Prenatal screening for Down syndrome: a survey of willingness in women and family physicians to engage in shared decision-making

Objective To assess the willingness of women and their family physicians (FPs) to engage in shared decision-making (SDM) as regards prenatal Down-syndrome screening and the factors that might influence their willingness to do so. Methods We conducted a survey of participants in Quebec City, Canada, using the theory of planned behavior. We used a general linear model and multilevel approach that took the fact that some women consulted the same FP into account. Results This study comprised 109 pregnant women and 41 FPs. On a scale of -3 to +3, the pregnant women's and FPs' response scores were, respectively, 2.11 +/- 1.38 and 2.66 +/- 0.40. In women, attitude, significant others, self-efficacy, perceived moral correctness, and their FP's attitude influenced their willingness to engage in SDM. However, women without a post-secondary education were less likely to engage in SDM than women with a post-secondary education, mostly because the former lacked a sense of self-efficacy. In FPs, only attitude and significant others influenced their willingness to engage in SDM. Conclusion Overall, the women and their FPs wished to engage in SDM as regards prenatal Down-syndrome screening. Only a few factors influenced this desire which therefore may be modifiable. Copyright (C) 2011 John Wiley & Sons, Ltd.