(577) An RCT to Assess Impact of Video Education on Decisional Conflict Regarding Aneuploidy Testing

Informed consent for prenatal aneuploidy testing is challenging due to complexity of counseling and lack of access to genetic counselors. Prior educational interventions have not been available in multiple languages, accessible for those with low educational attainment, or with patient voices incorporated into the design. This RCT sought to assess the impact of an end-user-designed video education series on patient decisional conflict scale (DCS) with respect to prenatal genetic testing. Secondary aims assessed testing uptake and risk perception of aneuploidy.

Study Design:

English or Spanish speaking pregnant individuals were recruited at the dating ultrasound from Jan to July 2025. Participants completed a baseline genetics knowledge and demographics survey. Participants were randomized to video education (viewed prior to new OB visit) or standard care. A follow-up survey was administered to all participants after their new OB appointment to assess DCS (primary outcome). Thirty-six participants per group (total n = 72 participants) were required for 80% power to detect a decrease in DCS score from 30% to 23% (alpha = 0.05) based on prior literature. Genetic testing uptake was obtained via chart review. Wilcoxon rank sum test, Fisher’s exact test, or Pearson’s Chi-squared test were applied as appropriate.

Results:

A total of 72 participants were consented and enrolled (37 randomized to intervention). There were no baseline demographic or genetics knowledge differences between groups (Table 1). In the video intervention group, most participants (65%) watched the complete video series in-person. There were no differences in mean DCS, testing uptake, or risk perception between groups (Table 2).

Conclusion:

A patient-designed video education series regarding aneuploidy testing options did not impact DCS regarding testing decisions. Compared to prior literature, participants in both groups were certain about their choices (low DCS scores). Uptake of cell free DNA was near universal. Further studies are needed to explore how options are being presented and patient comprehension of their results.