THURS-068 - Abortion Literacy Among Adults in the United States: A Scoping Review

Brief Abstract Summary: Learn about the critical role that abortion literacy can play in improving equitable access to abortion and other reproductive healthcare! Although the field of health promotion and education has long recognized health literacy as a key determinant of access to healthcare services, knowledge about abortion has rarely been investigated in the U.S. With access to abortion care having been further constrained in the post-Roe v. Wade era by state policies based on disinformation, it is increasingly critical that we understand a variety of potential targets for intervention. This scoping review synthesizes the existing evidence on abortion literacy among U.S. adults and identifies gaps where additional research is critically needed to develop evidence-based interventions for health promotion.

Detailed abstract description:

Background: The field of health promotion and education widely recognizes health literacy as a key social determinant of health, yet abortion literacy has been largely overlooked. Public health practitioners at community-based organizations that serve abortion seekers have identified low levels of knowledge about abortion as a barrier to accessing timely reproductive healthcare and as a facilitator of harmful abortion stigma; however, abortion literacy remains relatively understudied. Therefore, this scoping review aimed to synthesize the existing empirical evidence on health-related abortion literacy among U.S. adults and identify gaps where further research may be needed to enhance our understanding and inform the promotion of accurate abortion information.

Methods: We conducted a comprehensive search for relevant studies using PubMed, Embase, CINAHL, and Web of Science. This search yielded 1,645 results, of which 612 were duplicates. Using Covidence software, two trained reviewers independently screened 1,024 studies for the following eligibility criteria: 1) original, peer-reviewed research, 2) conducted in the U.S., and 3) included at least one outcome that quantitatively assessed abortion knowledge. We excluded studies that exclusively assessed awareness of abortion policies or knowledge among healthcare professionals. We identified 15 studies that met all criteria to be included in the review.

Results: Each of the included studies (N=15) consisted of a survey that assessed individuals’ knowledge about abortion using self-reported endorsement of popular myths about abortion safety. The median proportion of participants who correctly responded to items assessing abortion knowledge was 37.0%. All 15 studies concluded that U.S. adults have low levels of knowledge about abortion and often endorse abortion misinformation. Several studies (n=5) also identified a significant relationship between lower abortion knowledge and greater support for restricting access to abortion care.

Conclusions: The extant literature indicates that U.S. adults have low levels of abortion knowledge. This lack of abortion literacy is a pressing public health issue that warrants further study to both understand its extent and develop evidence-based interventions for taking action. Specifically, additional research with representative samples of the adult population is needed to strengthen generalizability and assess potential disparities in knowledge across race-ethnicity, socioeconomic status, age, and geographic location. Furthermore, there is a critical need for a standardized, empirical measure of abortion literacy to enhance construct validity and facilitate comparisons across studies.