Assessment of pregnant women's intention to use a mobile application-based decision aid for prenatal screening for trisomies 21, 18 and 13: A mixed-methods cross-sectional study.

Abstract

Decsions about prenatal screening for trisomies are complex for some women. Mobile decision aids (mDAs) can help them make informed decisions based on their values and preferences. To assess pregnant women's intention to use an mDA for prenatal screening of trisomies 21, 18, and 13. This mixed-methods study in Quebec recruited a purposeful sample of women aged 18 or over, at least 16 weeks pregnant or who had given birth in the past year after a low-risk pregnancy. After they completed a paper-based decision aid, we assessed their intention, and its psychosocial determinants, to use a mobile version. Quantitative data underwent descriptive, bivariate, and multivariate analyses; qualitative data were thematically analyzed. 67 pregnant women participated, mostly French-speaking (89.6 %), aged 25-34 (59.7 %). Mean intention to use the mDA was 4.92 (SD: 2.03). Beliefs about consequences (β:1.21; p < 0.0001) and social influence (β:0.17; p = 0.03) were significant predictors of intention, explaining 77.5 % of variance, and 63 % of women evaluated the proposed mDA positively. Beliefs about consequences and social influence were the main pyschosocial factors associated with pregnant women's intention to use an mDA for prenatal screening. Healthcare providers could increase uptake by adopting strategies that underline the social acceptability and benefits of mDAs.