Comparing Game Facilitated Interactivity to Genetic Counseling for Prenatal Screening Education

项目摘要 产前遗传筛查的进展显著改善了染色体异常的识别， 怀孕期间的异常和遗传性疾病，但目前的标准，病人教育，在这方面 域在很大程度上是无效的。此外，美国妇产科学院建议， 产前护理提供者在怀孕的头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。这已经将产前筛查的重点从一个较高的 对所有怀孕的夫妇来说都很危险。传统上，诊所的信息是通过书面形式传输的。 与供应商的讨论和讨论。这种方法有一些缺点，包括时间有限， 提供者对风险水平的看法和临床医生有限的遗传知识所带来的偏见。这些 这些因素也可能导致在筛查期间代表性不足的人群中的筛查摄取差异。 怀孕最有效的方法教育有关产前筛查，是一对一的遗传 辅导，但由于辅导员人数有限，这是不可行的，特别是在农村和边境 地区新的创新教育游戏提供了更有效地解决医疗保健决策差距的承诺- 制作。大约59%的美国人玩电子游戏，他们中的大多数人玩游戏至少三个小时。 周事实上，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 18岁或以下的男孩（17%）。游戏技术可以显示复杂的信息， 适合不同教育背景的个人的语言格式，使他们成为理想的 临床环境中，特别是低健康素养人群。目的1：比较 产前筛查教育游戏，以提高知识和减少决策之间的冲突 代表性不足的妇女的健康知识水平各不相同。目标2：评估 产前筛查教育游戏在促进与提供者共同决策方面的有效性 与加强常规护理（诊所手册的交互式PDF）或一对一遗传咨询相比， （面对面或远程保健）。目的3：比较产前筛查教育游戏与 增加知识，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.