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Effect of Recent Abortion Legislation on Twitter User Engagement, Sentiment, and Expressions of Trust in Clinicians and Privacy of Health Information: Content Analysis

BACKGROUND: The Supreme Court ruling in Dobbs v Jackson Women’s Health Organization (Dobbs) overrules precedents established by Roe v Wade and Planned Parenthood v Casey and allows states to individually regulate access to abortion care services. While many states have passed laws to protect access...

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Autores principales: Swanson, Karl, Ravi, Akshay, Saleh, Sameh, Weia, Benjamin, Pleasants, Elizabeth, Arvisais-Anhalt, Simone
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10221497/
https://www.ncbi.nlm.nih.gov/pubmed/37171873
http://dx.doi.org/10.2196/46655
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author Swanson, Karl
Ravi, Akshay
Saleh, Sameh
Weia, Benjamin
Pleasants, Elizabeth
Arvisais-Anhalt, Simone
author_facet Swanson, Karl
Ravi, Akshay
Saleh, Sameh
Weia, Benjamin
Pleasants, Elizabeth
Arvisais-Anhalt, Simone
author_sort Swanson, Karl
collection PubMed
description BACKGROUND: The Supreme Court ruling in Dobbs v Jackson Women’s Health Organization (Dobbs) overrules precedents established by Roe v Wade and Planned Parenthood v Casey and allows states to individually regulate access to abortion care services. While many states have passed laws to protect access to abortion services since the ruling, the ruling has also triggered the enforcement of existing laws and the creation of new ones that ban or restrict abortion. In addition to denying patients the full spectrum of reproductive health care, one major concern in the medical community is how the ruling will undermine trust in the patient-clinician relationship by influencing perceptions of the privacy of patient health information. OBJECTIVE: This study aimed to study the effect of recent abortion legislation on Twitter user engagement, sentiment, expressions of trust in clinicians, and privacy of health information. METHODS: We scraped tweets containing keywords of interest between January 1, 2020, and October 17, 2022, to capture tweets posted before and after the leak of the Supreme Court decision. We then trained a Latent Dirichlet Allocation model to select tweets pertinent to the topic of interest and performed a sentiment analysis using Robustly Optimized Bidirectional Encoder Representations from Transformers Pre-training Approach model and a causal impact time series analysis to examine engagement and sentiment. In addition, we used a Word2Vec model to study the terms of interest against a latent trust dimension to capture how expressions of trust for our terms of interest changed over time and used term frequency, inverse-document frequency to measure the volume of tweets before and after the decision with respect to the negative and positive sentiments that map to our terms of interest. RESULTS: Our study revealed (1) a transient increase in the number of daily users by 576.86% (95% CI 545.34%-607.92%; P<.001), tweeting about abortion, health care, and privacy of health information postdecision leak; (2) a sustained and statistically significant decrease in the average daily sentiment on these topics by 19.81% (95% CI −22.98% to −16.59%; P=.001) postdecision leak; (3) a decrease in the association of the latent dimension of trust across most clinician-related and health information–related terms of interest; (4) an increased frequency of tweets with these clinician-related and health information–related terms and concomitant negative sentiment in the postdecision leak period. CONCLUSIONS: The study suggests that the Dobbs ruling has consequences for health systems and reproductive health care that extend beyond denying patients access to the full spectrum of reproductive health services. The finding of a decrease in the expression of trust in clinicians and health information–related terms provides evidence to support advocacy and initiatives that proactively address concerns of trust in health systems and services.
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spelling pubmed-102214972023-05-28 Effect of Recent Abortion Legislation on Twitter User Engagement, Sentiment, and Expressions of Trust in Clinicians and Privacy of Health Information: Content Analysis Swanson, Karl Ravi, Akshay Saleh, Sameh Weia, Benjamin Pleasants, Elizabeth Arvisais-Anhalt, Simone J Med Internet Res Original Paper BACKGROUND: The Supreme Court ruling in Dobbs v Jackson Women’s Health Organization (Dobbs) overrules precedents established by Roe v Wade and Planned Parenthood v Casey and allows states to individually regulate access to abortion care services. While many states have passed laws to protect access to abortion services since the ruling, the ruling has also triggered the enforcement of existing laws and the creation of new ones that ban or restrict abortion. In addition to denying patients the full spectrum of reproductive health care, one major concern in the medical community is how the ruling will undermine trust in the patient-clinician relationship by influencing perceptions of the privacy of patient health information. OBJECTIVE: This study aimed to study the effect of recent abortion legislation on Twitter user engagement, sentiment, expressions of trust in clinicians, and privacy of health information. METHODS: We scraped tweets containing keywords of interest between January 1, 2020, and October 17, 2022, to capture tweets posted before and after the leak of the Supreme Court decision. We then trained a Latent Dirichlet Allocation model to select tweets pertinent to the topic of interest and performed a sentiment analysis using Robustly Optimized Bidirectional Encoder Representations from Transformers Pre-training Approach model and a causal impact time series analysis to examine engagement and sentiment. In addition, we used a Word2Vec model to study the terms of interest against a latent trust dimension to capture how expressions of trust for our terms of interest changed over time and used term frequency, inverse-document frequency to measure the volume of tweets before and after the decision with respect to the negative and positive sentiments that map to our terms of interest. RESULTS: Our study revealed (1) a transient increase in the number of daily users by 576.86% (95% CI 545.34%-607.92%; P<.001), tweeting about abortion, health care, and privacy of health information postdecision leak; (2) a sustained and statistically significant decrease in the average daily sentiment on these topics by 19.81% (95% CI −22.98% to −16.59%; P=.001) postdecision leak; (3) a decrease in the association of the latent dimension of trust across most clinician-related and health information–related terms of interest; (4) an increased frequency of tweets with these clinician-related and health information–related terms and concomitant negative sentiment in the postdecision leak period. CONCLUSIONS: The study suggests that the Dobbs ruling has consequences for health systems and reproductive health care that extend beyond denying patients access to the full spectrum of reproductive health services. The finding of a decrease in the expression of trust in clinicians and health information–related terms provides evidence to support advocacy and initiatives that proactively address concerns of trust in health systems and services. JMIR Publications 2023-05-12 /pmc/articles/PMC10221497/ /pubmed/37171873 http://dx.doi.org/10.2196/46655 Text en ©Karl Swanson, Akshay Ravi, Sameh Saleh, Benjamin Weia, Elizabeth Pleasants, Simone Arvisais-Anhalt. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 12.05.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Swanson, Karl
Ravi, Akshay
Saleh, Sameh
Weia, Benjamin
Pleasants, Elizabeth
Arvisais-Anhalt, Simone
Effect of Recent Abortion Legislation on Twitter User Engagement, Sentiment, and Expressions of Trust in Clinicians and Privacy of Health Information: Content Analysis
title Effect of Recent Abortion Legislation on Twitter User Engagement, Sentiment, and Expressions of Trust in Clinicians and Privacy of Health Information: Content Analysis
title_full Effect of Recent Abortion Legislation on Twitter User Engagement, Sentiment, and Expressions of Trust in Clinicians and Privacy of Health Information: Content Analysis
title_fullStr Effect of Recent Abortion Legislation on Twitter User Engagement, Sentiment, and Expressions of Trust in Clinicians and Privacy of Health Information: Content Analysis
title_full_unstemmed Effect of Recent Abortion Legislation on Twitter User Engagement, Sentiment, and Expressions of Trust in Clinicians and Privacy of Health Information: Content Analysis
title_short Effect of Recent Abortion Legislation on Twitter User Engagement, Sentiment, and Expressions of Trust in Clinicians and Privacy of Health Information: Content Analysis
title_sort effect of recent abortion legislation on twitter user engagement, sentiment, and expressions of trust in clinicians and privacy of health information: content analysis
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10221497/
https://www.ncbi.nlm.nih.gov/pubmed/37171873
http://dx.doi.org/10.2196/46655
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