Using Google Ads to recruit and retain a cohort considering abortion in the United States

The objective was to develop and test the feasibility of a methodology to recruit and retain individuals in the United States (US) who were considering abortion at the point of searching for an abortion clinic.

We conducted the Google Ads Abortion Access Study, a national cohort study using a novel recruitment method - recruiting people searching for abortion care on Google. Advertisements for the study were displayed in search results. Users who clicked on the advertisement were directed to a landing page explaining the study and then to a screening form. Participants were eligible if they reported being pregnant and considering abortion. They completed an online baseline survey and 4 weeks later were invited by email or text message to complete a follow-up survey.

Over the course of 8 months, we recruited a racially/ethnically and geographically diverse cohort considering an abortion using Google Ads. After removing fraudulent cases, we recruited 1706 respondents, and among these, 1464 (86%) provided contact information for follow-up. Among those providing contact information, 1005 completed the follow-up survey, resulting in a 69% follow-up rate. Older age, white race, higher education, difficulty meeting basic needs, being not religious/spiritual and having no previous births were associated with higher follow-up. Total cost of the ads was $31.99 per completed baseline + follow-up survey.

Researchers can use online advertising to successfully recruit populations early in their abortion-seeking process to understand the barriers they face and how to improve abortion access. Disadvantages include high cost and a small potential for fraudulent data.

Google Ads is a feasible tool to recruit and follow a diverse sample of individuals who are considering abortion for studies investigating the barriers they face in obtaining a wanted abortion.