Enhancing Patient Prenatal Education-A Feasibility Study

An increasing number of genetic carrier screening tests pose a challenge to adequate prenatal patient education. Clinic based computer patient education programs may be an effective response to this challenge. Before mounting a RCT to assess their effectiveness it is essential to study the feasibility of operating such programs in clinic settings. We propose a feasibility study. Our first specific aim is to develop an interactive computer assisted instruction (ICAI) patient education program for six prenatal genetic carrier screening tests (Multiple-Marker, Advanced Maternal Age, Sickle Cell, Thalassemia, Cystic Fibrosis, and Tay Sachs/Canavan). Our second aim is to collect data on the impact of the ICAI program on patient knowledge and anxiety, as well as patient and provider acceptance of the ICAI program. Our third aim is to assess the impact of the ICAI program on clinic activities. Our fourth aim is to estimate the likely effect size of the ICAI on patient knowledge and anxiety and to develop study methods for a RCT of ICAI effectiveness. To accomplish this we propose first, to develop the ICAI program using Cognitive Response Interviewing and Usability Testing methodologies with pregnant patients, as well as provider interviews. Next we will measure patient knowledge and anxiety prior to and after completing the ICAI. We will also ascertain patient and provider assessment of the ICAI as a clinic based educational tool. Third, we will employ Patient Time Flow Analysis to assess the impact of the ICAI on clinic activities. Based on these data, we will design a RCT to assess ICAI program effectiveness in public health prenatal clinics and private obstetrical practices.