Informed choice about Down syndrome screening - effect of an eHealth tool: a randomized controlled trial.
BACKGROUND
The aim of this study was to evaluate the effect of an eHealth intervention (interactive website) on pregnant women's ability to make an informed choice about Down syndrome screening.


METHODS
The study was designed as a randomized controlled trial with allocation to an intervention group and a control group in a ratio of 1:1. Subsequent subgroup analysis was conducted. Participants were recruited from 5 August 2013 to 25 April 2014 at Odense University Hospital, Denmark. Inclusion criteria were: pregnant women aged ≥18 years who were invited to participate in Down syndrome screening. Exclusion criteria were: high risk of abortion, psycho-socially vulnerable women, late referral, inability to speak Danish and women declining to participate. The primary outcome was informed choice about Down syndrome screening. The Multidimensional Measure of Informed Choice was used to assess whether the choice was informed or uninformed.


RESULTS
A total of 1150 participants were included in the study, of which 910 (79%) completed the questionnaire. Only a minority (30% of the women in the intervention group) actually used the website. There was no significant difference in the groups with respect to making an informed choice. The mean knowledge scores were significantly higher for those in the intervention group who used the intervention.


CONCLUSIONS
An interactive website with information about Down syndrome screening had no direct effect on making an informed choice. However, the majority of the pregnant women who used the website were satisfied with the website and would recommend it to others.
Department of Gynecology and Obstetrics, Institute of Clinical Research, Research Unit of Gynecology and Obstetrics, University of Southern Denmark, Odense University Hospital, Odense, Denmark.|Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark.|OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark.
Mette M
http://orcid.org/0000-0002-3528-4619
MM
Skjøth
Institute of Public Health, University of Southern Denmark, Odense, Denmark.
Eva
http://orcid.org/0000-0002-5894-7243
E
Draborg
Department of Gynecology and Obstetrics, Institute of Clinical Research, Research Unit of Gynecology and Obstetrics, University of Southern Denmark, Odense University Hospital, Odense, Denmark.|Division of Surgery, University College London, Northwick Park Institute for Medical Research Campus, London, UK.
Ronald F
http://orcid.org/0000-0001-7906-2826
RF
Lamont
Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark.
Claus D
http://orcid.org/0000-0002-6637-0392
CD
Pedersen
Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.
Helle P
http://orcid.org/0000-0002-5075-8739
HP
Hansen
Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
Claus T
http://orcid.org/0000-0003-1191-373X
CT
Ekstrøm
Department of Gynecology and Obstetrics, Institute of Clinical Research, Research Unit of Gynecology and Obstetrics, University of Southern Denmark, Odense University Hospital, Odense, Denmark.|Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark.
Jan S
http://orcid.org/0000-0001-5222-2535
JS
Jørgensen
D000328:Adult; D002755:Choice Behavior; D003718:Denmark; D004314:Down Syndrome / Q000175:diagnosis*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011795:Surveys and Questionnaires; D017216:Telemedicine
Informed choice; decision making; eHealth tool; pregnancy; prenatal diagnosis; web-based intervention