Ethnic differences in determinants of participation and non-participation in prenatal screening for Down syndrome: A theoretical framework

• Published in: Prenatal diagnosis 2007-10, Vol.27 (10), p.938-950
• Main Authors: Fransen, Mirjam P., Essink-Bot, Marie-Louise, Oenema, Anke, Mackenbach, Johan P., Steegers, Eric A. P., Wildschut, Hajo I. J.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Chromosome aberrations; Decision Support Techniques; Down syndrome; Down Syndrome - diagnosis; Down Syndrome - ethnology; ethnic differences; Female; focus group interviews; Focus Groups; Fundamental and applied biological sciences. Psychology; Genetic Counseling - utilization; Genetics of eukaryotes. Biological and molecular evolution; Humans; Interviews as Topic; Medical genetics; Medical sciences; Molecular and cellular biology; Netherlands; Patient Acceptance of Health Care - ethnology; Pregnancy; Prenatal Diagnosis - utilization; prenatal screening; stage model; Suriname - ethnology; Turkey - ethnology
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.1805

Objective To develop a theoretical framework for analysing ethnic differences in determinants of participation and non‐participation in prenatal screening for Down syndrome. Methods We applied Weinstein's Precaution Adoption Process (PAP) Model to the decision of whether or not to participate in prenatal screening for Down syndrome. The prenatal screening stage model was specified by reviewing the empirical literature and by data from seven focus group interviews with Dutch, Turkish and Surinamese pregnant women in the Netherlands. Results We identified 11 empirical studies on ethnic differences in determinants of participation and non‐participation in prenatal screening for Down syndrome. The focus group interviews showed that almost all stages and determinants in the stage model were relevant in women's decision‐making process. However, there were ethnic variations in the relevance of determinants, such as beliefs about personal consequences of having a child with Down syndrome or cultural and religious norms. Discussion The prenatal screening stage model can be applied as a framework to describe the decision‐making process of pregnant women from different ethnic backgrounds. It provides scope for developing culturally sensitive, tailored methods to guide pregnant women towards informed decision‐making on participation or non‐participation in prenatal screening for Down syndrome. Copyright © 2007 John Wiley & Sons, Ltd.