Improving abortion underreporting in the USA: a cognitive interview study
Open Access
- 25 August 2022
- journal article
- research article
- Published by Taylor & Francis Ltd in Culture, Health & Sexuality
- Vol. 25 (1), 126-141
- https://doi.org/10.1080/13691058.2022.2113434
Abstract
Abortion is a difficult-to-measure behaviour with extensive underreporting in surveys, which compromises the ability to study and monitor it. We aimed to improve understanding of how women interpret and respond to survey items asking if they have had an abortion. We developed new questions hypothesised to improve abortion reporting, using approaches that aim to clarify which experiences to report; reduce the stigma and sensitivity of abortion; reduce the sense of intrusiveness of asking about abortion; and increase respondent motivation to report. We conducted cognitive interviews with cisgender women aged 18–49 in two US states (N = 64) to assess these new approaches and questions for improving abortion reporting. Our findings suggest that including abortion as part of a list of other sexual and reproductive health services, asking a yes/no question about lifetime experience of abortion instead of asking about number of abortions, and developing an improved introduction to abortion questions may help to elicit more accurate survey reports. Opportunities exist to improve survey measurement of abortion. Reducing the underreporting of abortion in surveys has the potential to improve sexual and reproductive health research that relies on pregnancy histories.Funding Information
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD084473)
This publication has 27 references indexed in Scilit:
- Alternative Estimates of Lifetime Prevalence Of Abortion from Indirect Survey Questioning MethodsPerspectives on Sexual and Reproductive Health, 2016
- Reducing under-reporting of stigmatized health events using the List Experiment: results from a randomized, population-based study of abortion in LiberiaInternational Journal of Epidemiology, 2015
- What Do Our Respondents Think We're Asking? Using Cognitive Interviewing to Improve Medical Education SurveysJournal of Graduate Medical Education, 2013
- Abortion Stigma: A Reconceptualization of Constituents, Causes, and ConsequencesWomen's Health Issues, 2011
- Abortion Incidence and Access to Services In the United States, 2008Perspectives on Sexual and Reproductive Health, 2011
- Conceptualising abortion stigmaCulture, Health & Sexuality, 2009
- Sensitive questions in surveys.Psychological Bulletin, 2007
- The Psychology of Survey ResponsePublished by Cambridge University Press (CUP) ,2000
- A Medical Record Linkage Analysis of Abortion UnderreportingFamily Planning Perspectives, 1996
- Innovations in Reproductive Health Care: Menstrual Regulation Policies and Programs in BangladeshStudies in Family Planning, 1988