Disseminating Evidence on Abortion Facilities to Health Departments: A Randomized Study of E-mail Strategies

ABSTRACT

Given the politicization of abortion, professionals working in U.S. health departments (HDs) may not be receptive to communications about abortion, despite often regulating abortion facilities. This paper reports results of a randomized, prospective, observational study to test the effects of e-mail language when disseminating evidence on abortion to HD professionals. Our sample was 302 HD employees who oversee healthcare facilities inspection/regulation in all 50 U.S. state HDs, clustered by HD and randomized into two study groups. In November–December 2019, we sent biweekly e-mails containing links to a website summarizing evidence on abortion facility regulation. E-mails/headers sent to one group emphasized public health values and did not include the word abortion; e-mails/headers to the other group used the word abortion. Primary outcome measures were e-mail open rates and click-through rates. Among 221 participants to whom e-mails were deliverable, the overall open rate was 36%. Open rate was 25% for PH values and 46% for abortion groups (p < .05). Effects were moderated by state abortion policy environment: in both supportive and restrictive environments, participants in the abortion messaging group were statistically more likely to open e-mails than those in the PH values group. There was no difference between groups in states with middle-ground abortion policy environments. Among participants opening at least one e-mail, 19% clicked through to the website, with no significant difference by group. This study demonstrates that repeated targeted e-mail campaigns can reach HD professionals with research summaries. Concerns that communications to HDs should avoid the word abortion are unsupported.

Acknowledgments

The authors are grateful to Molly Battistelli, Nicole Bloom, Cynthia Gutierrez, Miriam Parra, and Claudia Zaugg for project support; to Geoff Daily and Kerstin Svendsen for graphic design of communication materials; and to Vanessa Lamers and Russell Rubin at the Public Health Foundation for recruitment support. This study was supported by a research grant from an anonymous private foundation. The funder had no role in study design, data collection and analysis, interpretation of the results, or preparation of the manuscript.

Disclosure statement

None of the authors have any financial interest to disclose.

Additional information

Funding

This work was supported by an anonymous private foundation.