After the Fact, After the Act’ spotlights EC

How do you get the message out about emergency contraception (EC) to women of color? In Philadelphia, coordinators hit the airwaves with strategically placed radio advertisements and followed up with brochures, fliers, and posters to promote their EC awareness message of "After the Fact, After the Act."

The program was sponsored by the Washington, DC-based Reproductive Health Technologies Project (RHTP), a nonprofit organization that helps provide public education and build understanding of safe, effective reproductive health technologies for women. The Project and the Office of Population Research at Princeton (NJ) University sponsor the Emergency Contraception Hotline, 888-NOT-2-LATE, and its companion Emergency Contraception Web site, http://not-2-late.com.

Hotline call volume following the radio ad campaign increased by 110%, compared with 10 weeks prior to the project, and it remained high for several weeks thereafter, says program assistant Heather Zesiger.

To examine the effectiveness of its existing EC material, RHTP conducted focus groups, says Kirsten Moore, RHTP project manager. Results led to the development of programs for hard-to-reach populations, including low-income urban African-Americans, she says. Funding from an independent health issues philanthropy, Kaiser Family Foundation of Menlo Park, CA, enabled RHTP to retain Motivational Educational Entertainment (MEE) Productions in Philadelphia to coordinate a similar educational campaign in that city.

MEE specializes in socially responsible, research-based communications strategies targeting African-Americans, urban populations, and low-income youth on a wide range of topics, says Moore. It scheduled ads on top urban stations throughout much of July and August 1999 and supplemented them with features on local talk radio shows. The ads used a female narrator to inform audiences that "Sometimes we forget. Sometimes the condom breaks. Sometimes we’re raped. . . . Know that you have a second chance to prevent an unplanned pregnancy. With emergency contraception, it’s not too late to correct a mistake." The ad gave further EC information and directed audiences to their health care providers or the hotline.

To reinforce the campaign message "on the ground," MEE engaged more than 240 community-based organizations and opinion leaders as campaign partners, says Zesiger. The partners ranged from hair and nail salons to residents’ councils in public housing associations. All agreed to distribute brochures, fliers, and posters about emergency contraception and the hotline that were developed for the campaign.

The project and MEE also worked with more traditional partners in the health and family planning communities, including two local organizations, the Family Planning Council and CHOICE of Philadelphia, says Zesiger. Those organizations paid for an additional print run of 30,000 brochures with insert information on local clinics and the CHOICE hotline for distribution throughout their networks, she notes.

The Family Planning Council aided MEE in development of the Philadelphia EC brochure, which was widely distributed during Unity Day, a popular cultural arts event, as well as through the council’s extensive service network, according to Kathie Nixon, CRNP, RNC, the council’s director of patient services.

Believing access to EC goes hand in hand with awareness of the method, the council operates a service provider network to make EC available 24 hours a day, seven days a week. It tracks the network’s prescriptions of both emergent and prophylactic EC. Council figures do not reflect an increase in the number of women coming in for emergent EC during the awareness campaign; however, the campaign may have been too short in duration to impact usage, Nixon surmises.

Women at Genesis II/Caton Village, a Philadelphia drug and alcohol rehabilitation facility, didn’t know much about EC before the campaign started, says Muriel Robinson, a social work counselor at the facility. Robinson used educational material, including the EC brochure distributed through MEE, in group sessions to explore women’s knowledge of EC, contraceptives, and sexually transmitted diseases. Posters about EC were displayed at the facility to keep awareness high.

In discussing contraceptives with the women, Robinson pointed out that methods can fail. When examining different types of condoms, she asked them, "Have you checked a condom for pinholes before it’s used? Do you know if the condom has been previously used?" Those types of questions led women to talk about the need for EC.

Each woman was given three EC brochures, says Robinson, one to keep and two to give sisters, daughters, other family members, and friends as women shared information on the method.

No woman has had to use EC since the awareness program was held, says Robinson. However, the campaign provided an entry into discussion surrounding sexual health that continues to this day, she notes. "Clients continue to keep journals on their attitudes about sex, sexual behaviors, safe sex, and other issues. That is something that I think is really great."