Keywords

Italy, Emergency Contraception, Qualitative Methods, Diffusion of Innovations, Messaging Strategy

Select the category the research project fits.

Social Sciences/Humanities

Is this submission part of ICaP/PW (Introductory Composition at Purdue/Professional Writing)?

No

Abstract

Background: Italy's 2015 emergency contraception (EC) policy has increased access and reduced some barriers for women to obtain EC. EC is now available over-the-counter for individuals 18 years and older; however, women living in Italy continue to face knowledge and access barriers. Conscientious objection, where providers and pharmacists refuse to prescribe or dispense EC due to personal beliefs, further complicates access and dissemination. Objective: The purpose of the current paper is to understand EC knowledge, attitudes, and behaviors among women living in Italy. Additionally, a secondary purpose is to explore the impact of the 2015 EC policy. Methods: Thirty in-person interviews were conducted among women living in or around Florence, aged 18 to 50 years, and using the Italian healthcare system at the time of study enrollment. Researchers used an expanded grounded theory approach to understand women's experiences with EC with diffusion of innovations serving as a conceptual lens for data analysis. HyperRESEARCH, a data management system, assisted with open and axial coding and theme development. Results: Women described low observability of the 2015 policy, expressing surprise regarding increased EC availability. Participants suggested increased messaging in strategic locations to overcome this barrier. Participants held both positive and negative attitudes toward EC. While some perceived the relative advantage of EC compared with unintended pregnancy, others expressed concerns about irresponsibility and EC safety. Finally, conscientious objection impacted healthcare access, despite participant desire for autonomous EC decision-making, suggesting support for increased EC access despite provider barriers. Discussion: Findings offer practical recommendations to guide EC messaging in Italy to increase women's knowledge and to empower women’s access. Additionally, opportunities for communication strategies and access campaigns to improve attitudes and increase knowledge and uptake of over-the-counter EC are discussed.

Download

Share

COinS
 

Translating policy to practice: Theory-based formative research to improve EC OTC access and messaging in Italy

Background: Italy's 2015 emergency contraception (EC) policy has increased access and reduced some barriers for women to obtain EC. EC is now available over-the-counter for individuals 18 years and older; however, women living in Italy continue to face knowledge and access barriers. Conscientious objection, where providers and pharmacists refuse to prescribe or dispense EC due to personal beliefs, further complicates access and dissemination. Objective: The purpose of the current paper is to understand EC knowledge, attitudes, and behaviors among women living in Italy. Additionally, a secondary purpose is to explore the impact of the 2015 EC policy. Methods: Thirty in-person interviews were conducted among women living in or around Florence, aged 18 to 50 years, and using the Italian healthcare system at the time of study enrollment. Researchers used an expanded grounded theory approach to understand women's experiences with EC with diffusion of innovations serving as a conceptual lens for data analysis. HyperRESEARCH, a data management system, assisted with open and axial coding and theme development. Results: Women described low observability of the 2015 policy, expressing surprise regarding increased EC availability. Participants suggested increased messaging in strategic locations to overcome this barrier. Participants held both positive and negative attitudes toward EC. While some perceived the relative advantage of EC compared with unintended pregnancy, others expressed concerns about irresponsibility and EC safety. Finally, conscientious objection impacted healthcare access, despite participant desire for autonomous EC decision-making, suggesting support for increased EC access despite provider barriers. Discussion: Findings offer practical recommendations to guide EC messaging in Italy to increase women's knowledge and to empower women’s access. Additionally, opportunities for communication strategies and access campaigns to improve attitudes and increase knowledge and uptake of over-the-counter EC are discussed.