title: Do audio-guided decision aids improve outcomes? A randomized controlled trial of an audio-guided decision aid compared with a booklet decision aid for Australian women considering labour analgesia.
abstract: OBJECTIVE
  To assess the effectiveness of an audio-guided component: an audio-guided decision aid vs. a stand-alone booklet decision aid.
  
  
  BACKGROUND
  Despite extensive evaluation of decision aids in clinical settings the presentation style has not been properly assessed, and audio-guided decision aids are widely used although not supported by evidence-based research.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Two obstetric hospitals in Sydney, Australia. A total of 395 pregnant women having their first baby and approximately > or =36 weeks of gestation, planning a vaginal birth of a single infant and with self-assessed English sufficiency to read and listen to English-presented material.
  
  
  METHODS
  A decision aid for labour and childbirth analgesia that was presented in two ways: an audio-guided decision aid compared with a booklet only style decision aid.
  
  
  METHODS
  Decisional conflict, knowledge and anxiety.
  
  
  RESULTS
  Although both groups improved their knowledge scores and decreased their decisional conflict there were no significant differences between groups: mean knowledge score - audio-guided group, 65.9 vs. booklet group, 64.3; mean difference, 1.7; 95% CI (-7.5, 4.2); mean decisional conflict score - audio-guided group, 23.6 vs. booklet group, 24.3; mean difference, 0.7; 95% CI (-1.4, 2.9). Acceptability and compliance were high.
  
  
  CONCLUSIONS
  This evaluation highlights the lack of additional benefit in using audio-guided formats for presenting health information to consumers who are from a general English-speaking population. These results considered together with the increase in costs and work involved in producing audio components suggests that written and pictorial methods may be sufficient for decision aids aimed at a general audience.
authors.affiliation: Perinatal Research Group, Kolling Institute of Medical Research, University of Sydney, NSW, Australia. camiller@med.usyd.edu.au
authors.forename: Camille H
authors.initials: CH
authors.lastname: Raynes-Greenow
authors.forename: Christine L
authors.initials: CL
authors.lastname: Roberts
authors.forename: Natasha
authors.initials: N
authors.lastname: Nassar
authors.forename: Lyndal
authors.initials: L
authors.lastname: Trevena
mesh_terms: D000328:Adult; D000698:Analgesia / Q000706:statistics & numerical data*; D001296:Audiovisual Aids; D003661:Decision Support Techniques; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D009517:New South Wales; D010174:Pamphlets; D010358:Patient Participation; D017060:Patient Satisfaction; D011247:Pregnancy; D015397:Program Evaluation; D011795:Surveys and Questionnaires