Youth in Canada face ongoing challenges to access timely, effective and affordable contraception. Unintended pregnancy can be life-altering, particularly for youth. Youth may experience limits to education and job training, resources for food and shelter, and a poorer start for their children. In spite of universal coverage of contraceptives in some regions, universal access remains a dream. Youth who wish to avoid pregnancy do not always have the ability to use consistent or effective contraception.

The Ask Us Project is a two-part study taking place over four years (2021-2025). Phase 1 is an interview study with youth and service providers. The interviews are conducted by youth peer researchers. Through these interviews we are:

• Investigating the experiences, beliefs, attitudes, knowledge, and contraceptive access needs of youth in Canada (aged 15 to 25) from the perspectives of youth and service providers, and

• Identifying the attributes of contraceptive options that matter most when making decisions about methods to use, from the perspectives of youth and service providers.

After we complete the interviews, we will begin phase 2, a design project to create and test “youth stories.” These stories will communicate the results of our research to youth, health care professionals, and decision makers in Canadian contraception policy and practice.

This project is funded by the Canadian Institutes of Health Research.

By doing this research and understanding contraception access for youth in Canada, we may witness a range of benefits:

• Accelerated use of evidence through the sharing of “youth stories”

• Evidence-based contraceptive policy and practice change to improve youth access

• Improved equity and access to contraception care for youth

• Reductions in unintended pregnancy and need for abortion among youth

• Empowering youth with the skills and capacity to co-lead impactful health research

We are investigating:

1. What are youth and pharmacists’ experiences seeking and prescribing contraception following BC’s implementation of the contraception subsidy and pharmacist contraception prescribing?

2. What factors support or impede access to contraception for youth in BC, specifically through pharmacy access points, from the perspectives of both youth and pharmacists?

3. What methods of prescription contraception do youth and pharmacists choose to request or prescribe, and why?

On April 1st, 2023, BC implemented a first-in-Canada universal no-cost subsidy for prescription contraception. This subsidy covers prescription options like oral contraceptive pills, copper and hormonal intrauterine devices, hormonal injections, subdermal contraceptive implants, vaginal rings, as well as over-the-counter emergency oral contraceptives.

This policy eliminates the burden of cost that is often associated with many prescription contraception methods and increases confidentiality as pharmacists cannot charge fees for dispensing, assessment, or any other action associated with filling the prescription for contraceptives covered under the new contraception subsidy, thus minimizing the paper trail that often existed when pharmacists billed for contraceptives before the subsidy.

On June 1st, 2023, BC pharmacists’ scope of practice expanded to include independent prescribing for hormonal contraception. This second policy expands pharmacists’ scope of practice to include prescribing all forms of hormonal contraception.

Community pharmacists are the most accessible healthcare professionals in BC due to their numbers, broad geographic distribution, and pharmacy operating hours. Thus, people who may not have or have limited access to primary care may access the healthcare system through this expanded route of entry and receive the contraception information and services they desire.