Katada Chihiro, Ohashi Kazutomo, Okada Kimie, Sawai Hideaki
Department of Nursing, Hyogo Medical University, Hyogo, Japan.
Department of Nursing, Otemae University, Osaka, Japan.
Arch Public Health. 2023 Jul 27;81(1):138. doi: 10.1186/s13690-023-01157-5.
Non-invasive prenatal testing (NIPT) is offered as a reproductive choice in many countries. However, pregnant women, particularly those who are primipara or lack knowledge of prenatal testing, experience difficulties understanding adequate information and making decisions on NIPT. This study developed a preconception education program about NIPT, focusing on interest in genetics, and aimed to clarify the effectiveness of the program to help women make decisions on future NIPT.
This was a one-group, quasi-experimental, pre-post-test study. The study population was female undergraduate students in Japan who participated in the education program. This program included two games and was based on the Attention, Relevance, Confidence, and Satisfaction (ARCS) model, which is an instructional design that stimulates learning interest and motivation. The data of 73 pre-pregnant women who completed all three questionnaires-before, immediately after, and three months after the intervention-were analyzed to clarify the time effects. Moreover, all variables were analyzed using logistic regression analysis to investigate factors related to decisional conflict.
Interest in genetics, knowledge of genetics and prenatal testing, and indecisive attitudes toward NIPT significantly improved immediately after the intervention, and consequently, these changes and reduction of decisional conflict were maintained at three months. Moreover, low decisional conflict at follow-up was significantly associated with a high interest in genetics (adjusted odds ratio, 3.42).
These findings provide preliminary evidence that this preconception education program, which focused on facilitating interest in genetics, assists pre-pregnant women to reduce decisional conflict about future NIPT.
The trial was registered at the UMIN-CTR registry (January 16, 2023), registration number UMIN000050047.
在许多国家，无创产前检测（NIPT）已成为一种生育选择。然而，孕妇，尤其是初产妇或对产前检测缺乏了解的孕妇，在理解足够的信息并就NIPT做出决策时会遇到困难。本研究开发了一项关于NIPT的孕前教育计划，重点是对遗传学的兴趣，旨在阐明该计划对帮助女性就未来的NIPT做出决策的有效性。
这是一项单组、准实验性的前后测试研究。研究对象是参与该教育计划的日本女大学生。该计划包括两个游戏，并基于注意力、相关性、信心和满意度（ARCS）模型，这是一种激发学习兴趣和动机的教学设计。分析了73名在干预前、干预后立即和干预后三个月完成所有三份问卷的未孕女性的数据，以阐明时间效应。此外，使用逻辑回归分析对所有变量进行分析，以调查与决策冲突相关的因素。
干预后立即对遗传学的兴趣、遗传学和产前检测的知识以及对NIPT的犹豫不决态度显著改善，因此，这些变化和决策冲突的减少在三个月时得以维持。此外，随访时低决策冲突与对遗传学的高兴趣显著相关（调整后的优势比为3.42）。
这些发现提供了初步证据，表明这项以促进对遗传学的兴趣为重点的孕前教育计划有助于未孕女性减少对未来NIPT的决策冲突。
该试验在UMIN-CTR注册中心注册（2023年1月16日），注册号为UMIN000050047。
