An Interactive Web-based Birth Decision Aid for Shared Decision Making

Summary

An interactive web-based decision aid for shared decision making: birth choice after cesarean in Taiwan

Background: Taiwan has a high national caesarean rate coupled with a low vaginal birth after caesarean (VBAC) rate. Studies suggest that pregnant women do not receive sufficient information about birth choices after caesarean in Taiwan and shared decision making (SDM) is not an expectation. Chen conducted a pilot study. Improvements in knowledge for the decision aid group were larger than for the usual care group, although differences between groups were not statistically significant. An interactive multimedia technology and humanity communication may provide opportunities to increase engagement and support women during decision consultations. Following previous pilot study, the study aims to examine the effectiveness of an interactive web-based birth decision aid for SDM in pregnant women who have had a previous cesarean.

Methods: A quantitative approach will be conducted with a randomized pre-test and post-test experimental design in a medical center in northern Taiwan. Participants who have had one previous CS will be recruited at 14-16 weeks. A total of 172 women will be completed a baseline survey and will be randomly allocated to either the intervention (usual care plus an interactive web-based birth decision aid ) or usual care (general maternal health booklet) group. A follow up survey at 35-38 weeks measured change in decisional conflict, knowledge, birth preference and decision aid acceptability. Actual birth outcomes and satisfaction will be assessed one month after birth.

Contributions/ Implementation of clinical practice The study will potentially increase women and obstetricians to support VBAC and SDM. The interactive decision aid tool may reduce time-consumption for health education. Linking web-based data analysis of AI into medical record can be beneficial for clinical practice and research in the future.

Conditions

• Shared Decision Making
• Vaginal Birth After Cesarean

Interventions

DEVICE

web-based birth decision aid

Women in the intervention group receive both usual care and decision support (an interactive web-based birth decision aid). The innovative interactive web-based birth decision aid comprised five components: Component 1-a communication aid video involves 2 expert's talk about how to participate in SDM and prepare self with choice talk, option talk and decision talk(10 minutes )and practice communication skills with clinician(10 minutes); Component 2-overall of the function and features of birth decision aid. Component 3-introduce the benefits and risk of vaginal birth after cesarean; Component 4- the benefits and risk of elective repeat cesarean section; Component 5 -a quit to confirm women's knowledge regarding the two choices and confirm women's values.

Sponsors & Collaborators

• National Taipei University of Nursing and Health Sciences

  lead OTHER

Principal Investigators

• Shu Wen Chen, PhD · National Taipei University of Nursing and Health Science

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

20 Years

Max Age

45 Years

Sex

FEMALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-09-15

Primary Completion

2023-12-31

Completion

2023-12-31

Countries

• Taiwan

Study Locations