Audiovisual information affects informed choice and experience of information in antenatal Down syndrome screening – A randomized controlled trial

Björklund, Ulla; Marsk, Anna; Levin, Charlotta; Öhman, Susanne Georgsson

doi:10.1016/j.pec.2011.07.004

Cited by 53 publications

(82 citation statements)

References 20 publications

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“…[12][13][14]21 Other studies evaluating the effect of patient decision aids on decisionmaking regarding prenatal testing for fetal chromosomal abnormalities have been published. Previous studies have reported on the application of booklets with worksheets, 22,23 information films, 24,25 and interactive computer programmes. [26][27][28] Although results from these studies cannot easily be compared because of heterogeneity in settings, interventions and outcome measures, most have general findings that correspond with the results of the present study.…”

Section: Discussionmentioning

confidence: 99%

“…[26][27][28] Although results from these studies cannot easily be compared because of heterogeneity in settings, interventions and outcome measures, most have general findings that correspond with the results of the present study. Nearly all found the application of a decision aid to increase pregnant women's decision-relevant knowledge [22][23][24][25][26][27] and informed decision-making. 23,25 In this trial, high baseline levels of informed decision-making in the control group notwithstanding the application of the web-based multimedia decision aid resulted in an increase in informed decision-making that was slightly higher than the effect found in previous evaluations.…”

Section: Discussionmentioning

confidence: 99%

“…Nearly all found the application of a decision aid to increase pregnant women's decision-relevant knowledge [22][23][24][25][26][27] and informed decision-making. 23,25 In this trial, high baseline levels of informed decision-making in the control group notwithstanding the application of the web-based multimedia decision aid resulted in an increase in informed decision-making that was slightly higher than the effect found in previous evaluations. 23,25 As the information provided in a decision aid is standardised, thus not affected by the counsellor's knowledge and attitudes, it is more likely to be accurate and non-directive than traditional methods of counselling.…”

Section: Discussionmentioning

confidence: 99%

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The effect of a decision aid on informed decision-making in the era of non-invasive prenatal testing: a randomised controlled trial

et al. 2016

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Early in pregnancy women and their partners face the complex decision on whether or not to participate in prenatal testing for fetal chromosomal abnormalities. Several studies show that the majority of pregnant women currently do not make informed decisions regarding prenatal testing. As the range of prenatal tests is expanding due to the development of new techniques such as non-invasive prenatal testing (NIPT), autonomous reproductive decision-making is increasingly challenging. In this study, a randomised controlled trial was conducted to evaluate the effect of a web-based multimedia decision aid on decision-making regarding prenatal testing. The decision aid provided both written and audiovisual information on prenatal tests currently available, that is, prenatal screening by first-trimester combined testing, NIPT and invasive diagnostic testing through chorionic villus sampling or amniocentesis. Furthermore, it contained values clarification exercises encouraging pregnant women to reflect on the potential harms and benefits of having prenatal tests performed. The use of the decision aid improved informed decisionmaking regarding prenatal testing. Of pregnant women allocated to the intervention group (n = 130) 82.3% made an informed choice compared with 66.4% of women in the control group (n = 131), P = 0.004. As the vast majority of pregnant women made decisions consistent with their attitudes towards having prenatal testing performed, this improvement in informed decisionmaking could be attributed mainly to an increase in decision-relevant knowledge. This study shows that the implementation of a web-based multimedia decision aid directly facilitates the ultimate goal of prenatal testing for fetal chromosomal abnormalities, which is enabling informed autonomous reproductive choice. European Journal of Human Genetics (2016) 24, 1409-1416; doi:10.1038/ejhg.2016.39; published online 18 May 2016 INTRODUCTIONThe main purpose of prenatal testing for fetal chromosomal abnormalities is facilitating autonomous reproductive decision-making for pregnant women and their partners, rather than achieving high uptake rates or prevention of children with chromosomal abnormalities being born. 1,2 In order to achieve autonomous reproductive decisionmaking, the choice to accept or decline prenatal testing should be informed. An informed choice is made when a woman has adequate decision-relevant knowledge and when her participation or nonparticipation is consistent with her values and attitudes towards undergoing prenatal testing. 3,4 It requires healthcare professionals to provide accurate, comprehensive and neutral information about the options available. Subsequently, the pregnant woman has to be encouraged to integrate this knowledge with her personal values when reflecting on the possible implications of having prenatal testing performed. Most international evaluations show that the majority of pregnant women currently do not make informed decisions regarding prenatal testing. 5,6 With the development and introduction of n...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The effect of a decision aid on informed decision-making in the era of non-invasive prenatal testing: a randomised controlled trial

et al. 2016

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“…To safeguard informed decision‐making, emphasis has to be placed on further development of information tools and maintaining good counseling. The use of decision aids29, 30 or visuals aids such as an informational film31 may have a positive effect on informed decision‐making by improving knowledge and assisting women in making decisions that are consistent with their values. Special attention should be given to women with a lower educational level and/or inadequate health literacy.…”

Section: Discussionmentioning

confidence: 99%

Trial by Dutch laboratories for evaluation of non‐invasive prenatal testing. Part II—women's perspectives

et al. 2016

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ObjectiveTo evaluate preferences and decision‐making among high‐risk pregnant women offered a choice between Non‐Invasive Prenatal Testing (NIPT), invasive testing or no further testing.MethodsNationwide implementation study (TRIDENT) offering NIPT as contingent screening test for women at increased risk for fetal aneuploidy based on first‐trimester combined testing (>1:200) or medical history. A questionnaire was completed after counseling assessing knowledge, attitudes and participation following the Multidimensional Measure of Informed Choice.ResultsA total of 1091/1253 (87%) women completed the questionnaire. Of these, 1053 (96.5%) underwent NIPT, 37 (3.4%) invasive testing and 1 (0.1%) declined testing. 91.7% preferred NIPT because of test safety. Overall, 77.9% made an informed choice, 89.8% had sufficient knowledge and 90.5% had positive attitudes towards NIPT. Women with intermediate (odds ratio (OR) = 3.51[1.70–7.22], p < 0.001) or high educational level (OR = 4.36[2.22–8.54], p < 0.001) and women with adequate health literacy (OR = 2.60[1.36–4.95], p = 0.004) were more likely to make an informed choice. Informed choice was associated with less decisional conflict and less anxiety (p < 0.001). Intention to terminate the pregnancy for Down syndrome was higher among women undergoing invasive testing (86.5%) compared to those undergoing NIPT (58.4%) (p < 0.001).ConclusionsThe majority of women had sufficient knowledge and made an informed choice. Continuous attention for counseling is required, especially for low‐educated and less health‐literate women. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.

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“…Pregnant women can receive information about prenatal screening from different sources such as health care, pamphlets, books, the internet, friends and family (Park & Matthews, 2009). Film as a source of information has shown to increase the knowledge (Björklund et al, 2011, Hewison et al, 2001. Regarding information about prenatal screening, a study was performed with the aim to compare the growth of maternal-fetal emotional attachment in groups of women whose decisions about participation in screening were informed or not informed.…”

Section: Importance Of Informationmentioning

confidence: 99%

Prenatal Examinations for Down Syndrome and Possible Effects on Maternal-Fetal Attachment

Öhman¹

2011

Prenatal Diagnosis and Screening for Down Syndrome

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Audiovisual information affects informed choice and experience of information in antenatal Down syndrome screening – A randomized controlled trial

Cited by 53 publications

References 20 publications

The effect of a decision aid on informed decision-making in the era of non-invasive prenatal testing: a randomised controlled trial

The effect of a decision aid on informed decision-making in the era of non-invasive prenatal testing: a randomised controlled trial

Trial by Dutch laboratories for evaluation of non‐invasive prenatal testing. Part II—women's perspectives

Prenatal Examinations for Down Syndrome and Possible Effects on Maternal-Fetal Attachment

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