Elsevier

Contraception

Volume 91, Issue 3, March 2015, Pages 226-233
Contraception

Original research article
Exploring abortion attitudes of US adolescents and young adults using social media,☆☆

https://doi.org/10.1016/j.contraception.2014.11.009Get rights and content

Abstract

Objectives

To explore the use of social media for recruitment of adolescents and young adults in the United States and to describe how they learn and feel about abortion.

Study design

Americans 13–29 years of age were recruited through web-based social media to complete an online survey about sex and pregnancy-related decision making, including abortion. Descriptive statistics were used to compare the study population’s demographics and prevalence of sexual experience to national databases [US Census and National Survey of Family Growth (NSFG)] and to describe abortion attitudes and related topics.

Results

Survey completion rate was 78% and 996 participants’ responses were analyzed. The study population appeared diverse with respect to gender, ethnicity, race and geographic distribution with some similarities to the US Census and was sexually active at an earlier age compared to the NSFG. While the majority of participants supported abortion (74%), acceptance of abortion for themselves or their partners varied based on circumstances. The media were the most popular sources of information for learning about sex and abortion (73% and 68%, respectively). Parents had the most influence on individuals’ abortion stances compared to other sources.

Conclusions

Social media recruitment, compared to traditional methods, has the potential to reach a geographically, ethnically and racially diverse group of young people to study sensitive topics in an economical and expedient fashion. Similar to the general population, the study population’s abortion views fell on a spectrum with overall supportive attitudes toward abortion. The media served as common sources of information for learning about both sex and abortion.

Implications

Web-based social media offer a novel recruiting strategy to study sensitive topics such as abortion attitudes among difficult-to-reach populations such as adolescents and young adults. The presented findings begin characterizing young people’s abortion attitudes, offering a foundation for more in-depth research.

Introduction

Personal abortion attitudes influence how individuals cope with unwanted pregnancies and impact their family, friends and community. Societally, policy makers’ abortion attitudes influence resource allocation and people’s abilities to realize reproductive decisions. Although these attitudes have a broad reach, people tend to learn and form opinions about abortion through informal avenues and with incomplete information because the subject of abortion is often taboo in the United States. Popular discourse, which reduces a complex pregnancy-related decision that many individuals face into dichotomous “pro-life”/“pro-choice” rhetoric, compounds this problem and reinforces misconceptions and stigma [1], [2], [3].

Social psychologists Fishbein and Ajzen describe beliefs as fundamental building blocks of attitudes and behaviors [4]. A belief forms when some attribute is linked to an object based on direct observation, an inference or information from another source, assigning meaning to that object. The collection of beliefs forms an attitude or an evaluation of that object. Past researchers have studied if certain demographic characteristics or attitudes are associated with a more favorable evaluation of abortion. Characteristics that have been explored include gender, race, age, education, religiosity and particular beliefs about gender roles and female sexuality [5], [6], [7], [8], [9]. This research, however, does not elucidate how individuals form beliefs about abortion, which may happen through the process of acquiring and internalizing social norms during adolescence, as what happens with sexual socialization.

Unlike abortion socialization, sexual socialization has been studied extensively and results suggest that informal, nondidactic channels such as peers, media sources and family messaging shape attitudes toward sex [10], [11], [12]. Abortion and sexual socialization may have similarities. According to Stone and Waszak’s research, adolescents described relying on movies, television and anecdotal experiences to form their opinions about abortion [13]. Their knowledge was laden with misconceptions, possibly originating from some of their sources (television, movies) that tend to depict abortion in simplified, stereotypically negative ways [14]. In addition, membership in certain social networks may change abortion views, especially views that are not well developed, as suggested by Munson’s research exploring why certain individuals joined the “pro-life” movement [15]. Many of his informants initially had been “pro-choice” or ambivalent about abortion, joined the movement seeking social involvement and developed a “pro-life” stance over time through movement participation.

We employed internet-based recruitment and data collection to gather information about young people’s abortion attitudes, which allowed us to have access to this population and to explore this sensitive topic in a private manner. At the time of this study, 73% of 13- to 29-year-olds in the US participated in web-based social networks and 71% used Facebook specifically, creating a unique forum for recruitment [16], [17]. Other researchers have utilized Facebook advertisements for this purpose, studying topics as diverse as women’s childbirth preferences, substance abuse among young adults and young peoples’ attitudes toward chlamydia screening [18], [19], [20], [21]. These studies suggest that Facebook serves as a useful, cost-effective tool for accessing groups that are difficult to reach when using more traditional methodology. Moreover, a web-based survey, compared to other forms of data collection, offers privacy, anonymity and convenience [22].

We aimed to assess social media’s recruitment capabilities and to begin describing how young people learn and feel about abortion. Achievement of these objectives could generate hypotheses for future research exploring attitude formation in a deeper fashion.

Section snippets

Materials and methods

This study used a cross-sectional design through an online survey to explore abortion attitudes among young people. Following approval by the institutional review board, we recruited participants through Facebook advertisements targeted at English-speaking 13- to 29-year-olds living in the United States. Recruited individuals could learn about the study, determine their eligibility and take the survey from the study website. We monitored Facebook advertisements daily for click-through-rates

Results

The survey ran for 109 days and cost US$3970 for Facebook advertisements, reflecting an average CTR of 0.05% (8673 total clicks). The cost per enrolled participant was US$3. There were over 10,600 visitors to the study Web site with 24–82 visits per day, 1739 survey views and a 78% survey completion rate (Fig. 2). All surveys suspicious for repeat responding happened to be incomplete and were excluded from the analysis. Average survey completion time was 5 minutes. A similar proportion of

Discussion

The combination of internet-based recruitment and data collection has the potential to reach a group of individuals diverse in gender, race, ethnicity and geographic location to study abortion attitudes among young people. Using this methodology revealed that the study population was overall supportive of abortion, with varying acceptability for themselves or their partners. Participants most frequently learned about sex and abortion from the media, but friends or peers, lectures or classes at

Acknowledgement

We would like to sincerely thank Paul Blumenthal, Kate Shaw and Malavika Prabhu for their feedback on various versions of this manuscript; Khristina Wenzinger for her thoughtful editing; Ray Balise and Alex McMillan for statistics advice; University of Washington Department of Obstetrics and Gynecology, Society of Family Planning and the Lynne Mandel Endowment for believing in this resident research project from the beginning.

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    Funding: Lynne S. Mandel, Ph.D., Endowment Fellowship and Society of Family Planning.

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    Disclosures and financial conflicts of interest: None for all three authors.

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