Healthcare professionals' perceptions of the acceptability of the PREVENT-PE trial: A mixed-methods survey and...

There is a lack of published data on how healthcare professionals perceive the acceptability of third-trimester risk screening in pregnancy. The PREVENT-PE trial [ISRCTN41632964] demonstrated that a personalized approach to term pre-eclampsia risk assessment to inform risk-stratified timed birth at term reduced the incidence of term PE by 30%, without increasing Cesarean birth or neonatal morbidity. We aimed to evaluate the acceptability of the PREVENT-PE trial among healthcare professionals.

Staff were invited to an online survey comprising validated metrics of acceptability, which were analyzed descriptively. Also, the staff were invited to one-to-one interviews to probe the acceptability of the trial in more depth. Using template analysis, responses were mapped onto the following domains of acceptability: Sense-making (Intervention Coherence), Commitment (Affective Attitude), Change (Burden), Communication (Ethicality), Motivation (Opportunity Costs), Action (Self-Efficacy), and Evaluation (Perceived Effectiveness).

There were 65 completed surveys, whilst 19 healthcare professionals participated in interviews. Forty-one staff participants were from King's College Hospital, and twenty-one staff participants were from Medway Maritime Hospital, in line with the recruitment of participants to the trial. Approximately 29% of staff were of non-White ethnicity. Most staff were doctors or midwives, in similar proportions. One-third of staff participants had no prior involvement in clinical trials. Acceptability was endorsed by the majority of survey respondents (69.2%), as "very acceptable" (44.6%) or "somewhat acceptable" (24.6%). Interview findings endorsed acceptability from most staff toward participating in an evidence-based trial such as PREVENT-PE. Despite some concerns about implementation burden, system-level readiness, and counseling high-risk participants, the staff supported integrating such screening into routine maternity care if effectiveness is confirmed.

The PREVENT-PE trial had a high level of acceptability among healthcare professionals. Staff view risk screening in the third trimester of pregnancy as acceptable, with potential to positively impact patient outcomes.