Pregnant Women’s Views on How to Promote the Use of a Decision Aid for Down Syndrome Prenatal Screening: A Theory-Informed Qualitative Study
Référence bibliographique 
Agbadje, Titilayo Tatiana, Menear, Matthew, Dugas, Michèle, Gagnon, Marie-Pierre, Rahimi, Samira Abbasgholizadeh, Robitaille, Hubert, Giguere, Anik M. C., Rousseau, François, Wilson, Brenda J. et Légaré, France. 2018. «Pregnant Women’s Views on How to Promote the Use of a Decision Aid for Down Syndrome Prenatal Screening: A Theory-Informed Qualitative Study ». BMC Health Services Research, vol. 18, no 434, p. 1-15.
Intentions : The aim of the study «was to first identify the most appropriate theory-based BCTs [behaviour change techniques] for an intervention to promote the use of a PtDA [Patient decision aids] for DS [Down syndrome] prenatal screening, and then to explore pregnant women’s perceptions about the acceptability and relevance of these BCTs.» (p. 3)
Questions/Hypothèses : The authors propose «that the resulting intervention may improve pregnant women’s intention to adopt these tools for DS screening, and, potentially, their decisional and health outcomes.» (p. 3)
Échantillon/Matériau : L’échantillon est composé de 15 femmes enceintes de plus de 16 semaines, ou ayant récemment accouché, qui ont participé à des «focus groups». Les participantes ont été recrutées auprès de trois établissements situés dans la ville de Québec, soit auprès d’un département hospitalier d’obstétrique et de gynécologie, d’une clinique de médecine familiale ou d’une maison des naissances.
Type de traitement des données : Analyse de contenu Analyse statistique
«First, [the study shows that] the BCTs derived directly from the TDF [Theoretical Domains Framework] process were replicated through the BCW [Behaviour Change Wheel] process. This implies that the BCW may be comprehensive enough to be able to dispense with the TDF option […].» (p. 12) «Second, participating women found that 10 theory-derived BCTs were acceptable and relevant for use in an intervention to promote the use of a PtDA by women facing prenatal screening decisions. […] Third, participants proposed that a motivating factor for all pregnant women would be planned follow-up, which fits with the BCT “action planning”. […] Women in [this] study did not see the need for tailored strategies, except for demonstrating the PtDA for women with special needs. [Fourth, the analysis confirms that] “problem solving” (which includes “coping planning”) and “action planning”, are strategies usually used to support implementation, i.e. to move from intention to behaviour. [Lastly, the final] list only included 10 out of the 25 original BCTs, reducing the complexity of a potential intervention. [In this] study, many of the BCTs retained by the women necessarily involved the healthcare professional, for example, an action plan, and practical social support. This suggests that the most appropriate intervention would be an intervention plan in the clinical pathway of pregnant women that is implemented by the healthcare professional.» (p. 12-13)
Portocarrero, Maria Esther Leiva, Giguère, Anik M. C., Lépine, Johanie, Garvelink, Mirjam M., Robitaille, Hubert, Delanoë, Agathe, Lévesque, Isabelle, Wilson, Brenda J., Rousseau, François et Légaré, France.
Use of a Patient Decision Aid for Prenatal Screening for Down Syndrome: What do Pregnant Women Say?
Référence bibliographique 
Portocarrero, Maria Esther Leiva, Giguère, Anik M. C., Lépine, Johanie, Garvelink, Mirjam M., Robitaille, Hubert, Delanoë, Agathe, Lévesque, Isabelle, Wilson, Brenda J., Rousseau, François et Légaré, France. 2017. «Use of a Patient Decision Aid for Prenatal Screening for Down Syndrome: What do Pregnant Women Say? ». BMC Pregnancy and Childbirth, vol. 17, no 1, p. 1-9.
Intentions : This study aims «to identify factors influencing pregnant women’s use of a PtDA [patient decision aids] for prenatal screening for DS [Down syndrome].» (p. 2)
Échantillon/Matériau : This research uses a «sample of 45 pregnant women split equally between three health centers in the Quebec City region, Canada: a birthing center (services provided by midwives), a family medicine site (FMS) (services provided by family physicians) and a university hospital (services provided by obstetricians/gynecologists).» (p. 2)
Instruments : Guide d’entretien semi-directif
Type de traitement des données : Analyse de contenu
«We identified factors influencing pregnant women’s use of a PtDA for prenatal screening for DS.» (p. 5) «Overall, the three most frequently mentioned factors were: 1) influence of the woman’s partner, 2) presentation of the PtDA by a health professional and a discussion about it, and 3) lack of knowledge about PtDAs. Our results lead us to make four main observations. First, as we observed, even if participating women identified advantages to using a PtDA about prenatal screening for DS, they also identified disadvantages, suggesting a certain ambivalence overall. On the one hand they said it provided useful information for decision-making, but they also said the amount of information could create confusion during decision-making. […] Second […] results provide a more in-depth understanding of pregnant women’s opinions regarding the use of a PtDA [mentionning] that knowing this information on the risks and benefits of the options would most likely increase their stress. […] Third, the most frequently reported factor influencing the use of the PtDA was the woman’s partner […]. [Fourth], only a small number of participants said that the PtDA could help them identify what is most important for them and thus help them make the decision that best meets their values and their preferences.» (p. 7)