JMIR Publications

ABSTRACT

Background:

The majority of patients use the internet to search for health information. While there is a vast repository of searchable information online, much of the content is unregulated and therefore potentially incorrect, conflicting, or confusing. Abortion information online is particularly prone to being inaccurate as anti-choice websites publish purposefully misleading information in formats that appear as neutral resources. To understand how anti-choice websites appear neutral, we need to understand the specific website features of anti-choice features that impart trust to viewers.

Objective:

We sought to identify characteristics of false or misleading abortion websites that make these websites appear trustworthy to the public.

Methods:

We conducted a cross-sectional study using Amazon.com Inc’s Mechanical Turk platform. We used validated questionnaires to ask participants to rate eleven anti-choice sites and one neutral site identified by experts, focusing on site content, creators, and design. We collected socio-demographic data and participant views on abortion. We used a composite measure of “mean overall trust” as our primary outcome. Using correlation matrices, we determined which website characteristics were most associated with overall trust. Finally, we used linear regression to identify participant characteristics associated with overall trust.

Results:

Our analytic sample included 498 participants ranging from ages 22 to 70, 50.1% of whom identified as female. Across eleven anti-choice sites, creator trust (“I believe that the creators of this site are honest and trustworthy”) had the highest correlation coefficient with overall trust (0.70). Professional appearance (0.59), look and feel (0.59), perception that the information is created by experts (0.59), association with a trustworthy organization (0.58), valued features and functionalities (0.54), and interactive capabilities (0.52) all demonstrated strong relationships with overall trust. At the individual level, pro-choice leaning was associated with higher overall trust of the neutral site (B: -0.43, CI: -0.87, 0.01) and lower overall trust of the anti-choice sites (B: 0.52, CI: 0.05, .99).

Conclusions:

The overall trustworthiness of anti-choice websites is most associated with design characteristics and perceived trustworthiness of the site creator. Those who believe that access to abortion should be limited are more likely to trust anti-choice websites.