Pregnancy Clinical Trial
Official title:
The Effect of Standardized Video Education on Prenatal Genetic Testing Choices, Decisional Conflict, and Decisional Regret
The purpose of the investigator's study is to assess the effect of a standardized prenatal testing educational video on the use of prenatal genetic testing and decision-making.
This is a prospective randomized trial of video education on prenatal testing vs. usual care,
with the goal to assess women's prenatal testing choices, understanding of testing options
and decisional conflict and regret. Participants will be recruited from a convenience sample
of patients presenting for prenatal care at Naval Medical Center San Diego (NMCSD).
While receiving prenatal care at NMCSD, all women are offered the option of screening for
aneuploidy (serum screen (with or without nuchal translucency ultrasound) or cell free DNA
testing) or diagnostic testing (chorionic villous sampling or amniocentesis) or no testing in
pregnancy.
After providing consent, participants will be randomized to video education or usual care.
Randomization will be completed using a random number table. Women randomized to the
intervention group (video education) will view the prenatal screening video made by the
Genetic Support Foundation and the Washington Department of Health, the 4.5 minute video "How
to Decide About Prenatal Genetic Testing," available at:
https://www.geneticsupportfoundation.org/genetics-and-you/pregnancy-and-genetics/prenatal-gen
etic-testing-videos .7 They will then complete the study related surveys at their initial
obstetric visit. The educational video was created with input from clinicians including
licensed genetic counselors, obstetricians, maternal fetal medicine physicians, and patients.
Extensive testing and reviewing was completed to ensure adequate comprehension by a wide
range of audiences and minimize counseling bias. Women randomized to the control group will
receive routine prenatal care with no additional study intervention other than completion of
the study related surveys at baseline (initial prenatal testing). Current national guidelines
recommend offering all women prenatal diagnosis and prenatal screening at the beginning of
the pregnancy.1
The primary outcome for this study will be screening uptake rates, and will be based on
review of the patient's electronic medical record. Secondary outcomes will include invasive
diagnostic test rates, participant knowledge about testing (as assessed using the Maternal
Serum Screening Knowledge Questionnaire,2 and decisional conflict (as assessed by the
Decisional Conflict Scale) and decisional regret (as assessed by the Decision Regret Scale).
These assessments will be conducted at time of prenatal testing (< 20 weeks). (Appendix A)
The study questionnaire will include a check box for participants to indicate if they would
be willing to participate in a follow on qualitative study to assess participant's personal
experience related to their method of education about prenatal testing. This component of the
study will aim to determine personal and social reasoning behind their decisions, and to
further explore their experience, beliefs and behaviors. Interested participants from each
group (both intervention and control) will be contacted to arrange a telephone or in person
interview. (Appendix C) Participants will be interviewed in person or over the phone.
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