Dr. Maria Gallo, College of Public Health, Epidemiology
SUMMARY / ABSTRACT
Crisis pregnancy centers (CPCs) are non-profit organizations with the mission of supporting pregnant people in not having an abortion. To this end, CPCs offer pregnant people free services (e.g., urine pregnancy tests, non-diagnostic ultrasounds, and peer counseling on a limited range of pregnancy options) and the opportunity to earn infant-related material items by attending classes. Public funding increasingly plays an important role in the functioning of CPCs: in Ohio, state funding of CPCs increased from $7.5 million in 2019 to $14 million in 2023. Despite advertising the provision of health procedures and receiving state funding and endorsement, CPCs typically do not employ medical staff and are not licensed as medical facilities. According to a recent U.S. Supreme Court case, CPCs are not compelled to disclose that they are not medical facilities. Professional medical organizations warn of possible health risks from attending a CPC. While the literature on CPCs has been expanding in recent years, almost no quantitative data has been published related to attending a CPC.
I am leading a survey (R21HD108911; project period, 5/9/2022-4/30/2024) with propensity-score matching to quantify health-related outcomes associated with attending a CPC and, among those attending a CPC, disparities in services received. Specifically, we are using survey data among pregnant people in Ohio to address two aims: 1) To assess whether delayed entry into prenatal care is more common among people who had previously attended a CPC for the current pregnancy relative to non-attendees; and 2) To assess whether the pregnancy options counseling provided at CPCs differs by client demographics (e.g., race/ethnicity, marital status, and religion) after controlling for client pregnancy plans before the CPC visit. The study enrollment has been lower than anticipated (136 enrolled to date with a target of 400 specified in the R21 application). I am proposing to extend the study enrollment period to allow us to try a new mode of recruitment, namely, via Google Ads. Using Google's online advertising program, we will target our advertisements to appear online to people who search Google with key words suggesting that they might be newly pregnant. This additional pilot work will allow us to assess whether this online recruiting is feasible for scaling up our enrollment of recent CPC attendees and matched controls. From this, we will develop a R01 application to NICHD to conduct a larger, multi-state survey to understand the experiences and health effects of CPC attendance among pregnant people.