Krishnamurti Tamar, Eggers Sara L, Fischhoff Baruch
Carnegie Mellon University, Social and Decision Sciences, 208 Porter Hall, 5000 Forbes Avenue, Pittsburgh, PA 15213, United States.
Soc Sci Med. 2008 Aug;67(4):618-27. doi: 10.1016/j.socscimed.2008.04.016. Epub 2008 Jun 5.
In ruling on the over-the-counter status (OTC) of the emergency contraceptive, "Plan B", the US Food and Drug Administration (FDA) questioned whether younger adolescent females could adequately self-select and self-medicate. That determination requires a judgment of fact, regarding how increased emergency contraceptive availability would affect adolescents' behavior, and a judgment of values, regarding the acceptability of different outcomes. We present a general approach to such problems, using analytical and empirical methods grounded in behavioral decision research. We illustrate it with findings from 30 in-depth interviews and follow-up surveys, with adolescent females aged 13-19 in the Pittsburgh area reporting how Plan B availability would affect three decisions (having sex, choosing contraceptives, using Plan B). Although the FDA expressed concern about younger teens using Plan B as their primary form of contraception, neither younger nor older teens revealed such an intention. However, teens preferred easier availability, should emergency contraceptive be needed. Incorporating an understanding of teens' decision-related perspectives can make such policies more predictable and transparent.
在对紧急避孕药“紧急避孕丸”（Plan B）的非处方状态进行裁决时，美国食品药品监督管理局（FDA）质疑年龄较小的青春期女性是否能够充分地自我选择和自我用药。这一判定需要对事实进行判断，即增加紧急避孕药的可获得性将如何影响青少年的行为，以及对价值观进行判断，即不同结果的可接受性。我们提出了一种针对此类问题的通用方法，运用基于行为决策研究的分析方法和实证方法。我们通过对匹兹堡地区13至19岁的青春期女性进行的30次深度访谈和后续调查结果进行说明，这些女性报告了紧急避孕丸的可获得性将如何影响三个决定（发生性行为、选择避孕措施、使用紧急避孕丸）。尽管FDA对年龄较小的青少年将紧急避孕丸作为主要避孕方式表示担忧，但年龄较小和较大的青少年均未表现出这样的意图。然而，青少年表示，如果需要紧急避孕药，她们更希望其更容易获得。理解青少年与决策相关的观点能够使此类政策更具可预测性和透明度。
