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

项目摘要 随着时间的推移，获得各种避孕方法的机会和关于父母同意的相关法律发生了变化 特别是，仅孕激素紧急避孕药（EC）-也被称为 品牌名称Plan B-已经受到州和联邦两级不断变化的访问法律的影响。最 自其发布以来，EC获得的重大变化是FDA批准其为非处方药（OTC） 在2006年，该药物在以前只能凭处方获得。改善获得服务的便利性 计划B可能对EC吸收和疗效产生重大影响。以前的研究有限， 后续，使用的数据缺乏适当的替代品，并且在很大程度上无法衡量吸收 这种研究也没有研究种族和民族的差异，特别是西班牙裔之间的差异。 非西班牙裔黑人女性。出于多种社会经济原因，访问医生以获得 EC处方可能会对这些人群的获取造成不同的障碍。因此，有一个关键的 需要了解非处方药获得EC对摄取率、妊娠率和出生率的影响。我们的目标是 通过研究2006年核准计划B的影响来满足这一关键需求。根据我们的初步数据 分析，中心假设是，由于非处方药的可用性增加， 增加摄入量，降低怀孕率和出生率。这个项目将使用来自三个数据源的数据 尼尔森消费者小组、美国社区调查和行为风险因素监测系统 解决以下具体目标：（1）衡量非处方药可获得性对摄取和总体的影响 妊娠率和出生率，以及（2）测量EC的OTC可用性对妊娠的不同影响， 最有可能意外怀孕的种族/民族群体的出生率-西班牙裔妇女， 非西班牙裔黑人女性和青少年利用这三个数据源，我们将进行差异化- 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 来源，使我们能够研究增加获得EC的长期影响，使用详细的，个人的， 水平数据。这也是第一个研究种族和民族差异的研究。拟议的研究是 重要的是，它将揭示增加获得EC对意外死亡率的影响。 怀孕;导致分娩的意外怀孕与孕产妇和婴儿健康较差有关 结果，对身心健康的影响，以及负面的经济后果。这项研究将有利于 通过提供关于简单政策工具的证据， （改善获得EC的机会），这可能对减少意外怀孕产生重大影响。

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.