Poster
Valdez, D., Bueno, B., Ezike N., Solon, M., Lo W., Turner R.C., Crawford B.L., Jozkowski K.N. (2022, November 6 - November 9) “I am no less pro-choice for deciding against an abortion”: Using Natural Language Processing to mine online abortion forums for narratives, insights, and personal abortion beliefs. American Public Health Association (APHA) Annual Meeting, Boston, MA.
Background: Although abortion attitudes are framed as a pro-choice/pro-life dichotomy, actual beliefs about abortion do not neatly ascribe to those labels. Narrative accounts of abortion, which often refer to experiences with abortion in some capacity, are shown to demonstrate how abortion beliefs depart from the dichotomy and vary along legal, moral, and ethical factors. Support groups, including forums from social networking websites, are ideal avenues to explore abortion beliefs as compliments to ongoing work on US abortion climate.
Purpose: This study uses Natural Language Processing algorithms to mine and interpret posts on online Reddit forums germane to abortion.
Methods: We applied several analyses to categorize and visualize (N=5,908) Reddit posts: (1) term frequency invariance document frequency (TF-IDF) to assess frequency of terms used; (2) k-means clustering to group posts into themes, and (3) principal components analysis (PCA) to visualize our data. We also ran a Valence Aware Dictionary and sEntiment [sic] Reasoner (VADER) sentiment analysis to calculate affect per theme.
Results: Our analyses revealed five themes specific to abortion: (1) personal abortion narratives, (2) pro-life hypocrisy, (3) pro-choice hypocrisy, (4) help seeking medication abortion, and (5) Reddit forum rules and regulations for posting abortion-related content.
Discussion & Conclusion: A qualitative review of themes revealed that people on Reddit willingly disclosed personal narratives about abortion. Many narratives expressly detailed how a person’s situation often does not neatly ascribe to the pro-choice pro-life dichotomy, yet advocates from either side of the debate often judge a person based on their decision to keep or abort a pregnancy.
Hawbaker, A., Mena-Meléndez, L., & Jozkowski, K.N. (2022, November 6 - November 9). Medical Exceptionalism: Public Trust in Medical Authority and Americans’ Acceptance of Abortion Legality. American Public Health Association Annual Meeting, Boston, MA.
Background: Public opinion research consistently reports health-related conditions as morally permissible reasons for abortion, and an overwhelming majority of Americans support abortion access for health risks. This is true for medical conditions related to maternal health and, to a lesser extent, fetal health. Yet where some research finds decreasing levels of trust in public health professionals, other studies document that Americans exhibit widespread trust in physicians. Abortion in the U.S. serves as a locus for the union of these apparently discrepant trends in public health skepticism and trust in medical professionals.
Purpose: The purpose of this study is to explore how Americans discuss the role of medical providers and healthcare workers when expressing attitudes in favor of or opposed to abortion access. This project examines the place of medical institutions and physician trust in shaping attitudes toward abortion among the American public by analyzing the ways that participants describe the place of doctors in determining the health risks of continuing a pregnancy.
Methods: This study uses 170 qualitative interviews with English- (n=110) and Spanish-speaking (n=60) respondents in the U.S. are semi-structured and investigate the complexities and nuances Americans’ hold in their attitudes toward abortion. Interviews were analyzed using Applied Thematic Analysis.
Results: Respondents are less expansive about the conditions under which abortion is permissible for health reasons as compared with many of the other abortion reasons considered in interviews (for example, abortion in the case of rape or incest). Consistent with existing research, we find that a broad acceptance of abortion in the case of medical and health conditions among interviewees. We also find that this acceptance is coupled with participant descriptions about the ethical and professional roles of doctors in the abortion process. This suggests an implicit trust in the morality and professional judgment of these same providers.
Discussion & Conclusion: This study expands understandings of the nuances of abortion attitudes as related to the specific condition of maternal health risk, and informs legal and political study regarding the jurisdiction of medical professionals in abortion care after the overturning of Roe v. Wade by the Supreme Court in June 2022. While the Supreme Court has placed the authority of medical discernment in the hands of state legislatures and law enforcement, this study demonstrates that a majority of Americans express beliefs that medical professionals have the primary role in determining medical risk in pregnancy.
Bueno, X., Buyuker, B., Jozkowski, K.N., Crawford, B.L., Turner, R.C., & Lo, W. (2022, November 6 - November 9). Familism, Sexism, and Abortion Attitudes among Latinx and non-Latinx Population in the US. American Public Health Association (APHA) Annual Meeting, Boston, MA.
Research examining people’s attitudes toward abortion mainly focuses on demographic correlates, rarely accounting for attitudinal characteristics such as familism and sexism. Familism, a measure of family honor, family interconnections, and support from/to family members is a central characteristic of Latinx culture but has not been examined in relation to abortion attitudes. We theorize that greater endorsement of familism may predict lower endorsement of abortion legality. Alternatively, ambivalent sexism comprised of benevolent and hostile sexism is associated with abortion attitudes with less sexist attitudes predicting greater endorsement of abortion legality. Research examining abortion attitudes across different races/ethnic groups is mixed with some suggesting no differences and other work suggesting differences between Latinx and non-Latinx.
As familism and sexism are related, we examined whether familism and sexism influenced support for abortion legality, if differences emerged across race/ethnic groups, and whether these relationships differ depending on abortion circumstance. We administered an online survey in English and Spanish (n=1,183 Latinx; n=1,863 non-Latinx) using Qualtrics’ national panel setting quotas for certain demographic characteristics (e.g., race/ethnicity, language preference) to ensure sample diversity. Abortion attitudes were assessed via a 7-item measure of different abortion circumstances based on the General Social Survey. We used logistic regression to assess the effects of familism and sexism on support for abortion legality, controlling for gender, age, education, religious practice, political affiliation, and nativity. Preliminary results indicate familism and benevolent sexism are key predictors of attitudes toward abortion legality in most abortion circumstances and the effects are stronger among Latinx than non-Latinx.
Better understanding cross-cultural differences is essential to improve healthcare, especially sexual and reproductive health services such as abortion.
Oral
Hadfield, J.I., Bueno, B., Ezike N., Solon, M., Lo W., Turner R.C., Crawford B.L., Jozkowski K.N. (2022, November 6 - November 9). Exploring the Role of Political Engagement and Abortion Law Knowledge with Support for Abortion Access: A Focus on Racial-Ethnic Disparities. American Public Health Association (APHA) Annual Meeting, Boston, MA.
Abstract: Given the social and health implications that unequal access to reproductive health has, it is important to explore whether a link exists between race-ethnicity and different factors involved in explaining beliefs towards abortion access. Little is known about whether racial-ethnic disparities within political engagement and abortion law knowledge might impact people’s support for abortion access. Thus, this study aims to examine whether and how political engagement and abortion law knowledge, may inform racial-ethnic disparities regarding support for abortion access.
We administered a web-based survey in English and Spanish to a national sample of n=2,383 participants that identified as Black/African American, Latinx, or White. The outcome variable asked participants about their position regarding how easy it should be to get an abortion and whether there should be fewer or more abortion restrictions in the US and in their state. We used political engagement, abortion law knowledge, and demographic (e.g. race-ethnicity) variables as predictors. Quantile regression was used to investigate the effect of political engagement and abortion law knowledge on support for abortion access across different racial-ethnic groups.
Political engagement was significantly associated with support for abortion access at the 25th and 75th percentiles. Abortion knowledge was significantly associated with support for abortion access at all three percentiles. We found significant differences in support for abortion access between Black and White participants at the 25th percentile with Black respondents providing higher endorsements compared to White respondents. There was also a significant effect on support for abortion access among political affiliations and education levels.
We conclude that the association between racial-ethnic groups and support for abortion access entails certain complexity. There are not consistent significant differences among the racial-ethnic groups in our study, and observed differences were reduced exclusively to Black/African Americans (compared to white non-Latinx) in the most polarized segments of the scale distribution. In sum, abortion law knowledge and party affiliation are the strongest predictors of abortion access support, while political engagement or educational attainment still play a significant but weaker role in this assessment. The collection of these results show that abortion access may not be a direct racialized issue, however, the racialization present in US sociodemographics (e.g., education, political party) may be attributing to racial-ethnic differences that ultimately influence levels of support toward abortion access.
Jozkowski, K.N., Bueno, X., Mena-Meléndez, L., Buyuker, B., Hadfield, J.I., LaRoche, K.J., Crawford, B.L., Turner, R.C., & Lo, W. (2022, November 6 - November 9). Peoples’ Awareness and Knowledge of and Sentiments toward Texas’ and Mississippi’s Abortion Laws: Results from a nationally representative study. American Public Health Association (APHA) Annual Meeting, Boston, MA.
For nearly five decades national polls indicate relative stability in U.S. adults’ attitudes toward abortion. However, since 2010, there has been a proliferation of legislation restricting abortion. For example, in 2018 Mississippi passed the Gestational Age Act—restricting abortion after 15 weeks— and in 2021 Texas passed the Texas Heartbeat Act—restricting abortion at about 6 weeks and criminalizing people involved in seeking or providing abortion. These laws already (Texas) or have the potential (depending on the Supreme Court’s decision in Dobbs v. Jackson Women’s Health, pertaining to Mississippi’s law) to drastically impede people’s ability to access abortion. Given their significance, we are examining the extent that people may (1) be aware of these laws, (2) know how they restrict abortion, (3) understand their implications regarding public health and policy-related outcomes, and (4) support or oppose them. Further, we are examining the extent that people’s awareness, knowledge, and sentiment toward the laws and abortion attitudes may be influenced by the Dobbs v. Jackson Women’s Health decision. We are in the process of conducting a multi-wave survey to assess awareness, knowledge, and sentiments toward Mississippi’s and Texas’ abortion laws specifically; we are also assessing people’s knowledge of pregnancy, abortion, and reproductive health and abortion attitudes in the context of various circumstances, including weeks’ gestation.
Using nationally representative panels we administered an online survey to three samples of English and Spanish-speaking U.S. adults: Sample 1a (N1a=1000) is currently underway to assess awareness, knowledge, sentiments, and attitudes prior to the Dobbs v. Jackson Women’s Health decision announcement via Ipsos’ KnowledgePanel. Sample 1b (N1b=700) comprising people who participated in Survey 1a will occur after the decision is announced to examine potential changes in sentiments/attitudes. Finally, Sample 2 (N2=1000) will also occur post-the decision announcement, but comprise a unique sample collected via NORC’s AmeriSpeak panel to make cross-sectional comparisons of awareness, knowledge, sentiment, and attitudes with Sample 1a. This presentation is the first in a series and will cover the overarching purpose of the study, study design, sample demographics, and descriptives for variables of interest—abortion, pregnancy, reproductive health knowledge, awareness of Mississippi and Texas laws, perceptions of the implications of these laws, sentiment toward these laws, and attitudes toward abortion. We will provide descriptive content that the remaining presentations will draw on to investigate associations between these constructs and examine potential changes in awareness, knowledge, and attitudes before and after the decision is announced.
Learning Objectives:
1. Describe the extent that U.S. adults are knowledgeable about abortion, pregnancy, and general reproductive health
2. Explain the extent that U.S. adults are aware of and understand the implications of Mississippi’s Gestational Age Act and Texas’ Heartbeat Act.
3. Compare the extent that U.S. adults are supportive of or opposed to Mississippi’s Gestational Age Act and Texas’ Heartbeat Act.
Bueno, X., Buyuker, B., Mena-Melendez, L., Hadfield, J.I., LaRoche, K.J., Jozkowski, K.N., Crawford, B.L., Turner, R.C., Lo, W. (2022, November 6 - November 9). Knowledge and Attitudes toward State-level Abortion Laws: The Cases of Texas and Mississippi. American Public Health Association (APHA) Annual Meeting, Boston, MA.
Abstract: In the past decade, there has been a proliferation of state-level laws aimed at restricting access to abortion. Two laws – from Texas and Mississippi – are of particular importance given their significant impact on the abortion policy landscape. Texas’ 2021 Senate Bill 8 used a unique enforcement mechanism to limit abortion at approximately 6 weeks’ pregnancy without federal level intervention. Mississippi’s 2018 Gestational Age Act, which was challenged via lawsuit and heard by the US Supreme Court in 2021 (i.e., Dobbs v. Jackson Women’s Health) restricts abortion at 15 weeks. The outcome of this case could ultimately overturn the precedent established in Roe v. Wade, the decision establishing abortion up to the point of fetal viability as a constitutionally protected right. Both laws have been featured prominently in the media during the last two years; however, it is unclear to what extent the general public is aware of and supports such laws, as well as the extent that people are knowledgeable of the public health, social, and policy implications associated with this legislation. To address these questions, we will examine how general awareness of these laws and knowledge of its implications predict people’s sentiment toward the laws and toward abortion attitudes more generally. Particular attention will be paid to racial/ethnic subgroup comparisons because racial and ethnic minorities are disproportionately affected by legislation that limits access to abortion. Data for this investigation come from a larger study examining people’s knowledge, sentiments, and attitudes before and after the public announcement of the decision in Dobbs v. Jackson Women’s Health (expected in summer 2022), thus, data collection for the first wave is currently underway and the second wave of data collection will be completed in July 2022. Data are being collected through an online survey administered by Ipsos to their Knowledge Panel, a nationally representative panel of English and Spanish-speaking U.S. adults (N = 1000). We developed our survey using a parallel translation model to concurrently develop conceptually identical instruments in both languages. Although public opinion research suggests people are generally supportive of abortion in some circumstances, legislation restricting access continues to persist and has become increasingly extreme (e.g., earlier weeks’ gestation; restriction without exceptions). Findings from this study may provide insight on the disconnect between legislation and people’s view toward abortion by clarifying how knowledgeable people are about these abortion laws of interest and their implications in relation to one’s attitudes.
Learning outcomes:
1. Describe how knowledge of and sentiment toward Texas’s Senate Bill 8 predict attitudes toward abortion.
2. Describe how knowledge of and sentiment toward the Mississippi’s Dobbs v. Jackson Women’s Health case predict attitudes toward abortion.
3. Identify possible racial/ethnic disparities in the relationship between people’s state-level abortion law knowledge and abortion attitudes.
Mena-Melendez, L., Bueno, X., Buyuker, B., Hadfield, J.I., LaRoche, K.J., Jozkowski, K.N., Crawford, B.L., Turner, R.C., & Lo, W. (2022, November 6 - November 9). Does the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization influence people’s knowledge and sentiment about abortion? American Public Health Association (APHA) Annual Meeting, Boston, MA.
Background: In the summer of 2022, the U.S. Supreme Court will rule on Dobbs v. Jackson Women’s Health Organization (Dobbs v. Jackson), which seeks to ban abortions in Mississippi after fifteen weeks of pregnancy and overrule the 1973 landmark decision of Roe v. Wade. If Dobbs v. Jackson is upheld, this could result in the most sweeping legislative change to abortion policy in the U.S. in 50 years. It has mobilized activists on both sides of the abortion debate, but it is unclear how the ruling might influence abortion knowledge and sentiment. Previously, national pollsters have asked about people’s knowledge and sentiment about abortion and Roe v. Wade, but research assessing people’s knowledge about state-level abortion laws and abortion sentiment is limited.
Study Aim: We will examine people’s knowledge about state-level abortion laws and abortion sentiment before and after the Dobbs v. Jackson decision announcement. The upcoming ruling serves as a natural experiment to estimate the effects of the decision on people’s abortion knowledge and sentiment.
Data and Methods: Our study comprises three samples: Sample 1a data collection is currently underway to assess awareness, knowledge, and sentiments toward abortion laws prior to the Dobbs v. Jackson decision. Sample 1b will occur after the decision and comprise a sub-sample of people who participated in Sample 1a to examine potential changes in attitudes. Finally, Sample 2 will also occur after the decision, but comprise a unique sample to examine changes in awareness, knowledge, and sentiment post the decision. Sample 1a (N1a = 1000) and Sample 1b (N1b = 700) will be collected via Ipsos’ KnowledgePanel and Sample 2 will be collected via NORC’s AmeriSpeak panel (N2 = 1000). All panels are nationally representative of English and Spanish-speaking U.S. adults. We will assess the effect of the Supreme Court decision on people’s knowledge and sentiments by conducting pre-post within-group comparisons using data from the samples before (Sample 1a) and after (Sample 1b) the ruling. Subsequently, we will conduct between-group comparisons of knowledge and sentiments using data from the sample before the ruling (Sample 1a) and the unique sample after the ruling (Sample 2), which will allow us to examine cross-sectional group differences.
Implications: Assessing people’s abortion knowledge and sentiment pre-post the Dobbs v. Jackson decision can elucidate the extent that this major judicial decision is salient to the general public and the extent that may change people’s abortion sentiment.
Learning Outcomes
1. Describe the effect of the U.S. Supreme Court’s decision on Dobbs v. Jackson on people’s knowledge about state-level abortion laws and abortion sentiment.
2. Discuss the influence that U.S. Supreme Court decisions (involving change or continuity) bear on people’s knowledge and attitudes on controversial social issues, such as abortion.
3. Evaluate the uniqueness of the U.S. Supreme Court’s decision on Dobbs v. Jackson as a natural experiment and our methodological contributions to assess the effect of the decision on people’s abortion knowledge and sentiments.
Crawford, B.L., Jozkowski, K.N., LaRoche, K.J., Mena-Meléndez, L., Bueno, X., Buyuker, B., Hadfield, J., Turner, R.C., & Lo, W. (2022, November 6 - November 9). Does political party affiliation and identification with pro-life and pro-choice labels moderate the relationship between abortion and reproductive health-knowledge and abortion attitudes? American Public Health Association (APHA) Annual Meeting, Boston, MA.
Background: Knowledge and perceptions of pregnancy and abortion—disregarding their accuracy—may help shape abortion attitudes. Indeed, knowledge of abortion law significantly predicts abortion attitudes, but the relationship is moderated by political affiliation and endorsement of abortion labels (e.g., pro-choice/pro-life). However, less is known about the relationship between abortion attitudes and perceptions/knowledge of pregnancy and abortion. Specifically, studies have not examined how attitudes regarding specific laws and general abortion legality may be related to knowledge/perceptions of (a) the average length of a pregnancy, (b) when most people find out they are pregnant, (c) when fetal milestones such as heartbeat or viability occur, and (d) at how many weeks’ gestation most abortions take place. Given the influx of restrictive abortion legislation based on weeks’ gestation and fetal development markers, expanding this area of inquiry can improve interventions intended to influence abortion attitudes.
Study Aim: The purpose of this study is to: (1) assess the relationship between abortion attitudes regarding specific laws and general legality and participants’ knowledge/perceptions of pregnancy, fetal development, and abortion and (2) examine if that relationship is moderated by ideological group membership, including political affiliation and endorsement of abortion labels.
Data and Methods: We will use nationally representative data from the first wave (N = 1,000) of longitudinal data collected in English and Spanish using IPSOS KnowledgePanel. This data collection is in progress and will be collected before the Supreme Court decision in Dobbs v. Jackson. In the first OLS regression model, we will assess if participants’ knowledge/perceptions of (a) the average length of a pregnancy, (b) when most pregnant people find out they are pregnant, (c) of the timing of different fetal milestones, and (d) at how many weeks’ gestation most abortions take place is significantly related to abortion attitudes regarding specific laws and general legality. In the second model, we use interaction terms to assess if the relationship between knowledge/perceptions and attitudes is moderated by political affiliation and abortion identity labels.
Implications: People’s perceptions of abortion may not be accurate. Advocates on both sides see informational interventions as an effective way to change abortion attitudes. However, if the relationship between knowledge/perceptions and attitudes is moderated by ideological group membership, the effects of these interventions may result in changes that are not in the desired direction. Thus, having a more nuanced understanding of the relationship between knowledge/perceptions and attitudes is crucial to improving intervention.
Learning outcomes:
1. Describe the relationship between people’s reproductive health knowledge and their attitudes regarding specific laws and general abortion legality
2. Explain how the relationship between reproductive health knowledge and attitudes regarding specific laws and general abortion legality may vary across political affiliations and endorsement of abortion labels