Women's preferences for and experiences with prenatal genetic testing decision making: Sociodemographic disparities in preference-concordant decision making.
Fabiola Molina, Christine Dehlendorf, Steven E Gregorich and 1 others
PMID 30502029WHAT IT FOUND
56% of pregnant women wanted prenatal genetic testing decisions to be theirs, 39% wanted shared decisions, and 5% wanted provider-driven decisions. 57% experienced their preferred process, but Spanish-speaking Latinas were less likely.
Key findings
0156% preferred autonomous decision making, 39% preferred shared decision making, and 5% preferred provider-driven decision making.
0257% experienced preference-concordant decision making, and women preferring shared or provider-driven decisions had lower adjusted odds of concordance than women preferring autonomous decisions.
03Spanish-speaking Latinas had lower adjusted odds of preference-concordant decision making than White women (adjusted odds ratio 0.40, 95% confidence interval 0.22-0.73).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All women were from San Francisco Bay Area prenatal care sites and had agreed to a decision-making study, so findings may not apply elsewhere. The analysis is observational, so it shows associations, not causes. Women were asked after the testing period to recall decisions made weeks or months earlier, so responses may be inaccurate. Preference-concordance was a constructed variable based on three questions, so its validity may be limited. Data on provider language concordance and interpreter use were not collected, so possible contributors to disparities were not examined.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that a provider-driven or shared decision-making style causes worse outcomes or that changing counseling style will fix disparities. The study observed recalled preferences and associations, pooled intervention and control groups, and did not test an intervention or measure interpreter use.