Impact of Over-the-Counter Availability of Emergency Contraception on Uptake, Pregnancy, and Births

非处方紧急避孕药对服用、怀孕和分娩的影响

• 批准号: 9766376
• 负责人: Chloe E. Bird
• 金额: $ 24.14万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-17 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9766376
• 关键词: Abortion Rates; Address; Affect; American; Behavioral Risk Factor Surveillance System; Birth; Birth Rate; Community Surveys; Consumption; Contraceptive methods; Data; Data Analyses; Data Set; Data Sources; Ethnic Origin; Ethnic group; Face; Hispanics; Hour; Improve Access; Individual; Infant Health; Knowledge; Laws; Light; Maternal Health; Measures; Mental Health; Methods; Minority; Mission; Mothers; Names; Not Hispanic or Latino; Outcome; Outcome Study; Parental Consent; Pharmaceutical Preparations; Pharmacy facility; Physicians; Plan B; Policies; Population; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Progestins; Proxy; Public Health; Race; Research; Risk; Teenagers; Time; Unsafe Sex; Variant; Visit; Woman; Work; age group; base; economic outcome; emergency contraception; follow-up; health disparity; health economics; high risk sexual behavior; improved; innovation; interest; minority health; physical conditioning; racial and ethnic; racial difference; social; socioeconomics; theories; tool; unintended pregnancy; uptake; young woman

Project Summary Access to various contraceptive methods and associated laws on parental consent have changed over time and across states in the U.S. In particular, progestin-only emergency contraception (EC)—also known by the brand name Plan B—has been subject to changing access laws at both the state and federal levels. The most significant change in access to EC since its release was its FDA approval as an over-the-counter (OTC) medication in 2006, where previously it had been available by prescription only. Improving ease of access to Plan B may have a substantial impact on both EC uptake and efficacy. Previous research has had limited follow-up, used data that lacked the appropriate denominators, and was largely unable to measure the uptake of EC; such research also did not examine differences by race and ethnicity, in particular among Hispanic women and non-Hispanic Black women. For multiple socioeconomic reasons, visiting a physician to obtain a prescription for EC may present differential barriers to access for these populations. Thus, there is a critical need to understand the impact of OTC access to EC on uptake and pregnancy and birth rates. Our objective is to meet this critical need by studying the impact of the 2006 approval of Plan B. Based on our preliminary data analyses, the central hypothesis is that increased access to EC because of OTC availability will result in increased uptake and lower pregnancy and birth rates. This project will use data from three data sources—the Nielsen Consumer Panel, American Community Survey, and Behavioral Risk Factor Surveillance System—to address the following specific aims: (1) measure the effect of OTC availability of EC on uptake and overall pregnancy and birth rates, and (2) measure the differential impact of OTC availability of EC on pregnancy and birth rates among racial/ethnic groups that are most likely to have unintended pregnancies—Hispanic women, non-Hispanic Black women, and teenagers. Using these three data sources, we will conduct difference-in- differences analyses to study the outcomes of interest. This research is innovative because it uses data sources that allow us to examine the long-term impact of increased access to EC using detailed, individual- level data. It is also the first study to examine differences by race and ethnicity. The proposed research is significant because it will shed light on the effect of increased access to EC on the rate of unintended pregnancy; unintended pregnancies resulting in births are associated with poorer maternal and infant health outcomes, impacts on physical and mental health, and negative economic outcomes. This research will benefit vulnerable minority populations and promote public health by providing evidence on a simple policy tool (improved access to EC) that may have a substantial impact on reducing unintended pregnancy.

项目摘要 随着时间的流逝，访问各种避孕方法和有关父母同意的相关法律已经改变 尤其是在美国的各州，仅孕激素的紧急避孕（EC） - 也是 品牌计划B - 在州和联邦一级都受到不断变化的访问法律的约束。最多 由于其发布是因为它作为非处方（OTC），因此获得EC的访问权限发生了重大变化。 2006年的药物，以前仅通过处方获得。提高易于使用的便利性 计划B可能会对EC的吸收和效率产生重大影响。以前的研究有限 随访，使用缺乏适当分母的数据，并且在很大程度上无法测量吸收 ec;这样的研究也没有检查种族和种族的差异，特别是在西班牙裔中 妇女和非西班牙裔黑人妇女。出于多种社会经济原因，拜访身体以获得 EC的处方可能会出现这些人群访问的差异障碍。那是一个关键的 需要了解OTC访问EC对摄取，妊娠和出生率的影响。我们的目标是 通过研究2006年批准B的影响。根据我们的初步数据 分析的中心假设是，由于OTC的可用性，增加获得EC的访问将导致 增加摄取和降低妊娠和出生率。该项目将使用来自三个数据源的数据 - 尼尔森消费小组，美国社区调查和行为风险因素监视系统 - 解决以下特定目的：（1）衡量EC的OTC可用性对吸收和整体的影响 怀孕和出生率，以及（2）衡量EC的OTC可用性对怀孕和 种族/族裔的生日率最有可能患有意外怀孕 - 他的妇女， 非西班牙裔黑人妇女和青少年。使用这三个数据源，我们将进行差异 差异分析以研究感兴趣的结果。这项研究具有创新性，因为它使用数据 使我们能够使用详细的，个体的 - 级别数据。这也是第一个研究种族和种族差异的研究。拟议的研究是 意义重大，因为它会阐明获得EC的访问对意外率的影响 怀孕;意外怀孕结果与较差的母子和婴儿健康有关 结果，对身心健康的影响以及负面的经济成果。这项研究将受益 脆弱的少数民族人口并通过在简单政策工具上提供证据来促进公共卫生 （改善获得EC的机会）可能会对减少意外怀孕产生重大影响。