A Randomized Pilot Trial of the Donor Conception Tool to Empower Parental Telling and Talking (TELL Tool) with Their Children About Their Genetic Origins.
Patricia E Hershberger, Valerie Gruss, Alana D Steffen and 7 others
PMID 39023461WHAT IT FOUND
Parents using the TELL Tool reported telling their donor-conceived children more often than parents using the parenting eBook, but the study was too small to show this clearly.
They also felt more confident and less anxious about telling.
Key findings
01At the 4-week follow-up, 60 participants reported the primary outcome: 77% of TELL Tool participants (n=23) reported telling their children about their genetic origins, compared with 54% (n=16) in the eBook group; the reported difference in proportion was 0.233 (95% CI, -0.001 to 0.467).
02Anxiety scores, measured on a scale where 50 is the US average and 10 points is a standard step, changed by -0.85 at immediate posttest and -2.47 by 12 weeks in the TELL Tool group, while the eBook group rose by about 1 point; between-group differences were significant at posttest (p = .05) and 12 weeks (p = .04).
03Parents in the TELL Tool group showed greater improvement in telling confidence and parenting competence than parents in the eBook group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a pilot trial designed to test procedures, not to prove the TELL Tool works. The disclosure outcome was based on parents' own report, not independent confirmation. Most parents had children aged 1 to 7, and most participants were female, White, and well-educated, so results may not fit parents of older children or more diverse families. Fewer parents assigned to the eBook completed consent than those assigned to the TELL Tool, even though participants were blinded. Retention was 72% at posttest and 68% at 12 weeks among consented participants. The trial happened during COVID-19, when families faced day-care and schooling disruptions.
Declared interests
Dr. Hershberger is past chair of the American Society for Reproductive Medicine Nurses Professional Group Executive Board and reports honoraria from the Midwest Reproductive Symposium International and The Donor Egg Meeting 2024. The TELL Tool is copyrighted by the University of Michigan and the University of Illinois Chicago, and the authors report no monetary compensation for its use. The remaining authors report no conflicts of interest.
The easy way to misread this
Do not treat the TELL Tool as proven to increase disclosure. This was a small pilot, the reported range of possible differences was -0.001 to 0.467, and the outcome relied on parent self-report.