Risks, trust and knowledge: determinants of pregnant women's decisions regarding participation in a future Q fever screening and treatment program during a large epidemic in The Netherlands.

ABSTRACT

OBJECTIVE: Contracting Q fever during pregnancy carries a risk of developing obstetric complications. The aim of this study was to gain insight into pregnant women's decisions regarding participation in a future Q fever screening and treatment program. METHODS: Pregnant women (N = 148) in Q fever high-risk areas in The Netherlands were recruited via midwives' practices and via an online panel for a cross-sectional questionnaire survey. The outcome measures included intention to participate in the program, Q fever exposure risk, perceived Q fever risk, trust in health professionals and authorities, disease-related knowledge and additional outcome measures. RESULTS: Fifty-six percent of the respondents intended to participate in the screening and treatment program. The sole determinant of a higher intended program uptake was a more positive appraisal of program efficacy and convenience. This appraisal was in turn associated with perceived risk and knowledge. CONCLUSION: Women's appraisal of program efficacy and convenience, their disease-related knowledge and perceived Q fever risk seem to be crucial for their intended program uptake. A successful implementation of a Q fever screening and treatment program may thus depend on the benefits and downsides of the program, and on securing that women are aware of the risks of the disease.