Prenatal screening for Down syndrome: a survey of willingness in women and family physicians to engage in shared decision‐making

St‐Jacques, Sylvie; Gagnon, Serge; Njoya, Merlin; Brisson, Michel; Frémont, Pierre; Rousseau, François

doi:10.1002/pd.2624

Cited by 58 publications

(48 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These findings are congruent with earlier research on SDM implementation in this context [26], which showed that attitude, subjective norm, self-efficacy, and moral norm were determinants of pregnant women’s intention to engage in SDM. Although the variables “descriptive norm” and “anticipated regret” were not investigated in the earlier study, the influence of social pressure came out through the subjective norm variable, which refers to the influence of significant individuals in women’s entourage.…”

Section: Discussionsupporting

confidence: 91%

“…Our results support earlier research on SDM implementation indicating that women showed a strong intention to engage in SDM regarding prenatal screening for Down syndrome [26]. Moreover, this high level of intention may reflect a need felt by pregnant women facing prenatal screening choices to become more skilled in discussing screening tests with their health care provider, which is congruent with the literature on pregnant women’s decision-making needs [4,6,9].…”

Section: Discussionsupporting

confidence: 89%

“…In addition, in the context of prenatal screening, pregnant women with fewer years of education have reported being less willing to engage in shared decision making (SDM) [26]. This is congruent with a growing body of literature indicating that health literacy is a potential barrier to SDM [27-29] and to the use of DAs [30,31].…”

Section: Introductionmentioning

confidence: 93%

See 2 more Smart Citations

Role of Psychosocial Factors and Health Literacy in Pregnant Women’s Intention to Use a Decision Aid for Down Syndrome Screening: A Theory-Based Web Survey

et al. 2016

Self Cite

View full text Add to dashboard Cite

BackgroundDeciding about undergoing prenatal screening is difficult, as it entails risks, potential loss and regrets, and challenges to personal values. Shared decision making and decision aids (DAs) can help pregnant women give informed and values-based consent or refusal to prenatal screening, but little is known about factors influencing the use of DAs.ObjectiveThe objective of this study was to identify the influence of psychosocial factors on pregnant women’s intention to use a DA for prenatal screening for Down syndrome (DS). We also added health literacy variables to explore their influence on pregnant women’s intention.MethodsWe conducted a survey of pregnant women in the province of Quebec (Canada) using a Web panel. Eligibility criteria included age >18 years, >16 weeks pregnant, low-risk pregnancy, and having decided about prenatal screening for the current pregnancy. We collected data based on an extended version of the Theory of Planned Behavior assessing 7 psychosocial constructs (intention, attitude, anticipated regret, subjective norm, descriptive norm, moral norm, and perceived control), 3 related sets of beliefs (behavioral, normative, and control beliefs), 4 health literacy variables, and sociodemographics. Eligible women watched a video depicting the behavior of interest before completing a Web-based questionnaire. We performed descriptive, bivariate, and ordinal logistic regression analyses.ResultsOf the 383 eligible pregnant women who agreed to participate, 350 pregnant women completed the Web-based questionnaire and 346 were retained for analysis (completion rate 350/383, 91.4%; mean age 30.1, SD 4.3, years). In order of importance, factors influencing intention to use a DA for prenatal screening for DS were attitude (odds ratio, OR, 9.16, 95% CI 4.02-20.85), moral norm (OR 7.97, 95% CI 4.49-14.14), descriptive norm (OR 2.83, 95% CI 1.63-4.92), and anticipated regret (OR 2.43, 95% CI 1.71-3.46). Specific attitudinal beliefs significantly related to intention were that using a DA would reassure them (OR 2.55, 95% CI 1.73-4.01), facilitate their reflections with their spouse (OR 1.55, 95% CI 1.05-2.29), and let them know about the advantages of doing or not doing the test (OR 1.53, 95% CI 1.05-2.24). Health literacy did not add to the predictive power of our model (P values range .43-.92).ConclusionsImplementation interventions targeting the use of a DA for prenatal screening for DS by pregnant women should address a number of modifiable factors, especially by introducing the advantages of using the DA (attitude), informing pregnant women that they might regret not using it (anticipated regret), and presenting the use of DAs as a common practice (descriptive norm). However, interventions on moral norms related to the use of DA should be treated with caution. Further studies that include populations with low health literacy are needed before decisive claims can be made.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

Role of Psychosocial Factors and Health Literacy in Pregnant Women’s Intention to Use a Decision Aid for Down Syndrome Screening: A Theory-Based Web Survey

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…First, there was a ceiling effect, with physicians showing high scores on all these measures before the intervention. Since patient and public involvement is getting popular and physicians are more aware of SDM, it is not surprising that we observed high intention, as other studies have done [17,34]. Second, the TPB defines and distinguishes between several precise behaviors in great detail [35].…”

Section: Discussionmentioning

confidence: 54%

Impact of DECISION + 2 on patient and physician assessment of shared decision making implementation in the context of antibiotics use for acute respiratory infections

et al. 2013

Self Cite

View full text Add to dashboard Cite

BackgroundDECISION + 2, a training program for physicians, is designed to implement shared decision making (SDM) in the context of antibiotics use for acute respiratory tract infections (ARTIs). We evaluated the impact of DECISION + 2 on SDM implementation as assessed by patients and physicians, and on physicians’ intention to engage in SDM.MethodsFrom 2010 to 2011, a multi-center, two-arm, parallel randomized clustered trial appraised the effects of DECISION + 2 on the decision to use antibiotics for patients consulting for ARTIs. We randomized 12 family practice teaching units (FPTUs) to either DECISION + 2 or usual care. After the consultation, both physicians and patients independently completed questionnaires based on the D-Option scale regarding SDM behaviors during the consultation. Patients also answered items assessing the role they assumed during the consultation (active/collaborative/passive). Before and after the intervention, physicians completed a questionnaire based on the Theory of Planned Behavior to measure their intention to engage in SDM. To account for the cluster design, we used generalized estimating equations and generalized linear mixed models to assess the impact of DECISION + 2 on the outcomes of interest.ResultsA total of 270 physicians (66% women) participated in the study. After DECISION + 2, patients’ D-Option scores were 80.1 ± 1.1 out of 100 in the intervention group and 74.9 ± 1.1 in the control group (p = 0.001). Physicians’ D-Option scores were 79.7 ± 1.8 in the intervention group and 76.3 ± 1.9 in the control group (p = 0.2). However, subgroup analyses showed that teacher physicians D-Option scores were 79.7 ± 1.5 and 73.0 ± 1.4 respectively (p = 0.001). More patients reported assuming an active or collaborative role in the intervention group (67.1%), than in the control group (49.2%) (p = 0.04). There was a significant relation between patients’ and physicians’ D-Option scores (p < 0.01) and also between patient-reported assumed roles and both D-Option scores (as assessed by patients, p < 0.01; and physicians, p = 0.01). DECISION + 2 had no impact on the intention of physicians to engage in SDM.ConclusionDECISION + 2 positively influenced SDM behaviors as assessed by patients and teacher physicians. Physicians’ intention to engage in SDM was not affected by DECISION + 2.Trial registrationClinicalTrials.gov trials register no. NCT01116076.

show abstract

“…In addition, not all clinicians are convinced of the benefits of SDM (33)(34)(35). Patient-reported barriers for SDM are their lack of awareness about having a choice, low confidence in their capacity to participate, a self-perceived lack of knowledge, low health literacy, low numeracy skills and uncertainty about what questions to ask (36)(37)(38)(39)(40)(41).…”

Section: Barriers To Shared Decision-makingmentioning

confidence: 99%

Shared decision-making in rheumatology : what matters to patients?

Nota

View full text Add to dashboard Cite

Prenatal screening for Down syndrome: a survey of willingness in women and family physicians to engage in shared decision‐making

Abstract: Overall, the women and their FPs wished to engage in SDM as regards prenatal Down-syndrome screening. Only a few factors influenced this desire which therefore may be modifiable.

Cited by 58 publications

References 27 publications

Role of Psychosocial Factors and Health Literacy in Pregnant Women’s Intention to Use a Decision Aid for Down Syndrome Screening: A Theory-Based Web Survey

Role of Psychosocial Factors and Health Literacy in Pregnant Women’s Intention to Use a Decision Aid for Down Syndrome Screening: A Theory-Based Web Survey

Impact of DECISION + 2 on patient and physician assessment of shared decision making implementation in the context of antibiotics use for acute respiratory infections

Shared decision-making in rheumatology : what matters to patients?

Contact Info

Product

Resources

About