Message framing in abortion education: effects on attitudes toward and intention to provide and refer for abortion care
Awarded 2018
Complex Family Planning Fellowship Research
Melissa Figueroa, MD
Albert Einstein College of Medicine

Framing effect is when content equivalent material is interpreted differently depending on framing.  It has been associated with modification of participant attitudes and intentions in marketing and psychology. Evaluating framing effect on medical students’ abortion attitudes and intentions may identify differential responses to types of message framing.
Therefore, we aimed to examine the impact of positive and negative message framing of abortion education materials on medical student abortion attitudes and intentions. We created two videos with paired abortion education content, one positively and one negatively framed. From October 2018 to April 2019 we conducted anonymous online pre- and immediate post-video surveys to investigate abortion attitudes and intentions among 2nd and 3rd year medical students at Einstein, then used statistical analysis to compare demographics across video groups and evaluate differences in attitudes and intentions between video groups.
There were 194 students who completed both pre- and post-video surveys, accounting for 70% of the total population. No demographic differences were noted between video groups. Personal abortion experience, clerkship abortion exposure, religiosity, and willingness to change beliefs were not associated with differences in attitudes and intentions. Significant differences in attitudes and intentions were seen with watching the video intervention, regardless of framing. The majority (94%) of students identified as pro-choice. Controlling for pro-choice and clerkship status, no differences in abortion attitudes or intentions were seen. No difference in willingness to advocate for abortion was noted between video groups. A difference in willingness to participate in an abortion procedure was statistically significant when comparing negative to positive video groups.
In conclusion, exposure to a video, regardless of framing, positively affected student abortion attitudes and intentions to provide.  The positively framed video had a greater effect on increasing Einstein student willingness to participate in an abortion procedure compared to negative framing.  Benefits of change in willingness to participate should be explored. Attitude and intention scores were not different between video groups. However, framing effects on student abortion attitudes and intentions to provide need to be investigated in groups with more varied geographic locations and identification with regard to choice.