scholarly journals Development of a Discrete Choice Experiment (DCE) questionnaire to elicit values by pregnant women and decision-makers for the expansion of a NIPS-based prenatal screening program

2021 ◽  
Author(s):  
Hung Manh Nguyen ◽  
Carmen Lindsay ◽  
Mohammad Baradaran ◽  
Jason Robert Guertin ◽  
Leon Nshimyumukiza ◽  
...  
Keyword(s):  
Literature Review ◽  
Pregnant Women ◽  
Online Survey ◽  
Prenatal Screening ◽  
Screening Program ◽  
Pilot Project ◽  
Decision Makers ◽  
Added Value ◽  
Chromosomal Anomalies ◽  
Care Providers

Abstract BackgroundIn an accountable world, being able to take into account the value given by relevant stakeholders to an intervention that could be offered to the population is considered as desirable. DCE is an approach particularly suited for the measurement of such values in the field of prenatal care. Yet, DCE studies in the field of prenatal screening have focused mainly on pregnant women and their care providers but have neglected another key actor, the decision-makers. The objective of the study was to develop a DCE instrument applicable to pregnant women and decision-makers, for the evaluation of new conditions to be added to a screening program for fetal chromosomal anomalies.MethodsAn instrument development study was undertaken. Methods employed included a literature review, a qualitative study performed on pregnant women and decision-makers, and a pilot project to validate the developed instrument and test the feasibility of its administration through an online survey platform. ResultsAn initial list of ten attributes and levels were built from the information provided by the literature review and the qualitative research component of the study. Seven attributes were built based on responses provided by participants from both groups. Two attributes were built from what was said by women only and one from what was said by decision-makers only. Search for consensus through consultations and a focus group discussion led to the retention of eight attributes. A pilot project was then performed with 33 pregnant women. This led to the exclusion of one attribute that showed poor influence on the choice making. The final version of the instrument contains seven attributes.ConclusionThis paper presents the construction of a DCE instrument that can be administered to pregnant women on the demand side, and decision-makers on the supply side. Such an instrument to measure the social desirability of an intervention could be an added value to the decision-making process of Health Technology Assessment agencies.

scholarly journals Routinization of prenatal screening with the non-invasive prenatal test: pregnant women’s perspectives

2021 ◽  
Author(s):  
Karuna R. M. van der Meij ◽  
Annabel Njio ◽  
Linda Martin ◽  
Janneke T. Gitsels-van der Wal ◽  
Mireille N. Bekker ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Pregnant Women ◽  
Prenatal Screening ◽  
Screening Program ◽  
Informed Choice ◽  
Aneuploidy Screening ◽  
Non Invasive ◽  
Fetal Aneuploidy ◽  
Societal Pressure ◽  
Prenatal Test

AbstractDue to the favorable test characteristics of the non-invasive prenatal test (NIPT) in the screening of fetal aneuploidy, there has been a strong and growing demand for implementation. In the Netherlands, NIPT is offered within a governmentally supported screening program as a first-tier screening test for all pregnant women (TRIDENT-2 study). However, concerns have been raised that the test’s favorable characteristics might lead to uncritical use, also referred to as routinization. This study addresses women’s perspectives on prenatal screening with NIPT by evaluating three aspects related to routinization: informed choice, freedom to choose and (personal and societal) perspectives on Down syndrome. Nationwide, a questionnaire was completed by 751 pregnant women after receiving counseling for prenatal screening. Of the respondents, the majority (75.5%) made an informed choice for prenatal screening as measured by the multidimensional measure of informed choice (MMIC). Education level and religious affiliation were significant predictors of informed choice. The main reason to accept screening was “seeking reassurance” (25.5%), and the main reason to decline was “every child is welcome” (30.6%). The majority of respondents (87.7%) did not perceive societal pressure to test. Differences between test-acceptors and test-decliners in personal and societal perspectives on Down syndrome were found. Our study revealed high rates of informed decision-making and perceived freedom to choose regarding fetal aneuploidy screening, suggesting that there is little reason for concern about routinization of NIPT based on the perspectives of Dutch pregnant women. Our findings highlight the importance of responsible implementation of NIPT within a national screening program.

scholarly journals Informed Choice for Participation in Down Syndrome Screening: Development and Content of a Web-Based Decision Aid

2015 ◽  
Vol 4 (3) ◽  
pp. e113 ◽  
Author(s):  
Mette Maria Skjøth ◽  
Helle Ploug Hansen ◽  
Eva Draborg ◽  
Claus Duedal Pedersen ◽  
Ronald F Lamont ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Pregnant Women ◽  
Decision Aid ◽  
Screening Program ◽  
Informed Choice ◽  
Care Providers ◽  
Patient Decision Aid ◽  
Web Based ◽  
Patient Decision ◽  
Down Syndrome Screening

Background In Denmark, all pregnant women are offered screening in early pregnancy to estimate the risk of having a fetus with Down syndrome. Pregnant women participating in the screening program should be provided with information and support to allow them to make an informed choice. There is increasing interest in the use of Web-based technology to provide information and digital solutions for the delivery of health care. Objective The aim of this study was to develop an eHealth tool that contained accurate and relevant information to allow pregnant women to make an informed choice about whether to accept or reject participation in screening for Down syndrome. Methods The development of the eHealth tool involved the cooperation of researchers, technology experts, clinicians, and users. The underlying theoretical framework was based on participatory design, the International Patient Decision Aid Standards (IPDAS) Collaboration guide to develop a patient decision aid, and the roadmap for developing eHealth technologies from the Center for eHealth Research and Disease Management (CeHRes). The methods employed were a systematic literature search, focus group interviews with 3 care providers and 14 pregnant women, and 2 weeks of field observations. A qualitative descriptive approach was used in this study. Results Relevant themes from pregnant women and care providers with respect to information about Down syndrome screening were identified. Based on formalized processes for developing patient decision aids and eHealth technologies, an interactive website containing information about Down syndrome, methods of screening, and consequences of the test was developed. The intervention was based on user requests and needs, and reflected the current hospital practice and national guidelines. Conclusions This paper describes the development and content of an interactive website to support pregnant women in making informed choices about Down syndrome screening. To develop the website, we used a well-structured process based on scientific evidence and involved pregnant women, care providers, and technology experts as stakeholders. To our knowledge, there has been no research on the combination of IPDAS standards and the CeHRes roadmap to develop an eHealth tool to target information about screening for Down syndrome.

scholarly journals The Presence of Mycotoxins in Human Amniotic Fluid

Toxins ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 409
Author(s):  
Karolina Gromadzka ◽  
Jakub Pankiewicz ◽  
Monika Beszterda ◽  
Magdalena Paczkowska ◽  
Beata Nowakowska ◽  
...  
Keyword(s):  
High Risk ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Prenatal Screening ◽  
Genetic Defects ◽  
Chromosomal Anomalies ◽  
Risk Characterization ◽  
Fusarium Mycotoxins ◽  
Human Amniotic Fluid ◽  
Toxic Metabolites

Mycotoxin exposure assessments through biomonitoring studies, based on the analysis of amniotic fluid, provides useful information about potential exposure of mothers and fetuses to ubiquitous toxic metabolites that are routinely found in food and the environment. In this study, amniotic fluid samples (n = 86) were collected via abdominal amniocentesis at 15–22 weeks of gestation from pregnant women with a high risk of chromosomal anomalies or genetic fetal defects detected during 1st trimester prenatal screening. These samples were analyzed for the presence of the most typical Aspergillus, Penicillium and Fusarium mycotoxins, with a focus on aflatoxins, ochratoxins and trichothecenes, using the LC-FLD/DAD method. The results showed that the toxin was present in over 75% of all the tested samples and in 73% of amniotic fluid samples from fetuses with genetic defects. The most frequently identified toxins were nivalenol (33.7%) ranging from <LOQ to 4037.6 ng/mL, and aflatoxins (31.4%), including aflatoxin G1, ranging from <LOQ to 0.4 ng/mL. Ochratoxin A and deoxynivalenol were identified in 26.7% and 27.9% of samples, respectively. Bearing in mind the above, the detection of mycotoxin levels in amniotic fluid is useful for the estimation of overall risk characterization with an attempt to link the occurrence of fetal abnormalities with exposure to mycotoxins in utero.

scholarly journals The effectiveness of risk assessments in informing decision makers

2021 ◽  
Author(s):  
◽  
Christopher Peace
Keyword(s):  
Risk Assessment ◽  
Pilot Study ◽  
Literature Review ◽  
Case Studies ◽  
Online Survey ◽  
Success Factors ◽  
Necessary Conditions ◽  
Decision Makers ◽  
Risk Assessments ◽  
Critical Success

<p>Purpose: This research examined the effectiveness of risk assessments in an organisational setting and found that risk assessors may not effectively assess risks and so may not provide the best available information or effective advice to decision makers. However, guidance on the conduct of risk assessments is scattered across many organisational, economic and technological domains with little consistency in definitions and processes, perhaps contributing to ineffective risk assessments. This is an area of academic and practical relevance that can be investigated rigorously and has the potential to improve decision making.  Design/methodology: The main research question was:  RQ. Can a generic goal tree, populated with critical success factors and necessary conditions derived from the literature and case studies, be developed that would help decision makers and risk assessors to evaluate the effectiveness of risk assessments before they are used to aid a decision?  The research described here used a pragmatist approach to managerial practice and associated practitioner problems related to (1) how effectively risk assessments informed decision makers before decisions were made; (2) how formal risk assessments were carried out; and (3) how risk assessments might be improved. Following a comprehensive literature review, an online survey was used to determine what methods are employed currently, while case studies investigated the conduct of risk assessments in context. The literature review indicated that risk has many connotations and diverse definitions and conceptualisations, leading to the conclusion that a given risk assessment should state the definition of risk used. The ISO31000 definitions of risk ("effect of uncertainty on objectives") and risk assessments were found to be most useful for this research. The online survey of risk and safety practitioners found little use of structured techniques or consideration of human factors, a finding also reflected in the case studies.  Potential critical success factors and necessary conditions for an effective risk assessment were identified from the literature review and linked using the Theory of Constraints logic processes to form a tentative goal tree (GT) including the entities and relationships underpinning effective risk assessment. This also provided a means of structuring and reporting the online survey data, and critiquing a pilot study and five further case studies, and selected professional practice developments.  The case studies explored in detail how risk assessments were carried out in support of a management decision. Each case was investigated using document and literature reviews, and structured, one-on-one interviews, including review of the tentative GT by interviewees. Qualitative data from the case studies was analysed using NVivo and quantitative data from the online survey was analysed using SPSS.  Findings: This research demonstrated the ontological and epistemological basis of the GT, justifying it as effective research tool and enquiry system and the goal tree diagram as an effective problem representation system. Together, the goal tree process and diagram provide guidance to practice, and in this research, act as a qualitative tool for predicting the effectiveness of risk assessments.  Research limitations: This work was limited to an online survey, a pilot study and five case studies to explore risk assessments in an organisational setting. However, the findings corroborate anecdotal evidence that risk assessments are not effective, and the need for mechanisms for improvement.  Practical implications: This research has identified a need for training in risk assessments in New Zealand. Mechanisms for improving risk assessments are identified, with one (a ‘risk canvas’) being developed for and tested during a series of training workshops and found to improve performance and confidence (but not consistency or reproducibility of risk assessment results). Other proposed mechanisms include use of the McKinsey 7-S model in gap analysis; open access research evidence; and further development of the goal tree.  Originality: The research used a single goal tree and magnitudinal ratings of necessary conditions to judge the effectiveness of risk assessments in five organisations. The risk canvas to aid basic risk assessments was shown to provide improved risk assessment process.</p>

scholarly journals The effectiveness of risk assessments in informing decision makers

2021 ◽  
Author(s):  
◽  
Christopher Peace
Keyword(s):  
Risk Assessment ◽  
Pilot Study ◽  
Literature Review ◽  
Case Studies ◽  
Online Survey ◽  
Success Factors ◽  
Necessary Conditions ◽  
Decision Makers ◽  
Risk Assessments ◽  
Critical Success

<p>Purpose: This research examined the effectiveness of risk assessments in an organisational setting and found that risk assessors may not effectively assess risks and so may not provide the best available information or effective advice to decision makers. However, guidance on the conduct of risk assessments is scattered across many organisational, economic and technological domains with little consistency in definitions and processes, perhaps contributing to ineffective risk assessments. This is an area of academic and practical relevance that can be investigated rigorously and has the potential to improve decision making.  Design/methodology: The main research question was:  RQ. Can a generic goal tree, populated with critical success factors and necessary conditions derived from the literature and case studies, be developed that would help decision makers and risk assessors to evaluate the effectiveness of risk assessments before they are used to aid a decision?  The research described here used a pragmatist approach to managerial practice and associated practitioner problems related to (1) how effectively risk assessments informed decision makers before decisions were made; (2) how formal risk assessments were carried out; and (3) how risk assessments might be improved. Following a comprehensive literature review, an online survey was used to determine what methods are employed currently, while case studies investigated the conduct of risk assessments in context. The literature review indicated that risk has many connotations and diverse definitions and conceptualisations, leading to the conclusion that a given risk assessment should state the definition of risk used. The ISO31000 definitions of risk ("effect of uncertainty on objectives") and risk assessments were found to be most useful for this research. The online survey of risk and safety practitioners found little use of structured techniques or consideration of human factors, a finding also reflected in the case studies.  Potential critical success factors and necessary conditions for an effective risk assessment were identified from the literature review and linked using the Theory of Constraints logic processes to form a tentative goal tree (GT) including the entities and relationships underpinning effective risk assessment. This also provided a means of structuring and reporting the online survey data, and critiquing a pilot study and five further case studies, and selected professional practice developments.  The case studies explored in detail how risk assessments were carried out in support of a management decision. Each case was investigated using document and literature reviews, and structured, one-on-one interviews, including review of the tentative GT by interviewees. Qualitative data from the case studies was analysed using NVivo and quantitative data from the online survey was analysed using SPSS.  Findings: This research demonstrated the ontological and epistemological basis of the GT, justifying it as effective research tool and enquiry system and the goal tree diagram as an effective problem representation system. Together, the goal tree process and diagram provide guidance to practice, and in this research, act as a qualitative tool for predicting the effectiveness of risk assessments.  Research limitations: This work was limited to an online survey, a pilot study and five case studies to explore risk assessments in an organisational setting. However, the findings corroborate anecdotal evidence that risk assessments are not effective, and the need for mechanisms for improvement.  Practical implications: This research has identified a need for training in risk assessments in New Zealand. Mechanisms for improving risk assessments are identified, with one (a ‘risk canvas’) being developed for and tested during a series of training workshops and found to improve performance and confidence (but not consistency or reproducibility of risk assessment results). Other proposed mechanisms include use of the McKinsey 7-S model in gap analysis; open access research evidence; and further development of the goal tree.  Originality: The research used a single goal tree and magnitudinal ratings of necessary conditions to judge the effectiveness of risk assessments in five organisations. The risk canvas to aid basic risk assessments was shown to provide improved risk assessment process.</p>

Identifiable Dietary Patterns of Pregnant Women: A Canadian Sample

2022 ◽  
pp. 1-8
Author(s):  
Lydia Tegwyn Mosher ◽  
Jamie A. Seabrook ◽  
Jasna Twynstra
Keyword(s):  
Pregnant Women ◽  
Health Care Providers ◽  
Online Survey ◽  
Maternal Diet ◽  
Nutrition Information ◽  
Sociodemographic Characteristics ◽  
Gluten Free ◽  
Care Providers ◽  
Balanced Diet ◽  
Low Carbohydrate

Purpose: To estimate the percentage of a sample of pregnant women in Canada following a vegetarian, vegan, low-carbohydrate, gluten-free, Mediterranean, or well-balanced diet, before and during pregnancy and to explore if pregnant women received and were satisfied with nutrition information received from health care providers (HCPs). Methods: Participants were conveniently sampled through Facebook and Twitter. An online survey collected data on sociodemographic characteristics, maternal diet, and whether women received and were satisfied with nutrition information from their HCPs. The McNemar test assessed changes in the proportion of diets followed before and during pregnancy. Results: Of 226 women, most followed a well-balanced diet before (76.9%) and during (72.9%) pregnancy (p = 0.26). Vegetarian, gluten-free, vegan, and low-carbohydrate diets were the least followed diets before and during pregnancy (vegetarian: 7.6% vs 5.3%; gluten-free: 4.9% vs 4.0%; vegan: 2.7% vs 2.2%; low-carbohydrate:4.0% vs 0.4%). Overall, the number of women following restrictive diets before pregnancy was significantly reduced throughout pregnancy (19.1% vs 12.0%, p < 0.001). Only 52.0% of women received nutrition information from their primary HCP, and 35.6% were satisfied with the nutrition information received. Conclusions: Most women followed a well-balanced diet before and during pregnancy and approximately one-third were satisfied with the information received from HCPs.

scholarly journals Prenatal care providers’ perceptions of the SARS-Cov-2 vaccine for themselves and for pregnant women

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256080
Author(s):  
Philippe Deruelle ◽  
Camile Couffignal ◽  
Jeanne Sibiude ◽  
Alexandre J. Vivanti ◽  
Olivia Anselem ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Pregnant Women ◽  
Online Survey ◽  
Multinomial Logistic Regression ◽  
Healthcare Providers ◽  
Care Providers ◽  
Professional Societies ◽  
Prenatal Care Providers ◽  
Flu Vaccine ◽  
To Receive

Background Prenatal care providers will play an important role in the acceptance of SARS-Cov-2 vaccination for pregnant women. Objective To determine the perceptions of French prenatal care providers: midwives, general practitioners (GPs) and obstetricians and gynaecologists (Ob-Gyn) regarding SARS-CoV-2 vaccination during pregnancy. Study design An anonymous online survey was sent to members of French professional societies representing prenatal practitioners. The participants were asked to answer questions on their characteristics and give their opinions of the SARS-CoV-2 vaccine for themselves and women who are pregnant or willing to become pregnant. Results Access to the survey was opened from January 11th, 2021, to March 1st, 2021. A total of 1,416 responses were collected from 749 Ob-Gyn, 598 midwives and 69 GPs. Most respondents (86.7% overall, 90.4% for Ob-GYN, 81.1% for GPs and 80.1% for midwives) agreed to receive the SARS-CoV-2 vaccine. Vaccination against SARS-CoV-2 would be offered to pregnant women by 49.4% 95%CI [48.1–50.8] of the participants. Midwives were less likely to recommend vaccination than GP and Ob-Gyn (37.5%, 50.7% and 58.8%, respectively). The multinomial logistic regression revealed that being an obstetrician, working in a group, usually offering a flu vaccine and wanting to be vaccinated against SARS-CoV-2 were positively associated with considering pregnant women for SARS-CoV-2 vaccination. Conclusion Most French prenatal healthcare providers are favourable towards vaccinating pregnant women, but a large minority express reservation. More evidence on safety and involvement by professional organisations will be important to encourage the access of pregnant women to vaccination against SARS-CoV-2.

Literarure Review Tentang Penerapan Senam Yoga Untuk Mengurangi Kecemasan Ibu Hamil

2021 ◽  
Vol 1 ◽  
pp. 597-602
Author(s):  
Dewi Hastutik Fitriani ◽  
I Isytiaroh ◽  
Windha Widyastuti
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Anxiety Level ◽  
Google Scholar ◽  
Care Providers ◽  
Scientific Report

AbstractAnxiety in pregnant women will increase as the time of delivery approaches. One way to reduce this anxiety is by doing yoga exercises. This scientific report was written to describe the implementation of yoga exercise to reduce anxiety in pregnant women based on a literature review. This literature review was constructed by analyzing three articles taken from Google Scholar with “Yoga Exercise”, “Anxiety” and “Pregnancy” as the keywords, in the form of fulltext articles, and published in 2020. The results showed that average anxiety level decreased from 25.75 to 16.92 after doing Yoga Exercises (from the range 6-27). In conclusion, yoga exercise could reduce the anxiety level in pregnant women. Hence, health care providers are expected to be able to implement and teach yoga exercises to reduce anxiety in pregnant women.Keywords: anxiety, pregnancy, yoga exercise AbstrakKecemasan pada ibu hamil akan meningkat seiring dengan mendekatinya waktu persalinan. Salah satu cara untuk menurunkan kecemasan pada ibu hamil dalam menghadapi persalinan dapat dilakukan dengan senam yoga. Tujuan karya tulis ilmiah ini adalah mengetahui penerapan senam yoga untuk mengurangi kecemasan pada ibu hamil berdasarkan literature review. Metode karya tulis ilmiah yang digunakan adalah literature review dengan jumlah tiga artikel yang diambil dari laman jurnal google scholar dengan kata kunci “Senam Yoga” , “Kecemasan” dan “Kehamilan” berupa artikel fulltex, terbit tahun 2020. Responden dari ketiga artikel berjumlah 86 responden. Hasil dari literature review ketiga artikel menunjukkan bahwa terdapat penurunan rata-rata kecemasan sebelum melakukan senam yoga yaitu 25,75 dan sesudah melakukan senam yoga yaitu 16,92 (dari rentang 6-27). Simpulannya adalah senam yoga dapat menurunkan kecemasan pada ibu hamil. Saran bagi tenaga kesehatan diharapkan agar dapat menerapkan senam yoga untuk menurunkan kecemasan pada ibu hamil.Kata kunci : kecemasan, kehamilan, senam yoga

Management des Crowdsourcing-Prozesses in der Organisation

2019 ◽  
Author(s):  
Stefan Stumpp
Keyword(s):  
Value Creation ◽  
Value Chain ◽  
Online Survey ◽  
Literature Search ◽  
Decision Makers ◽  
Added Value ◽  
Management Process ◽  
Systematic Literature Search ◽  
Internet Users ◽  
Comprehensive Picture

Crowdsourcing - the integration of a large group of Internet users into the value chain - is becoming increasingly important for organisations. In his dissertation Stefan Stumpp examines what makes this principle so valuable, which areas of the organization benefit from it and how this integration works. On the basis of a systematic literature search, interviews with experts, crowdsourcing practitioners and innovation decision makers and an online survey of 212 organisations, a management process is developed that serves as a guide for organisations to integrate crowds into their own value creation. In addition, areas of application along the value activities are shown and the added value and risks of crowdsourcing are demonstrated. As a result, the author gives a comprehensive picture of a method that allows to take advantage of the manpower, knowledge, creativity and assets of the crowd.

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