Implementing Group Prenatal Counseling for Expanded Noninvasive Screening Options

Abstract

Recently, practices have begun integrating cell-free DNA-based noninvasive prenatal screening as a screening option for a variety of genetic conditions. According to the National Society of Genetic Counselors, the integration of cfDNA screening into clinical prenatal practice may "significantly shift the paradigm of prenatal testing and screening for all women." The purpose of this study was to determine whether group information sessions can feasibly serve as an alternative to extended one-on-one genetic counseling for the increasing number of women making decisions about prenatal testing and screening. This study assessed the effect of group genetic information sessions coupled with abbreviated counseling on pregnant women's knowledge about and attitudes toward prenatal testing and screening.

Facilitating informed choice about non-invasive prenatal testing (NIPT): a systematic review and qualitative meta-synthesis of women’s experiences

“…Women’s understanding has been shown to improve in a research setting, or a clinical setting with dedicated time and resources for counselling [89]. Outside of these settings, group prenatal counselling by expert clinicians has been suggested as a way to alleviate the barriers of time and provider confidence [90–92]. In the format proposed by Gammon and colleagues [90], several patients would receive education on prenatal screening and testing options at the same time, followed by a confidential, one-on-one session for individual questions and familial risk assessment.…”

“…Outside of these settings, group prenatal counselling by expert clinicians has been suggested as a way to alleviate the barriers of time and provider confidence [90–92]. In the format proposed by Gammon and colleagues [90], several patients would receive education on prenatal screening and testing options at the same time, followed by a confidential, one-on-one session for individual questions and familial risk assessment. Gammon and colleagues [90] found that receiving counselling in this format increased participants’ acceptance of prenatal testing, their confidence in that decision, and their knowledge of the relevant technologies.…”

“…In the format proposed by Gammon and colleagues [90], several patients would receive education on prenatal screening and testing options at the same time, followed by a confidential, one-on-one session for individual questions and familial risk assessment. Gammon and colleagues [90] found that receiving counselling in this format increased participants’ acceptance of prenatal testing, their confidence in that decision, and their knowledge of the relevant technologies. This study provides us with an indication that group prenatal or genetic counselling sessions may be a viable option as we consider expanding access to NIPT.…”

“…However, it is possible that ensuring women are well-informed about NIPT and other prenatal screening modalities may help to safeguard against such a use of the test. For example, Gammon and colleagues [90] found that participants who received group counselling were less likely to opt for screening for fetal sex.…”

Educational and Ethical Considerations for Genetic Test Implementation Within Health Care Systems

“…47 To address gaps in coverage, alternative health care delivery models to increase genetic counseling access in CGC-desert areas include telegenetic medicine and interactive web consults, greater health care workforce provider education and training (i.e., registered nurses [RNs], licensed clinical social workers) in CGC-limited settings, group counseling sessions, and cultivation of innovative institutional collaborations between rural facilities and larger academic partners. [48][49][50] Nurses. RNs are the largest body of health care provider and play a key role in the provision of health care services to patients, families, and communities.…”