What is the optimal tool for measuring abortion stigma? A systematic review
Sarah E Ratcliffe1,2, Clare S Smylie2, Rebecca T Pinkus2
1School of Psychology, Centre for Medical Psychology & Evidence-based Decision-Making, The University of Sydney, Sydney, Australia.
Summary
This study reviewed 102 articles to identify and assess measures of abortion stigma. The Individual Level Abortion Stigma scale and Abortion Provider Stigma Scale - Revised showed best performance for individual-level stigma.
Area of Science:
- Healthcare Access and Delivery
- Public Health
- Psychometric Measurement
Background:
- Abortion stigma presents a significant barrier to comprehensive and sustainable healthcare.
- Systematic identification and evaluation of existing abortion stigma measures are crucial for improving healthcare.
- Understanding the psychometric properties of these measures is essential for accurate assessment.
Approach:
- A systematic review was conducted, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Eight databases were screened, and data from 102 articles were extracted and analyzed.
- Psychometric properties were rigorously assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines.
Key Points:
- Twenty-one original measures of abortion stigma were identified, assessing individual and community levels.
- Measures targeted individuals who have had abortions, healthcare professionals, and the public, primarily from the United States.
- The Individual Level Abortion Stigma scale, Abortion Provider Stigma Scale - Revised, and Stigmatising Attitudes, Beliefs and Actions Scale demonstrated strong psychometric properties.
Conclusions:
- Significant gaps exist in abortion stigma measurement concerning geography, conceptualization, and structural-level stigma.
- Further development and validation of measurement tools are necessary to address these gaps.
- Improved measurement of abortion stigma is vital for advancing reproductive healthcare and reducing disparities.
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