Comparing Game Facilitated Interactivity to Genetic Counseling for Prenatal Screening Education

项目总结 产前基因筛查的进步显著提高了染色体鉴定的水平 妊娠期间的异常和可遗传的情况，但目前的患者教育标准 这在很大程度上是无效的。此外，美国妇产科医师学会建议 产前护理提供者在怀孕前三个月为所有妇女提供产前基因筛查， 无论年龄或遗传风险状况如何。这将产前筛查的重点从较高的子集转移到了 所有怀孕夫妇都有风险。传统上，诊所的信息是通过书面形式传递的 材料和与供应商的讨论。这种方法有许多缺点，包括时间有限， 提供者对风险水平的认知以及临床医生有限的遗传知识带来的偏见。这些 这些因素也可能导致代表人数不足的人群在筛查方面的差异。 怀孕了。关于产前筛查的最有效的教育方法是一对一的遗传 咨询，但由于咨询人员数量有限，这是不可行的，特别是在农村和边疆地区 区域。新的创新教育游戏承诺更有效地解决医疗决策方面的差距- 制作。约59%的美国人玩电子游戏，其中大多数人每天至少玩三个小时 星期。事实上，18岁或以上的女性在玩游戏的人口中所占的比例要大得多。 (44%)低于18岁或18岁以下的男孩(17%)。游戏技术可以在文化和文化上展示复杂的信息 适合不同教育背景的个人的语言适当的格式，使它们成为 临床环境，特别是在健康素养低的人群中。目标1：比较以下几种方法的有效性 产前筛查教育游戏，提高知识，减少决策冲突 代表不足的妇女与不同健康知识水平的孕妇。目标2：评估 产前筛查教育游戏的有效性，以促进与提供者分享决策 与增强的日常护理(诊所宣传册的交互式PDF格式)或一对一遗传咨询相比 (面对面或远程医疗)。目标3：比较产前筛查教育游戏和 提高知识，减少孕妇伴侣之间的决策冲突。

PROJECT SUMMARY Advancements in prenatal genetic screening have significantly improved the identification of chromosomal abnormalities and heritable conditions during pregnancy, yet current standards for patient education in this domain are largely ineffective. Further, the American College of Obstetricians and Gynecologists recommends prenatal care providers offer all women prenatal genetic screening in the first trimester of pregnancy, regardless of age or genetic risk status. This has moved the focus of prenatal screening from a subset of higher risk couples to all pregnant couples. Classically, information in the clinic has been transferred by written materials and discussions with providers. This approach has a number of weaknesses, including limited time, biases presented by provider perceptions of risk level, and limited genetic knowledge of clinicians. These factors may also contribute to disparities in screening uptake among under-represented populations during pregnancy. The most effective approach to education about prenatal screening, is one-on-one genetic counseling, but due to the limited number of counselors this is not feasible, especially in rural and frontier areas. New innovative education games offer promise to more effectively address gaps in healthcare decision- making. About 59% of all Americans play video games and most of them play for at least three hours per week. In fact, women age 18 or older represent a significantly greater portion of the game-playing population (44%) than boys 18 or younger (17%). Game technology can display complex information in a culturally and linguistically appropriate format to individuals of diverse educational backgrounds that make them ideal for clinical settings especially among low health literacy populations. Aim 1: To compare the effectiveness of a prenatal screening education game to improve knowledge and reduce decisional conflict among underrepresented women with a diverse range of health literacy levels of pregnant women. Aim 2: To assess the effectiveness of the prenatal screening education game to promote shared decision making with providers compared to enhanced usual care (an interactive pdf of the clinic's brochure) or one-on-one genetic counseling (in-person or tele-health). Aim 3: To compare the effectiveness of a prenatal screening education game to improve knowledge and reduce decisional conflict among partners of pregnant women.