Development and testing of a decision aid to achieve shared decision-making for routine labor induction

Area of Science:

• Obstetrics and Gynecology
• Health Services Research
• Patient Engagement

Background:

• Quality improvement project focused on labor induction decision-making for healthy pregnancies at 39 weeks or later.
• Aimed to address needs of populations less likely to engage in shared decision-making.
• Sought to identify and test implementation strategies for prenatal care settings.

Purpose of the Study:

• To develop and refine a patient decision aid for labor induction.
• To test the decision aid's effectiveness in promoting shared decision-making.
• To identify strategies for successful implementation in diverse clinical practices.

Main Methods:

• Employed quality improvement and qualitative methodologies.
• Developed, tested, and refined a patient decision aid through multiple Plan-Do-Study-Act cycles.
• Conducted interviews with a diverse group of pregnant individuals and medical providers across various practice settings.

Main Results:

• Shared decision-making regarding labor induction was achieved in the majority of cases (23/24).
• Most participants understood their induction choices and their associated pros and cons.
• Providers reported the decision aid improved counseling quality and reduced bias.

Conclusions:

• An evidence-based decision aid can facilitate shared decision-making for labor induction among diverse pregnant populations.
• The decision aid contributed to empowering patient experiences and positive decision-making processes.
• Implementation strategies supported the successful use of the decision aid in clinical practice.