Development and Pilot Testing of a Patient-Centered Web-Based Reproductive Decision Support Tool for Primary Care.
J Gen Intern Med
; 36(10): 2989-2999, 2021 10.
Article
em En
| MEDLINE
| ID: mdl-33538956
ABSTRACT
BACKGROUND:
Patient-centered counseling to help women achieve their reproductive goals is an essential yet often absent component of primary care.OBJECTIVE:
We developed and piloted MyPath, a novel web-based decision support tool integrating reproductive goals assessment, information about optimizing health before pregnancy, and contraceptive decision support, for use prior to primary care visits in the Veterans Administration (VA).DESIGN:
We created MyPath using best practices for decision tool development, including a conceptual framework informed by theory and user-centered design with input from patients, providers, and scientific experts. We conducted a non-randomized pilot in two VA Women's Health primary care clinics. A control group (n = 28) was recruited prior to and intervention group (n = 30) recruited after introduction of MyPath into clinics.PARTICIPANTS:
Women Veterans ages 18-44 with an upcoming visit scheduled with one of eight providers.INTERVENTIONS:
After recruitment of controls, providers and staff received a brief introduction to MyPath. Patients scheduled to see providers in the intervention phase used MyPath on an iPad in the waiting room prior to their visit. MAINMEASURES:
Acceptability, feasibility, discussions about pregnancy and/or contraceptive needs, and contraceptive decision quality by a survey of participants and providers. KEYRESULTS:
Nearly all participants who used MyPath reported they learned new information (97%) and would recommend it to other Veterans (93%). No providers reported that MyPath significantly increased workload. A greater proportion of intervention participants reported having discussions about reproductive needs in their visit compared to controls (93% vs 68%; p = 0.02). Intervention participants also experienced greater increases in pre-/post-visit knowledge and communication self-efficacy and a trend towards greater reduction in contraceptive decision conflict compared to controls.CONCLUSIONS:
MyPath was highly acceptable to women, increased the proportion of primary care visits addressing reproductive needs, and improved decision quality without increasing providers' perceived workload. A larger randomized evaluation of effectiveness is warranted.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Tomada de Decisões Assistida por Computador
/
Assistência Centrada no Paciente
Tipo de estudo:
Clinical_trials
/
Guideline
/
Prognostic_studies
Limite:
Adolescent
/
Adult
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Female
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Humans
/
Pregnancy
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article