Abstract
BackgroundThe list experiment is a promising measurement tool for eliciting truthful responses to stigmatized or sensitive health behaviors. However, investigators may be hesitant to adopt the method due to previously untestable assumptions and the perceived inability to conduct multivariable analysis. With a recently developed statistical test that can detect the presence of a design effect – the absence of which is a central assumption of the list experiment method – we sought to test the validity of a list experiment conducted on self-reported abortion in Liberia. We also aim to introduce recently developed multivariable regression estimators for the analysis of list experiment data, to explore relationships between respondent characteristics and having had an abortion – an important component of understanding the experiences of women who have abortions.MethodsTo test the null hypothesis of no design effect in the Liberian list experiment data, we calculated the percentage of each respondent “type,” characterized by response to the control items, and compared these percentages across treatment and control groups with a Bonferroni-adjusted alpha criterion. We then implemented two least squares and two maximum likelihood models (four total), each representing different bias-variance trade-offs, to estimate the association between respondent characteristics and abortion.ResultsWe find no clear evidence of a design effect in list experiment data from Liberia (p = 0.18), affirming the first key assumption of the method. Multivariable analyses suggest a negative association between education and history of abortion. The retrospective nature of measuring lifetime experience of abortion, however, complicates interpretation of results, as the timing and safety of a respondent’s abortion may have influenced her ability to pursue an education.ConclusionOur work demonstrates that multivariable analyses, as well as statistical testing of a key design assumption, are possible with list experiment data, although with important limitations when considering lifetime measures. We outline how to implement this methodology with list experiment data in future research.
Highlights
The list experiment is a promising measurement tool for eliciting truthful responses to stigmatized or sensitive health behaviors that has recently been applied to the measurement of abortion. [6,7,8] Originating in the 1980s, the list experiment is frequently used in the political science and economics literatures, though rarely – if at all – in public health and epidemiology
The method relies on two core assumptions: first, the assumption of no design effect – that participants do not change their response to the control items based on the presence or absence of the treatment item; and second, that participants give a truthful answer to the sensitive item. [13]
Because only one of the five differences was negative, and quite small in magnitude, there is no statistical evidence that respondents altered their responses to the control items based on whether or not abortion was added to the list
Summary
The list experiment is a promising measurement tool for eliciting truthful responses to stigmatized or sensitive health behaviors. The list experiment is a promising measurement tool for eliciting truthful responses to stigmatized or sensitive health behaviors that has recently been applied to the measurement of abortion. The respondent is shown a list of non-sensitive beliefs or experiences, and is prompted to report how many of the items are true for him or her, but not to specify which ones. The method relies on two core assumptions: first, the assumption of no design effect – that participants do not change their response to the control items based on the presence or absence of the treatment item; and second, that participants give a truthful answer to the sensitive item. The method relies on two core assumptions: first, the assumption of no design effect – that participants do not change their response to the control items based on the presence or absence of the treatment item; and second, that participants give a truthful answer to the sensitive item. [13]
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