The Meaning of Screening: Exploring user experience of an aneuploidy screening educational game

The Meaning of Screening is an interactive, gamified educational web-based app designed to support aneuploidy screening decision-making and was created through interviews and iterative development with patients, providers, and experts. The goal of this qualitative study is to summarize users' game experience, including how the app impacted their decision-making process. For this study, participants recruited into the randomized controlled trial to assess the effectiveness of the app on informational needs, preferences, and shared decision-making of patients' aneuploidy screening decision were interviewed about their experience with the game. Participants were selected through a two-step process: opting into interviews followed by sampling to achieve population representativeness. Inductive content analysis was conducted on the transcripts, with codes created from the transcribed interview content, where the interviewee's words were used as descriptors. Seventeen participants were interviewed about their experience with and opinions about the app titled "Meaning of Screening." Over half of the participants were aware of aneuploidy screening prior to interacting with the game (n = 13). Three major categories were identified through inductive content analysis: Impact, User Experience, and Integration into Clinical settings. Participants shared their experience with the game, with many expressing it helped to increase knowledge and understanding, assist values clarification, support decision-making factors, and promote shared decision-making with their partner and healthcare provider. Healthcare professionals play a crucial role in patients' aneuploidy screening decision-making by offering accurate, thorough, and unbiased information about available options. However, during prenatal visits, the provider has competing topics to discuss. When limited time doesn't allow for proficient education in the clinic, it is important that patients obtain accurate information through other means. This allows the patient to integrate this knowledge with their values when considering the potential implications of undergoing aneuploidy screening. Results from this study support the Meaning of Screening app can provide additional education to support decision-making about aneuploidy screening.