The emergency contraceptive pill: a survey of knowledge and attitudes among students at Princeton University

Abstract

Objective: Our purpose was to measure and analyze knowledge and attitudes about emergency contraceptive pills. The hypothesis we tested was that more accurate knowledge about the regimen would be associated with favorable attitudes towards its use.

Study design: We conducted a random sample telephone survey and a series of focus group discussions at Princeton University (results for 11 focus groups are presented elsewhere) A total of 550 undergraduate and graduate students were selected randomly for participation in the survey, and the response rate was 82%. The study's primary outcome measure was attitudes toward the emergency contraceptive pill as a method of fertility control. We used multivariate regression analysis with ordered logit models to test the hypothesized association between knowledge and attitudes.

Results: Basic awareness and approval of the emergency contraceptive pill were widespread, yet students lacked detailed knowledge, which did contribute to health and ethical misgivings about the regimen. Students with accurate information, especially those students who knew that the therapy is a large dose of regular oral contraceptives and that side effects are generally minor, were significantly more likely than others to report favorable attitudes. Many students confused the pills dispensed by the university health services (Oral, Wyeth-Ayerst, Philadelphia) with the abortifacient RU 486. Students noted discussion of the method is rare, and many wanted to know more about it. Statistical results are reported with a 95% confidence level.

Conclusions: Educational efforts should offer specific information about the composition of emergency contraceptive pills, the side effects, and how the regimen works.

PIP: A random survey was conducted using the campus voice mail system among 550 students of Princeton University to determine their knowledge of and attitudes about postcoital contraception (which has been available at the university health center for more than 15 years). The survey elicited a response rate of 82% and included demographic information in the data collected. The results showed that 95% (98% of the undergraduates) of the sample knew about emergency oral contraception (EOC), but 52% of the respondents could not distinguish EOC from RU-486, only 38% knew that the correct time of use was within 72 hours, only 26% knew that EOC was a regimen which used a large dose of combined oral contraceptives, and 25% knew that the effectiveness of EOC is 75%. 54% of the students believed that EOC is associated with unpleasant side effects, and 7% thought there would be serious side effects (this attitude was significantly related to nonendorsement). Only 12% of the students correctly identified the fertile period in the menstrual cycle and understood the timing factors associated with EOC. 80% of the students approved of EOC, and 91% approved in cases of rape. Those who identified themselves as Democrats were significantly more likely to approve, and those who were highly religious were significantly less likely. Ethical concerns were cited by 32% of the respondents, and 57% had health concerns. 84% felt that EOC was readily accessible, but only 43% knew it was available throughout the week. 30% of the students had experience with a situation in which more information about EOC would have been helpful. Regression analysis of these findings revealed that approval was higher among students who knew the ingredients and side effects of EOC, knew of a situation where it would have been helpful, were not religious, and/or were Democrats. Ethical concerns were associated with health concerns, strong religious feeling, Republican affiliation, and a lack of knowledge about ingredients.