Prenatal Disorder Clinical Trial
Official title:
Improved Prenatal Genetic Screening Decision Making Through Interactive Technology
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.
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.
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