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Shifting Abortion Attitudes Using an Empathy-Based Media Intervention: a Randomized Controlled Study" (2019)

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Shifting Abortion Attitudes Using an Empathy-Based Media Intervention: a Randomized Controlled Study University of Arkansas, Fayetteville ScholarWorks@UARK Theses and Dissertations 5-2019 Shifting Abortion Attitudes using an Empathy- based Media Intervention: A Randomized Controlled Study Mary Ellen Hunt University of Arkansas, Fayetteville Follow this and additional works at: https://scholarworks.uark.edu/etd Part of the Public Health Education and Promotion Commons, Women's Health Commons, and the Women's Studies Commons Recommended Citation Hunt, Mary Ellen, "Shifting Abortion Attitudes using an Empathy-based Media Intervention: A Randomized Controlled Study" (2019). Theses and Dissertations. 3256. https://scholarworks.uark.edu/etd/3256 This Dissertation is brought to you for free and open access by ScholarWorks@UARK. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of ScholarWorks@UARK. For more information, please contact [email protected]. Shifting Abortion Attitudes using an Empathy-based Media Intervention: A Randomized Controlled Study A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Community Health Promotion by Mary Ellen Hunt Kansas State University Bachelor of Science in Family Studies and Human Services, 2012 University of Arkansas Master of Science in Community Health Promotion, 2014 May 2019 University of Arkansas This dissertation is approved for recommendation to the Graduate Council. ______________________________ Kristen Jozkowski, Ph.D. Dissertation Director __________________________________ ___________________________________ Ron Warren, Ph.D. Heather Blunt-Vinti, Ph.D. Committee Member Committee Member ___________________________________ ___________________________________ Brandon Crawford, Ph.D. Kelly Cleland, M.P.A., M.P.H. Committee Member ex officio Committee Member __________________________________ Wenjuo Lo, Ph.D. Committee Member ABSTRACT U.S. abortion restrictions diminish access and perpetuate a culture of hostility toward abortion seekers. Support for restrictions is high—potentially, because restriction knowledge is low and attitudes are complex. The current study focused on knowledge and support of restrictions and empathy for abortions seekers among Arkansans. The purpose was to evaluate the effectiveness of a video intervention intended to increase awareness of Arkansas abortion restrictions and induce empathy for abortion seekers. Using a randomized controlled trial with pre-, post-, and follow-up design, a sample of Arkansans (N = 369) were randomly assigned to one of five video conditions--either a control or an intervention, varying by actor’s race and pregnancy narrative. Data were analyzed across the study with repeated-measures analyses of variance, chi-squared analyses, and hierarchical regressions. Manuscript 1: For knowledge of restrictions, there was a statistically significant interaction between the effects of time and video condition. Specifically, post-test scores were significantly higher than pre-test and follow-up scores. In terms of support for restrictions, the time main effect was significant, but the group main effect was nonsignificant. Manuscript 2: chi-squares indicated participants who watched a testimonial where the woman was raped had higher empathetic feeling scores. Post-test empathy sum scores were a function of sex, experience with abortion and sexual assault, baseline Empathic Concern, and video condition; follow-up scores were a function of personal experiences with abortion and sexual assault, sex, and Empathic Concern. The testimonial depicting a Black woman who was raped induced the most empathy at post-test. The intervention was effective in increasing awareness and decreasing support for myriad Arkansas abortion restrictions. Knowledge scores were significantly higher among those who watched a testimonial; this may be because information was repeated or because emotional connections made the information more memorable. Support decreased across the study, however, the intervention did not have the hypothesized effect on this outcome. Prior personal experiences and internalization of abortion stigma can affect empathy induction. People were more empathetic for the woman who was raped compared with the consensual narrative. The hierarchy of abortion narratives may influence perceptions of abortion seekers. Key words: abortion, abortion legislation, empathy, video intervention, Arkansas ©2019 by Mary Ellen Hunt All Rights Reserved ACKNOWLEDGEMENTS First and foremost, I acknowledge Dr. Kristen Jozkowski as the most influential person in my academic progression and career. I have had the immense privilege of being Kristen’s mentee for seven years and, without a doubt, everything I know and every skill I have gained originates from her. Additionally, I have had the unique opportunity to watch her grow as a professor and mentor simultaneous with my development. I have seen her build a research lab from a trio of graduate students, to an army of fourteen undergraduate students, five doctoral students, and three post-docs. She has taught me about power and structure by watching her navigate academic bureaucracy and patriarchy. She has taught me to think critically about gender, sexism, feminism, sexual violence, and public health. She has introduced me to colleagues and collaborators. She wrote and submitted dozens of recommendation letters when I was on the job market. She gave valuable feedback on my application materials. She talked with me on the phone after each on-site interview and listened to me detail my experiences. She has given me tough love by drawing attention to my flaws, my weaknesses, and my strengths. She has spent hours with me--on the phone, in person, in writing, in blood--molding me, building me up, and pushing me. She’s listened to me complain and work through things. I may be the reason she started keeping tissues on hand in her office. I cannot thank her enough for allowing me to be in her orbit. She is going to be seriously famous and I get to say she was, and will always be, my mentor, colleague, and friend. Kristen, I hope you see this dissertation as a 300-page tribute to what you have taught me and who I have become under your tutelage. Next, I want to thank my amazing committee members, Dr. Ron Warren, Dr. Heather Blunt-Vinti, Dr. Brandon Crawford, Dr. Wenjuo Lo, and Kelly Cleland. Each person contributed perspective and a critical eye, resulting in a stronger and more rigorous study. Additionally, every member of my committee has not only demonstrated an investment in this project, but an investment in me as well. I could not have asked for a better team. Dr. Ron Warren offered tremendous insight on the media aspect of my dissertation. He met with me on several occasions to help with the script, survey, and video concept. Every time I left his office, his welcoming and warm disposition supplied reassurance and inspiration. Dr. Heather Blunt-Vinti identified components I had missed on the survey, script, and proposal. Dr. B has been part of my support system on the job search journey as well. In the early days, she conducted a mock interview with me so I could practice what I was going to say and has been willing to answer any questions I had with a fresh viewpoint. Dr. Brandon Crawford discussed with me my statistical analyses on many occasions, helped me run tests, and introduced new concepts to ponder. I also appreciate his sincere greetings and taking time to ask about my wellbeing every time we speak. Dr. Wenjuo Lo is one of the best teachers I have had in graduate school. He deliberated with me about statistical analyses and gave me tips on results organization. He never gives less than 100% of himself in meetings with me--he takes out his pad of paper to draw paths and equations so that I understand the theory behind why I would or would not choose an analysis. Finally, Kelly Cleland, who is a big deal, graciously accepted to be a member of this project and offered insight on reproductive rights and abortion content. She continually challenges me to critically think about this field and the way I present my words. There were many people who were instrumental this project’s successful execution. I would like to acknowledge the funding sources that made this project possible: The Society of Family Planning Research Fund and the Department of Health, Human Performance and Recreation of the University of Arkansas. I want to give a giant thanks to Jared Endsley, who shot and edited my intervention videos. Courtney Jensen, NaTosha DeVon, and Christina Aronowitz were my actor extraordinaires. Shari Witherspoon helped me spend the grant funds to buy participation incentives. The Sexuality Education and Consent Studies (SECS) undergraduate research assistants gave priceless outside feedback on the video graphic aesthetics, including informing me that one graphic with a red color scheme looked like “propaganda.” During the writing process, the SECS lab graduate students, Tiffany Marcantonio, Malachi Willis, Alejandra Kaplan, and Toby Klein, read and gave feedback on the first dissertation manuscript which resulted in a more streamlined product. I’d like to give a special shout out to Tiffany, who provided editing suggestions on both of my manuscripts and the grant that funded the project. She made invaluable comments relating to organization and overall readability. In addition to academic contributions, Tiffany has been the captain of my emotional support team by listening to me vent and cry about the dissertation process
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