliability and Validity Measures .............................................................83 Validity: Face, Content, and Construct ......................................................83 Reliability: Stability and Equivalence .......................................................88 Background Characteristics ...........................................................89 Dispensing Practices ......................................................................90 Knowledge
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