Hovel Elizabeth, Pickett Michelle, Visotcky Alexis, Porada Kelsey, Ehrman Wendi, Thew Margaret, McFadden Vanessa
Medical College of Wisconsin, Department of Pediatrics, Division of Adolescent Medicine, Milwaukee, Wisconsin.
Medical College of Wisconsin, Department of Pediatrics, Division of Emergency Medicine, Milwaukee, Wisconsin.
J Pediatr Adolesc Gynecol. 2025 Aug;38(4):504-508. doi: 10.1016/j.jpag.2025.03.006. Epub 2025 Mar 17.
Following the US Supreme Court's Dobbs vs Jackson Women's Health (Dobbs) decision and subsequent changes to abortion access, increasing emergency contraception (EC) access for adolescents is vital. The first step is understanding providers' knowledge, attitude and practices regarding EC post-Dobbs.
This cross-sectional internet-based survey was sent to providers within 3 general pediatric primary care systems from November 2023 to January 2024. Questions addressed EC knowledge, attitudes (perceived barriers and desired support to increase EC prescription) and practices post-Dobbs.
There were 51 participants. Most (81%) providers felt adolescent EC prescription was more important post-Dobbs, but very few (7%) had increased their own prescribing practices. Overall, providers had a mean knowledge score of 71%. Providers closer to training had a higher EC knowledge score (77% vs 68%, P = .02), as did providers who were generally willing to provide EC (72% vs 58%, P = .004). Providers in urban and rural areas were more likely to have prescribed EC than suburban counterparts (54% urban, 40% rural, 16% suburban, P = .04). Various barriers were elicited, most commonly relating to lack of awareness and knowledge about EC. Over half of respondents noted they would be more likely to prescribe EC with clinical decision support built into the EMR (69%), an order set in the electronic medical record (57%), and education sessions (55%).
This study highlights a strong need to bolster provider EC education in pediatrics and address systems factors that will facilitate easier, more confident EC prescription.
在美国最高法院对多布斯诉杰克逊妇女健康案（多布斯案）做出裁决以及随后堕胎可及性发生变化之后，增加青少年获得紧急避孕（EC）的机会至关重要。第一步是了解医疗服务提供者在多布斯案之后关于紧急避孕的知识、态度和做法。
这项基于网络的横断面调查于2023年11月至2024年1月发送给3个普通儿科初级保健系统内的医疗服务提供者。问题涉及紧急避孕知识、态度（感知到的障碍以及增加紧急避孕处方所需的支持）以及多布斯案之后的做法。
共有51名参与者。大多数（81%）医疗服务提供者认为在多布斯案之后为青少年开具紧急避孕处方更为重要，但很少有人（7%）增加了自己的处方行为。总体而言，医疗服务提供者的平均知识得分是71%。接受培训时间更近的医疗服务提供者紧急避孕知识得分更高（77%对68%，P = 0.02），一般愿意提供紧急避孕的医疗服务提供者也是如此（72%对58%，P = 0.004）。城市和农村地区的医疗服务提供者比郊区的同行更有可能开具紧急避孕处方（城市为54%，农村为40%，郊区为16%，P = 0.04）。引发了各种障碍，最常见的是与对紧急避孕缺乏认识和了解有关。超过一半的受访者指出，他们在电子病历中内置临床决策支持（69%）、电子病历中的医嘱集（57%）以及教育课程（55%）的情况下更有可能开具紧急避孕处方。
本研究凸显了大力加强儿科医疗服务提供者紧急避孕教育以及解决有助于更轻松、更自信地开具紧急避孕处方的系统因素的强烈需求。
