DESCRIPTION (provided by applicant): The purpose of this application is to 1) develop a prenatal screening gaming application prototype (PS-GAP) and 2) conduct a preliminary assessment of the PS-GAP on knowledge, satisfaction, and decisional conflict about prenatal genetic screening for pregnant women and their partners. Specific Aim 1: Create a gaming tool for pregnant women and their partners to use to improve knowledge and to assess personal values about prenatal genetic screening. Methods: Develop a prototype in collaboration with gaming experts and clinical experts, leveraging preliminary studies and related work in the healthcare field. The prototype will then be revised in an iterative process with various stakeholder groups. Specific Aim 2: Assess the gaming prototype on knowledge, user satisfaction and decisional conflict about prenatal genetic screening among pregnant women and their partners. Methods: Determine usability and acceptability through both heuristic evaluation and user testing. Pregnant women and the partners will independently engage with the PS-GAP and then compare their choices. All participants will complete post-surveys measuring knowledge, satisfaction and decisional conflict. A sub group will be randomly selected for in-depth interviews about their experiences. Future Research: This R21 will demonstrate feasibility of the development and preliminary utility of a gaming tool on knowledge and decisional conflict related to prenatal genetic screening. Future research will be a multi-site randomized control trial to test the effectiveness of this approach on relevant outcomes including knowledge, distress, and satisfaction with decision-making. Potential Impact: Because of its focus on improved patient decision-making and engagement, this type of tool has widespread application. For example, it can augment other clinically relevant materials throughout pregnancy and be potentially useful in other value-laden genetic testing environments. Research Team: Our team is uniquely qualified to achieve the aims of this study. This application includes collaboration with the University of Utah's Entertainment Arts and Engineering program, one of the top programs in the U.S for game development, and the P20 NIH Utah Center for Excellence in Ethical, Legal and Social Research focused on population screening in prenatal screening and newborn screening in women's and children's health care.

PUBLIC HEALTH RELEVANCE: Our broad objective is to improve parental decision making about prenatal genetic screening. We will develop and assess a gaming prototype in collaboration with experts in serious game design. In this project, we will engage in a series of focus groups with stakeholders to design a game that promotes learning and engagement in different simulated choices in a non-directive fashion and allows a comparison of the game choices with an individual's reproductive partner. A preliminary assessment of the gaming prototype will be conducted within a clinic setting on knowledge, satisfaction, and decisional conflict about prenatal genetic screening for pregnant women and their partners.