One in six American women will be raped in her lifetime, which can result in pregnancy, injury, sexually transmitted infections, post-traumatic stress disorder, a need to seek forensic and victim services, and potential legal system involvement for safety and prosecution (Tjaden &Thoennes, 2006). However, there is a gap in the literature on how the over-the-counter (OTC) status of Plan B(R) may impact contact with a healthcare provider because such limitation has the potential to affect the comprehensive care completed rape survivors will receive. The purpose of this mixed method study is to examine the impact of OTC Plan B(R) on survivors who might otherwise receive gold standard comprehensive care. A feminist perspective will frame this study. The data collection and analysis plan are informed by the PI's content specific integration of a nursing model, the Interaction Model of Client Health Behavior and a theory suited to public health phenomena, Bronfenbrenner's Ecological Systems Theory. This model will guide the use of a concurrent mixed method approach to meet the specific aims of 1) using an anonymous survey to quantify missed opportunities for desired care and 2) using a participatory action framework and open-ended questions to assess the conceptual model and post-assault Plan B(R) users'desire for interventions to facilitate access to all elements of comprehensive care. We will recruit participants from university based pharmacies in Michigan while they are obtaining Plan B(R). All participants will be asked to answer an anonymous questionnaire. Specifically, all participants accessing Plan B(R) will complete a questionnaire labeled the "Yellow Questionnaire" which will include questions related to the study's conceptual framework taken from the Survey on Women's Health Issues. Those identifying as completed rape survivors will answer the "Blue Questionnaire" with questions from the Sexual Experiences Survey. The results of this interdisciplinary research study will provide insight into the use of the PI's mode in evaluating missed opportunities for care and will help inform interventions for completed rape survivors using Plan B(R) who are at risk of not receiving comprehensive care. This project is the initial step for a doctoral student in a long-term research trajectory focused on completed rape survivors, Plan B(R), and efficacious interventions for comprehensive care.

Public Health Relevance

Now that emergency contraception (Plan B(R)) is available at the pharmacy without prescription, survivors of completed rape may self-treat to prevent pregnancy and forego the other five elements of comprehensive care: care for injuries, sexually transmitted infection prophylaxis, mental health referrals, forensic and victim services, and justice system involvement. This mixed method study will quantify potential missed opportunities for care, will provide insight into the use of the PI's model in evaluating missed opportunities fo care, and will elicit survivors'desires for alternative access to comprehensive care.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Predoctoral Individual National Research Service Award (F31)
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National Institute of Nursing Research Initial Review Group (NRRC)
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Banks, David
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University of Michigan Ann Arbor
Schools of Arts and Sciences
Ann Arbor
United States
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Munro-Kramer, Michelle L; Fava, Nicole M; Saftner, Melissa A et al. (2016) What are we missing? Risk behaviors among Arab-American adolescents and emerging adults. J Am Assoc Nurse Pract 28:493-502
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Lori, Jody R; Munro, Michelle L; Rominski, Sarah et al. (2013) Maternity waiting homes and traditional midwives in rural Liberia. Int J Gynaecol Obstet 123:114-8
Lori, Jody R; Munro, Michelle L; Moore, Jennifer E et al. (2013) Lessons learned in Liberia: preliminary examination of the psychometric properties of trust and teamwork among maternal healthcare workers. BMC Health Serv Res 13:134
Munro, Michelle L; Foster Rietz, Melissa; Seng, Julia S (2012) Comprehensive care and pregnancy: the unmet care needs of pregnant women with a history of rape. Issues Ment Health Nurs 33:882-96