Randomized experimental testing of new survey approaches to improve abortion reporting in the United States.

Randomized experimental testing of new survey approaches to improve abortion reporting in the United States.
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DOI:
10.1363/psrh.12217
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发表时间:
2022-12
影响因子:
5.8
通讯作者:
VandeVusse, Alicia
VandeVusse, Alicia
中科院分区:
医学2区
文献类型:
--
作者:
Lindberg, Laura D.;Maddow-Zimet, Isaac;Mueller, Jennifer;VandeVusse, Alicia

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由于社会耻辱感,调查中对堕胎的报告严重不足,影响了对堕胎、怀孕、生育以及相关人口和健康结果的研究。在这项研究中,我们评估了通过形成性混合方法研究确定的六种方法,以改善调查中堕胎的测量。这些方法包括改变调查中堕胎项目的位置、怀孕结果问题的顺序、详细程度、堕胎问题的介绍和堕胎问题的背景,以及使用分级敏感性。我们嵌入了一个预先注册的随机实验,在一个新设计的在线调查有关性和生殖健康行为(N = 6536)。我们采用完全交叉因子设计将受试者随机分配到实验组;我们使用logistic回归模型的标准化估计值估计平均治疗效果,并对与报告相关的人口统计学协变量进行调整。与对照条件相比,没有一个实验组显著改善流产报告。在今后的调查中,需要做更多的工作来改进堕胎报告,特别是因为美国越来越限制堕胎。尽管这项研究的结果为零,但它为未来改善堕胎测量的努力提供了一条有希望的道路。这证明了以比在现有国家生育率调查中嵌入变化更便宜、更快和更灵活的形式测试新方法的概念。
Abortions are substantially underreported in surveys due to social stigma, compromising the study of abortion, pregnancy, fertility, and related demographic and health outcomes. In this study, we evaluated six methodological approaches identified through formative mixed‐methods research to improve the measurement of abortion in surveys. These approaches included altering the placement of abortion items in the survey, the order of pregnancy outcome questions, the level of detail, the introduction to the abortion question, and the context of the abortion question, and using graduated sensitivity. We embedded a preregistered randomized experiment in a newly designed online survey about sexual and reproductive health behaviors (N = 6536). We randomized respondents to experimental arms in a fully crossed factorial design; we estimated an average treatment effect using standardized estimators from logistic regression models, adjusted for demographic covariates associated with reporting. None of the experimental arms significantly improved abortion reporting compared to the control condition. More work is needed to improve reporting of abortion in future surveys, particularly as abortion access becomes increasingly restricted in the United States. Despite this study's null results, it provides a promising path for future efforts to improve abortion measurement. It is proof of concept for testing new approaches in a less expensive, faster, and more flexible format than embedding changes in existing national fertility surveys.
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