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Multicenter Study
. 2018 Jun 8;18(1):434.
doi: 10.1186/s12913-018-3244-1.

Pregnant women's views on how to promote the use of a decision aid for Down syndrome prenatal screening: a theory-informed qualitative study

Titilayo Tatiana Agbadjé  1   2 , Matthew Menear  1   2 , Michèle Dugas  1   2 , Marie-Pierre Gagnon  3 , Samira Abbasgholizadeh Rahimi  1   2 , Hubert Robitaille  1   2 , Anik M C Giguère  2   4   5 , François Rousseau  6   7 , Brenda J Wilson  8 , France Légaré  9   10   11   12
Affiliations
Multicenter Study

Pregnant women's views on how to promote the use of a decision aid for Down syndrome prenatal screening: a theory-informed qualitative study

Titilayo Tatiana Agbadjé et al. BMC Health Serv Res. .

Abstract

Background: For pregnant women and their partners, the decision to undergo Down syndrome prenatal screening is difficult. Patient decision aids (PtDA) can help them make an informed decision. We aimed to identify behaviour change techniques (BCTs) that would be useful in an intervention to promote the use of a PtDA for Down syndrome prenatal screening, and to identify which of these BCTs pregnant women found relevant and acceptable.

Methods: Using the Behaviour Change Wheel and the Theoretical Domains Framework, we conducted a qualitative descriptive study. First, a group of experts from diverse professions, disciplines and backgrounds (eg. medicine, engineering, implementation science, community and public health, shared decision making) identified relevant BCTs. Then we recruited pregnant women consulting for prenatal care in three clinical sites: a family medicine group, a birthing centre (midwives) and a hospital obstetrics department in Quebec City, Canada. To be eligible, participants had to be at least 18 years old, having recently given birth or at least 16 weeks pregnant with a low-risk pregnancy, and have already decided about prenatal screening. We conducted three focus groups and asked questions about the relevance and acceptability of the BCTs. We analysed verbatim transcripts and reduced the BCTs to those the women found most relevant and acceptable.

Results: Our group of experts identified 25 relevant BCTs relating to information, support, consequences, others' approval, learning, reward, environmental change and mode of delivery. Fifteen women participated in the study with a mean age of 27 years. Of these, 67% (n = 10) were pregnant for the first time, 20% (n = 3) had difficulty making the decision to take the test, and 73% had made the decision with their partner. Of the 25 BCTs identified using the Behaviour Change Wheel, the women found the following 10 to be most acceptable and relevant: goal setting (behaviour), goal setting (results), problem solving, action plan, social support (general), social support (practical), restructuring the physical environment, prompts/cues, credible sources and modelling or demonstration of the behaviour.

Conclusions: An intervention to promote PtDA use among pregnant women for Down syndrome prenatal screening should incorporate the 10 BCTs identified.

Keywords: Behaviour change techniques; Behaviour change wheel; Down syndrome prenatal screening; Intervention; Patient decision aid; Pregnant women; Promotion; Shared decision making; Theoretical domains framework; Theory of planned behaviour.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics approval was obtained from the research ethics boards of the Centre de Santé et de Services Sociaux de la Vieille-Capitale (#2013–2014-29) in Quebec, and the CHU de Québec (#B14–02-1929). The project was described to eligible women and they were told that the data was anonymous and confidential. Those who wished to participate gave written consent.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Study phases
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References

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