Healthcare professionals’ perceptions of the acceptability of The PREVENT-PE Trial:A mixed-methods survey and interview study

Introduction: There is a lack of published data on how healthcare professionals perceive acceptability of third trimester risk screening in pregnancy. The PREVENT-PE trial [ISRCTN41632964] demonstrated that a personalised 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 Caesarean birth or neonatal morbidity. We aimed to evaluate the acceptability of the PREVENT-PE trial amongst healthcare professionals. <br/><br/>Materials and Methods: Staff were invited to an online survey comprising validated metrics of acceptability, which were analysed descriptively. Also, staff were invited to one-to-one interviews, to probe 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)<br/><br/>Results: There were 65 completed surveys, whilst 19 healthcare professionals participated in interviews. 41 staff participants were from King’s College Hospital, and 23 staff participants were from Medway Maritime Hospital, in line with 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 staffs toward participating in an evidence-based trial such as PREVENT-PE. Despite some concerns about implementation burden, system-level readiness and counselling high risk participants, Overall, staffs supported integrating such screening into routine maternity care if effectiveness is confirmed.<br/><br/>Conclusions: The PREVENT-PE trial had a high level of acceptability amongst healthcare professionals. Staff view risk screening in the third trimester of pregnancy as an acceptable, with potential to positively impact patient outcomes. <br/>