Preferences for self-managed abortion in Mississippi: A discrete choice experiment
Awarded 2022
Capturing tradeoffs in abortion care
Kelsey Holt, ScD
University of California, San Francisco

Self-managed medication abortion (SMMA) is rapidly becoming a major – and in some cases the only – option for those seeking abortion in states like Mississippi with complete abortion bans; requests for SMMA in Mississippi have tripled since Roe v Wade was overturned. Qualitative research has identified facilitators and barriers to SMMA, but no quantitative evidence on how individuals would prefer to access SMMA is available to date. Drawing from complementary strengths of team members from Mississippi in Action and UCSF, we propose a mixed-methods study to quantify relative preferences among people in Mississippi for attributes of SMMA services. We will characterize attributes of SMMA that shape decision-making by conducting 6-8 in-depth interviews with individuals who have recently sought abortion in Mississippi. We will work with an advisory council of people involved in supporting abortion access to synthesize the findings and co-design a discrete choice experiment (DCE) testing the attributes of SMMA relevant to individuals in Mississippi. We will use community-based convenience sampling to identify 240 Mississippi residents who have sought or might need an abortion to complete the DCE. We will use responses to quantify relative preferences for each attribute level, to calculate willingness to pay for a given level of each attribute, to identify distinct subsets of preferences using latent class analysis, and to estimate likely uptake of SMMA under potential delivery models. Findings will be used to define one or more models to ensure SMMA services can meet the preferences of people who may need abortions in Mississippi today.