Development and pilot test of a pregnancy decision making tool for women with physical disabilities
Kalpakjian, Claire Z.; Haapala, Heidi J.; Ernst, Susan D.; Orians, Brittany R.; Barber, Melissa L.; Mulenga, Lukonde; Bolde, Shannen; Kreschmer, Jodi M.; Parten, Rebecca; Carlson, Susan; Rosenblum, Sara; Jay, Gina M.
2023-02
Citation
Kalpakjian, Claire Z.; Haapala, Heidi J.; Ernst, Susan D.; Orians, Brittany R.; Barber, Melissa L.; Mulenga, Lukonde; Bolde, Shannen; Kreschmer, Jodi M.; Parten, Rebecca; Carlson, Susan; Rosenblum, Sara; Jay, Gina M. (2023). "Development and pilot test of a pregnancy decision making tool for women with physical disabilities." Health Services Research 58(1): 223-233.
Abstract
ObjectiveDesign and pilot test a new decision making tool for women with physical disabilities (impairment of physical function due to chronic conditions) considering pregnancy.Data Sources and Study SettingQuantitative surveys and qualitative interviews were collected from participants living in the community.Study DesignClinical guidelines and survey and focus group data about pregnancy informational and decisional needs guided content development. The tool was pilot tested in a 12-week trial with participants with physical disabilities considering or actively planning a pregnancy. Feasibility outcomes were acceptability, implementation, and demand (collected at end of the trial); preliminary efficacy focused on decisional conflict and readiness (baseline, 6 weeks, and end of trial).Data CollectionSurvey data were collected using an online form. One-on-one interviews were conducted to learn more about experience using the tool.Principal FindingsThirty eight participants with mild, moderate, or severe physical disabilities participated. Feasibility outcomes indicated that the tool provided participants with information, guiding questions, and helped them to consider multiple aspects of the decision about pregnancy. Most participants responded positively to the new decision making tool, finding it easy to use and the information balanced. Feedback highlighted opportunity for improvement, such as more specific information, peer stories, and the limitations of a paper format. There was significant linear effect of time, with increased decisional certainty and readiness, values clarity, and decisional support (partial η2 [90% CI] = 0.310 [0.08, 0.46], 0.435 [0.19, 0.60], 0.134 [0, 0.29], 0.178 [0.01, 0.35], respectively). Decisional certainty and readiness had high observed power (96.7% and 99.3%, respectively) with lower observed power for clarity and support (60.6% and 75.1%, respectively).ConclusionsThe new tool shows promise for supporting women with physical disabilities in navigating pregnancy decision making. Future development of complementary strategies to support health care providers will help improve shared decision making and patient-centered care.Publisher
Blackwell Publishing Ltd Wiley Periodicals, Inc.
ISSN
0017-9124 1475-6773
Other DOIs
Types
Article
Metadata
Show full item recordCollections
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.