Evaluating a Web-Based Training Program for Nurses on Shared Decision-Making and Screening for Down Syndrome: Protocol for a Randomized Control Trial (Preprint)

2020 ◽  
Author(s):  
Alex Poulin Herron ◽  
Titilayo Tatiana Agbadjé ◽  
Mélissa Côté ◽  
Codjo-Djignefa Djade ◽  
Geneviève Roch ◽  
...  
Keyword(s):  
Decision Making ◽  
Pregnant Women ◽  
Training Program ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Control Group ◽  
Intention To Use ◽  
Shared Decision ◽  
Web Based ◽  
The Impact

BACKGROUND Pregnant women have difficulty choosing from amongst the wide variety of available prenatal screening options. To help pregnant women and their partners make informed decisions based on their values, needs, and preferences, a decision aid (DA) and a web-based shared decision making (SDM) training program for health professionals have been developed. In Canada, nurses have responsibilities regarding maternity care and thus the potential to do decision coaching on prenatal screening. However, there is a gap of knowledge concerning the effectiveness of SDM interventions in this area of nursing practice. OBJECTIVE This study aims to assess the impact of an SDM training program on nurses’ intention to use a decision aid for prenatal screening as well as their knowledge and overall appreciation of the training. METHODS This is a two-arm parallel randomized trial. Nurses working with pregnant women from the province of Quebec, and speaking in French, will be recruited online by a private survey firm. They will be randomly allocated (1:1 ratio) to either an experimental group, which will complete a web-based SDM training program for prenatal screening, or to a control group, which will complete a web-based training program focusing on prenatal screening alone. The experimental intervention consists of a three hour web-based and fully automated training activity hosted on the University Laval platform and has four modules: 1) SDM; 2) Down syndrome prenatal screening; 3) DA; and 4) Communication between healthcare professionals and the patient. For the control group, the topic of SDM in Module 1 has been replaced with “Context and history of prenatal screening” and the topic of DA in Module 3 has been replaced with “Consent in prenatal screening.” In addition to sociodemographic questions using a self-administered questionnaire with closed ended questions, we will assess 1) intention to use a DA in prenatal screening clinical practice; 2) knowledge; 3) satisfaction with the training; 4) acceptability; and 5) perceived usefulness. The randomization will be done by a predetermined sequence and include 36 nurses. Participants and researchers will be blinded. Intention to use DA will be assessed by a Student t test and bivariate and multivariate analysis will be performed to assess knowledge and overall appreciation of the training. RESULTS This study is ongoing and results will be available at the end of 2020 CONCLUSIONS This study results will inform on the impact of an SDM training program on nurses’ intention to use a decision aid for prenatal screening as well as their knowledge and overall appreciation of the training. It will also provide feedback on ways to upgrade the SDM training program, if needed. CLINICALTRIAL ClinicalTrials.gov ID NCT04162288

scholarly journals Web-Based Training for Nurses on Shared Decision Making and Prenatal Screening for Down Syndrome: Protocol for a Randomized Controlled Trial

10.2196/17878 ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. e17878
Author(s):  
Alex Poulin Herron ◽  
Titilayo Tatiana Agbadje ◽  
Melissa Cote ◽  
Codjo Djignefa Djade ◽  
Geneviève Roch ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Training Program ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Decision Aids ◽  
Control Group ◽  
Intention To Use ◽  
Shared Decision ◽  
Web Based ◽  
The Impact

Background Pregnant women often find it difficult to choose from among the wide variety of available prenatal screening options. To help pregnant women and their partners make informed decisions based on their values, needs, and preferences, a decision aid and a web-based shared decision making (SDM) training program for health professionals have been developed. In Canada, nurses provide maternity care and thus can train as decision coaches for prenatal screening. However, there is a knowledge gap about the effectiveness of SDM interventions in maternity care in nursing practice. Objective This study aims to assess the impact of an SDM training program on nurses’ intentions to use a decision aid for prenatal screening and on their knowledge and to assess their overall impressions of the training. Methods This is a 2-arm parallel randomized trial. French-speaking nurses working with pregnant women in the province of Quebec were recruited online by a private survey firm. They were randomly allocated (1:1 ratio) to either an experimental group, which completed a web-based SDM training program that included prenatal screening, or a control group, which completed a web-based training program focusing on prenatal screening alone. The experimental intervention consisted of a 3-hour web-based training hosted on the Université Laval platform with 4 modules: (1) SDM; (2) Down syndrome prenatal screening; (3) decision aids; and (4) communication between health care professionals and the patient. For the control group, the topic of SDM in Module 1 was replaced with “Context and history of prenatal screening,” and the topic of decision aids in Module 3 was replaced with “Consent in prenatal screening.” Participants completed a self-administered sociodemographic questionnaire with close-ended questions. We also assessed the participants' (1) intention to use a decision aid in prenatal screening clinical practice, (2) knowledge, (3) satisfaction with the training, (4) acceptability, and (5) perceived usefulness of the training. The randomization was done using a predetermined sequence and included 40 nurses. Participants and researchers were blinded. Intention to use a decision aid will be assessed by a t test. Bivariate and multivariate analysis will be performed to assess knowledge and overall impressions of the training. Results This study was funded in 2017 and approved by Genome Canada. Data were collected from September 2019 to late January 2020. This paper was initially submitted before data analysis began. Results are expected to be published in winter 2020. Conclusions Study results will inform us on the impact of an SDM training program on nurses’ intention to use and knowledge of decision aids for prenatal screening and their overall impressions of the training. Participant feedback will also inform an upgrade of the program, if needed. Trial Registration ClinicalTrials.gov NCT04162288; https://clinicaltrials.gov/ct2/show/NCT04162288 International Registered Report Identifier (IRRID) DERR1-10.2196/17878

scholarly journals Web-Based Training for Nurses on Shared Decision Making and Prenatal Screening for Down Syndrome: Protocol for a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Alex Poulin Herron ◽  
Titilayo Tatiana Agbadje ◽  
Melissa Cote ◽  
Codjo Djignefa Djade ◽  
Geneviève Roch ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Training Program ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Decision Aids ◽  
Control Group ◽  
Intention To Use ◽  
Shared Decision ◽  
Web Based ◽  
The Impact

BACKGROUND Pregnant women often find it difficult to choose from among the wide variety of available prenatal screening options. To help pregnant women and their partners make informed decisions based on their values, needs, and preferences, a decision aid and a web-based shared decision making (SDM) training program for health professionals have been developed. In Canada, nurses provide maternity care and thus can train as decision coaches for prenatal screening. However, there is a knowledge gap about the effectiveness of SDM interventions in maternity care in nursing practice. OBJECTIVE This study aims to assess the impact of an SDM training program on nurses’ intentions to use a decision aid for prenatal screening and on their knowledge and to assess their overall impressions of the training. METHODS This is a 2-arm parallel randomized trial. French-speaking nurses working with pregnant women in the province of Quebec were recruited online by a private survey firm. They were randomly allocated (1:1 ratio) to either an experimental group, which completed a web-based SDM training program that included prenatal screening, or a control group, which completed a web-based training program focusing on prenatal screening alone. The experimental intervention consisted of a 3-hour web-based training hosted on the Université Laval platform with 4 modules: (1) SDM; (2) Down syndrome prenatal screening; (3) decision aids; and (4) communication between health care professionals and the patient. For the control group, the topic of SDM in Module 1 was replaced with “Context and history of prenatal screening,” and the topic of decision aids in Module 3 was replaced with “Consent in prenatal screening.” Participants completed a self-administered sociodemographic questionnaire with close-ended questions. We also assessed the participants' (1) intention to use a decision aid in prenatal screening clinical practice, (2) knowledge, (3) satisfaction with the training, (4) acceptability, and (5) perceived usefulness of the training. The randomization was done using a predetermined sequence and included 40 nurses. Participants and researchers were blinded. Intention to use a decision aid will be assessed by a t test. Bivariate and multivariate analysis will be performed to assess knowledge and overall impressions of the training. RESULTS This study was funded in 2017 and approved by Genome Canada. Data were collected from September 2019 to late January 2020. This paper was initially submitted before data analysis began. Results are expected to be published in winter 2020. CONCLUSIONS Study results will inform us on the impact of an SDM training program on nurses’ intention to use and knowledge of decision aids for prenatal screening and their overall impressions of the training. Participant feedback will also inform an upgrade of the program, if needed. CLINICALTRIAL ClinicalTrials.gov NCT04162288; https://clinicaltrials.gov/ct2/show/NCT04162288 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17878

Web-based Training for Nurses on Shared Decision-Making and Prenatal Screening for Down Syndrome: a Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Alex Poulin Herron ◽  
Titilayo Tatiana Agbadje ◽  
Sabrina Guay-Bélanger ◽  
Gérard Ngueta ◽  
Geneviève Roch ◽  
...  
Keyword(s):  
Decision Making ◽  
Down Syndrome ◽  
Pregnant Women ◽  
Training Program ◽  
Prenatal Screening ◽  
Intervention Group ◽  
Control Group ◽  
Intention To Use ◽  
Shared Decision ◽  
Web Based

BACKGROUND Background: Nurses provide maternity care and thus play an important role in supporting pregnant women making decisions about prenatal screening for Down syndrome. We developed a web-based shared decision making (SDM) training program for health professionals focusing on Down syndrome screening decisions. OBJECTIVE Objective: We assessed the impact of a SDM training program on nurses’ intention to use a decision aid with pregnant women deciding about prenatal screening for Down syndrome. METHODS Methods: In this 2-arm parallel controlled trial, French-speaking nurses working with pregnant women in the province of Quebec were recruited online by a private survey firm. They were conveniently allocated either to the intervention group (web-based SDM training program that included prenatal screening) or to the control group (web-based training program focusing on prenatal screening alone, with no SDM content). The primary outcome was intention to use a decision aid. Secondary outcomes were psychosocial variables of intention (e.g. social influence), as well as knowledge, satisfaction, acceptability, perceived usefulness and reaction to the pedagogical approach. All outcomes were self-assessed through online questionnaires including space for written comments. No blinding was performed. We used Student's t test and Fisher's exact test to compare continuous and categorical variables between groups. RESULTS Results: Of 57 participants assessed for eligibility, 40 were allocated to the intervention (n=20) or control group (n=20) and 36 (n=18 in each) completed the training program. Mean age of participants was 41 years (SD 9). Most were women (97.5%), Caucasian (95%), clinical nurses (70%), and had completed a baccalaureate degree (65%). Post-intervention, the mean score of intention was 6.3 (5.9; 6.7) for the intervention group and 6.0 (5.42; 6.64) for the control group. The difference in intention score and other psychosocial variables score between groups was not statistically significant. Knowledge scores about SDM were significantly different (79% in the intervention group, 64% in the control group, p=0.009). There was no significant difference in overall satisfaction [4.4 (SD 0.7) in the intervention group and 4.5 (SD 0.9)] in the control group and perceived usefulness [4.6 (SD 0.4) in the intervention group and 4.4 (SD 0.5)] in the control group. Acceptability of the training program showed a statistically significant difference [4.6 (SD 0.4) in the intervention group and 4.3 (SD 0.4) in the control group; p=0.02] as well as reaction to the pedagogical approach [4.7 (SD 0.4) in the intervention group and 4.4 (SD 0.4) in the control group; p=0.02]. Seventeen participants also gave written comments on the training. CONCLUSIONS Conclusions: Nurses’ intention to use SDM in prenatal care is already high, with training or without, but their knowledge about SDM could be improved with SDM training. Our results will inform future strategies to implement shared decision-making among nurses. CLINICALTRIAL Trial Registration: ClinicalTrials.gov NCT04162288; https://clinicaltrials.gov/ct2/show/NCT04162288?term=NCT04162288&draw=2&rank=1

scholarly journals Effect of Shared Decision-making on Anxiety of Women Recommended for Prenatal Screening Tests in Southeast of Iran

2020 ◽  
Author(s):  
Zahra Moudi ◽  
Raheleh Jam ◽  
Hossein Ansari ◽  
Mostafa Montazer Zohour
Keyword(s):  
Decision Making ◽  
Pregnant Women ◽  
Shared Decision Making ◽  
Prenatal Screening ◽  
Intervention Group ◽  
Screening Tests ◽  
Control Group ◽  
Shared Decision ◽  
Level Of Education ◽  
University Level

Objective: To study the effect of shared decision-making (SDM) on the anxiety of women who were recommended for prenatal screening tests. Materials and methods: This quasi-experimental study was conducted on a total of 200 pregnant women who referred to the health centers of Zahedan, Iran, for prenatal care within April 7 to September 7, 2019. The control group received routine care, and the intervention group attended a session based on SDM. The demographic characteristics form and Spielberger Six-item State-Trait Anxiety Inventory were filled out before and immediately after the counseling, as well as before receiving the results of maternal serum biochemical markers. Results: No statistically significant effect of SDM on anxiety was reported between the control and intervention groups immediately after the counseling session (P=0.46). However, the obtained data showed that the mean value of anxiety scores (16.52±3.06) was higher among the women in the intervention group than that reported for the control group (13.80±3.55) on the day before receiving the results of the blood tests (P<0.001). Nevertheless, logistic regression analysis showed only women with a university level of education were likely to have higher anxiety scores than women with lower educational levels (AOR=10.60; 95% CI: 2.07-54.24; P=0.005). Conclusion: Offering prenatal screening can cause a slight increase in the level of anxiety among women with a university level of education. Therefore, it is required to implement supportive strategies to help high-risk pregnant women in coping with anxiety.  

scholarly journals Web-Based Training for Nurses on Using a Decision Aid to Support Shared Decision Making about Prenatal Screening: a Controlled Trial (Preprint)

JMIR Nursing ◽  
10.2196/31380 ◽  
2021 ◽  
Author(s):  
Alex Poulin Herron ◽  
Titilayo Tatiana Agbadje ◽  
Sabrina Guay-Bélanger ◽  
Gérard Ngueta ◽  
Geneviève Roch ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Controlled Trial ◽  
Shared Decision ◽  
Web Based

scholarly journals Development, Implementation, and Testing of a Web Based Decision Aid for Facilitating Shared Decision Making for Disease Modifying Therapies for Sickle Cell Disease

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5919-5919
Author(s):  
Lakshmanan Krishnamurti ◽  
Diana Ross ◽  
Nitya Bakshi ◽  
Kirshma Khemani ◽  
Cynthia Sinha ◽  
...  
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Qualitative Interviews ◽  
Shared Decision ◽  
Web Based ◽  
Disease Modifying Therapies ◽  
Disease Modifying ◽  
The Impact

Abstract Background Sickle cell disease (SCD) is associated with substantial morbidity, and premature mortality. Hydroxyurea (Hu), chronic blood transfusion and hematopoietic stem cell transplantation (HCT) can modify the course of this disease, reduce complications, and improve survival. These interventions are diverse in their therapeutic intent, but are all associated with substantial burden of care, signfiicant side effects and the potential for late complications. The complexity inherent in making decisons about these disease modifying therapies is compounded by the socioeconomic disadvantage experienced by this largely minority, underserved population. That despite proven efficacy in clinical trials, uptake and adherence with HU remains poor, and that only a small proportion of eligible patients undergo HCT underscores the difficulty in making these decisions. The objective of this study was to use a theory based systematic approach to develop, implement and test a web based decision aid to support patients and caregivers in shared decision making regarding disease modifying therapies for SCD.The theoretical basis for this project is the Ottawa decision support framework( ODSF), an evidence-based, practical, mid-range theory for guiding patients making health or social decisions which uses a three-step process to assess client and practitioner determinants of decisions to identify decision support needs; provide decision support tailored to client needs and evaluate the decision making process and outcomes. Methods Following the ODSF, we conducted qualitative interviews of patients with SCD, their caregivers, policymakers, community advocates and healthcare providers and other stakeholders. Subjects were recruited at multiple regional and national SCD conferences which draw a mix of patients and professional audience. Interviews lasted 30-40 minutes and were transcribed verbatim, transcripts were coded using QSR NVivo 10 and analyzed using qualitative mixed methods. Themes from qualitative interviews were incorporated into the each of the following phases of the project: Phase 1: Qualitative interviews for needs assessment to facilitate the description of the participants' experiences in seeking information about and making decisions related to SCD and utilizing both open and closed-ended questions. Phase 2: Data synthesis, and construction of a storyboard, draft content, draft design and format for the decision aid. Phase 3: Alpha testing for quality and error correction. Extensive modifications were carried out systematically incorporating the recommendations received. Phase 4: Iterative cylces of Beta testing for feasibility, comprehensibility and usability with qualitative interviews and observations and incorporated recommendations. Phase5: Peer-review of the finalized decision aid by stakeholders who had not participated in the development of the instrument and had not previously examined the website. Results Needs assessment qualitative interviews with 205 individuals yielded information on decisional needs, preferences regarding content, presentation and ease of use as well as a distinct preference to learn from the experience of other patients and guided the devlopemnt of the decision aid. Alpha testing for quality and error correction was conducted with 51 patients / family members, clinicians, health educators and policy makers. Beta testing for feasiblity, comprehensibilty, and usability was completed by a total 111 participants. Peer review by 60 providers, patients and stakeholders of the final decision aid (www.sickleoptions.org) indicated a high level of satisfaction with the content, presentation, ease of use, use of graphics and the use of patient testimonials. We have enrolled and are gathering data on 120 subjects in a randomized clinical trial to evaluate the impact of the decion aid on clinical decision making. Conclusions This stiudy provides empirical evidence about the successful process of creating, implementing and testing a web based decision aid for patients to guide shared decision making in disease modifying therapy for SCD. It provides evidence of favorable patient and physician perceptions about the comprehensivility and usability of the decision aid. Results of an ongoing randomized clinical trial will generate additional information about the impact of the decision on clinical decision making. Disclosures No relevant conflicts of interest to declare.

scholarly journals Development of an electronic conversation aid to support shared decision making for children with acute otitis media

JAMIA Open ◽  
2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Jana L Anderson ◽  
e Silva Lucas Oliveira J ◽  
Juan P Brito ◽  
Ian G Hargraves ◽  
Erik P Hess
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Medical Knowledge ◽  
Complication Rates ◽  
Shared Decision ◽  
Web Based ◽  
Quality Issue ◽  
The Impact

Abstract Objective The overuse of antibiotics for acute otitis media (AOM) in children is a healthcare quality issue in part arising from conflicting parent and physician understanding of the risks and benefits of antibiotics for AOM. Our objective was to develop a conversation aid that supports shared decision making (SDM) with parents of children who are diagnosed with non-severe AOM in the acute care setting. Materials and Methods We developed a web-based encounter tool following a human-centered design approach that includes active collaboration with parents, clinicians, and designers using literature review, observations of clinical encounters, parental and clinician surveys, and interviews. Insights from these processes informed the iterative creation of prototypes that were reviewed and field-tested in patient encounters. Results The ear pain conversation aid includes five sections: (1) A home page that opens the discussion on the etiologies of AOM; (2) the various options available for AOM management; (3) a pictograph of the impact of antibiotic therapy on pain control; (4) a pictograph of complication rates with and without antibiotics; and (5) a summary page on management choices. This open-access, web-based tool is located at www.earpaindecisionaid.org. Conclusions We collaboratively developed an evidence-based conversation aid to facilitate SDM for AOM. This decision aid has the potential to improve parental medical knowledge of AOM, physician/parent communication, and possibly decrease the overuse of antibiotics for this condition.

scholarly journals Health literacy in pregnant women facing prenatal screening may explain their intention to use a patient decision aid: a short report

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Agathe Delanoë ◽  
Johanie Lépine ◽  
Maria Esther Leiva Portocarrero ◽  
Hubert Robitaille ◽  
Stéphane Turcotte ◽  
...  
Keyword(s):  
Health Literacy ◽  
Pregnant Women ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Intention To Use ◽  
Short Report ◽  
Patient Decision Aid ◽  
Patient Decision
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