637 - Smartphone Video Communication Skills Training for Expectant Mothers in a Fetal Anomalies Clinic: a Randomized Controlled Trial

Publication Number: 2622.637

Amanda M. Jentsch, Medical College of Wisconsin, New Berlin, WI, United States; Siobhan M. McDonnell, Medical College of Wisconsin, Willmar, MN, United States; Jessica Smith, Medical College of Wisconsin, Milwaukee, WI, United States; Ke Yan, Medical College of Wisconsin, Milwaukee, WI, United States; Melodee Liegl, Medical College of Wisconsin, Milwaukee, WI, United States; Steven R. Leuthner, Medical College of Wisconsin, Whitefish Bay, WI, United States; Mir A Basir, Medical College of Wisconsin, Brookfield, WI, United States

Background: Prenatal diagnosis of a fetal anomaly can be overwhelming for expectant parents. Their ability to cope with the diagnosis and participate in decision-making depends on the quality of communication with healthcare providers. Active communication behaviors such as asking questions and expressing opinions bring the patient's perspective into the clinical encounter. Active patients are more satisfied with care and experience better outcomes.

Objective: To evaluate whether a smartphone-based animated video intervention improves use of evidence-based communication behaviors among expectant mothers during a fetal anomalies clinic visit.

Design/Methods: In this IRB-approved randomized controlled trial (Clinicaltrials.gov: NCT06323343), English-speaking pregnant individuals aged ≥18 years with a prenatally diagnosed fetal anomaly were enrolled before their first appointment. Participants were randomized 1:1 to receive either an 8-minute animated video modeling nine evidence-based communication skills (Table 1) with a handout (Figure 1) or links to the clinic's public webpages (control). Materials were sent to participants up to one week before their visit. Twenty-four hours after the visit, participants completed a 13-item questionnaire assessing their use of taught communication skills. Anxiety levels were assessed.

Results: Forty-eight participants were recruited (24 intervention, 24 control); demographic characteristics (race, income, education, marital status) were similar between groups. 71% of participants completed follow up (16 intervention, 18 control). Among intervention participants, 83% viewed part of the video and 71% watched it in full. Across 13 assessment items, the median (IQR) of skills used in the first visit was 58% (38-73%) in the intervention group versus 55% (44-64%) in the control group (p=0.574). No significant differences were observed for individual behaviors. Fewer than half of participants in both groups used six of the recommended behaviors (Figure 2). Reported anxiety was similar between groups.

Conclusion(s): Most expectant mothers viewed the smartphone-based animated communication skills video before the clinic visit. However, many recommended communication behaviors remained underused. Further research should identify barriers to skills application, evaluate sustained behavioral effects, and test additional strategies to strengthen effective patient-provider communication during clinic encounters.

Table 1
Nine skills were selected from patient communication literature

Figure 1
Handout given to the intervention group at clinic check-in reiterated key communication skills introduced in the video. Skills intended for completion before the visit (question preparation, goal setting, and setting up EMR access) were not included.

Figure 2
Six of the thirteen communication behavioral assessment items were used by less than half of participants in both study groups.