| Summary: | Background: Emergency contraception (EC) effectively reduces the risk of pregnancy following unprotected or under-protected sexual intercourse. EC has recently become available without a prescription in Canada and the USA in order to improve its availability and use, especially by young women. At the same time, the Internet is increasingly relied on as a source for health information, and Internet use is now nearly universal in younger age groups. Nevertheless, how people use the web to look for information about EC, and the qualities of information they find, are not well understood. The objectives of this thesis were to: (1) investigate the change in Internet search patterns for EC-related search terms in Canada and the USA over time and through shifts in EC-related policy and (2) assess the qualities (e.g., credibility, readability) and source (e.g., financial affiliations) of web-based information available about EC. Methods: The impact of policy changes in Canada and the USA on Internet search volume was estimated using interrupted time series analysis for two search terms:“morning after pill” and “Plan B”. Quality ratings and readability scores were generated for the ten most frequently found websites in Canada and the USA. Results: Policy changes making EC available without a prescription in Canada and the USA appear to have had an impact on information-seeking patterns online for EC-related search terms. The university-based website ec.princeton.edu and Wikipedia (en.wikipedia.org) were found frequently in searches for EC-related search terms in both countries. The website sponsored by the makers of Plan B®, www.planb.ca, was found most frequently in Canadian searches. All websites achieved fair to medium ratings in a systematic quality assessment, and 14 (83%) of websites had a reading grade level higher than the reading grade levels recommended for written health information. Discussion: Regulatory changes making EC available without a prescription appear to have affected the frequency with which people look online for information about EC. Public health agencies may want to improve the quality, readability and prominence of their web pages in online searches for EC-related search terms to ensure easy and convenient access to comprehensible, unbiased, and high quality web-based materials. === Medicine, Faculty of === Population and Public Health (SPPH), School of === Graduate
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