MedPath

Game-Based Decision Aid to Educate Pregnant Women About Prenatal Screening

Not Applicable
Completed
Conditions
Prenatal Disorder
Interventions
Behavioral: Meaning of Screening
Registration Number
NCT03441672
Lead Sponsor
University of Utah
Brief Summary

Significant barriers exist for effectively informing women about prenatal screening in the clinical setting. This project developed and evaluated the efficacy of a game decision aid among pregnant women about prenatal screening in a randomized controlled study.

Detailed Description

Prenatal genetic screening has grown at a rapid rate and whole genome sequence of an unborn fetus is expected to be widely available in the next few years. However, significant barriers remain for effectively informing couples about their risks and options for identifying and managing chromosomal anomalies and heritable conditions during pregnancy. It is widely recognized that current standards for patient education in this domain are largely ineffective. Decisions about prenatal screening are based on pregnant couples' values and knowledge so clinicians are often challenged with being informative but non-directive. Prenatal screening has grown significantly in recent years because the American College of Obstetricians and Gynecologists recommends prenatal care providers now offer all women prenatal genetic screening in the first trimester of pregnancy, regardless of age, or genetic risk status. This has moved the focus of prenatal screening from a subset of higher risk pregnant couples to all pregnant couples and to an earlier time in pregnancy.

To address these information needs, we are undertaking a novel approach to inform couples about screening. "Gaming" tools have demonstrated promising outcomes for improved health care decision-making and compliance with health recommendations. In contrast to other computer applications for the dissemination of information, game technology goes beyond information delivery and engages users in different life choice scenarios. Further, these tools can assess whether the attractiveness (or unattractiveness) of different simulated choices can offer insights about one's values. In this value-laden context, the game allows individuals to explore their personal values in a non-directive fashion and allows a comparison of the game choices and values with an individual's reproductive partner.

The purpose of this application is to 1) develop a prenatal screening gaming application prototype (PS-GAP) and 2) conduct a preliminary assessment of the PS-GAP on knowledge, satisfaction, and decisional conflict about prenatal genetic screening for pregnant women and their partners.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
79
Inclusion Criteria
  • English speaking
  • less than 15 weeks gestation
  • attending first obstetric visit
  • low risk pregnancy
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Exclusion Criteria
  • Non-English speaking
  • High risk pregnancy
  • Past 15 weeks gestation
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
InterventionMeaning of ScreeningParticipants in the intervention group interact with the game technology to learn about prenatal screening, in addition to usual care provided in the clinic.
Primary Outcome Measures
NameTimeMethod
Level of knowledge about prenatal screening and prenatal diagnostic testingImmediately after intervention

prenatal screening knowledge is measured with a 23-item survey developed by an expert panel of genetic counselors, physicians, social scientists and data collection experts. All questions use a five point likert scale for response.

Secondary Outcome Measures
NameTimeMethod
Documentation of decision to undergo prenatal screeningUp to 4 weeks after intervention

Documentation of participant's decision to complete prenatal screening or not, as pulled from the medical record.

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