Accepted for/Published in: JMIR Formative Research
Date Submitted: Jul 10, 2023
Date Accepted: Jan 16, 2025
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Use of an online tailored decision aid to promote informed decision making about maternal pertussis vaccination: Process evaluation of a randomised controlled trial
ABSTRACT
Background:
To promote informed decision making and Maternal Pertussis Vaccination (MPV) uptake, we systematically developed an interactive, web-based decision aid for pregnant women. Intervention reach, use and acceptability are essential for it to be effective.
Objective:
In this process evaluation, we aim to evaluate (1) reach and (2) use of the intervention, and (3) the acceptability of the intervention.
Methods:
We analysed reach and use of the intervention among participants in the intervention group of a randomised controlled trial (RCT) that assessed the effects of the online tailored decision aid in the form of a web-app. Participants were recruited via social media and midwifery clinics and invited via e-mail to use the intervention at 18 weeks of pregnancy. Reach was measured objectively by assessing the number of participants that visited the intervention at least once. Use of the intervention was logged and included time spent on the decision aid, the number of times clicked, pages visited, and answers given in interactive components. Data of the baseline survey (<18 weeks of pregnancy) was used to measure socio-demographics, informed decision making, MPV uptake and determinants of uptake. A post-test survey (20-22 weeks of pregnancy) was used to evaluate the acceptability of the decision aid.
Results:
Of the 586 participants in the intervention group, 463 (79.0%) reached the homepage of the intervention. On average, participants spent 4.25 minutes on the decision aid (SD=4.39). Most participants used the decision aid once (56.2% of those who reached it, N=260) or twice (26.6%, N=123). The average number of clicks was 27.24 and varied widely (SD=25.08). Participants evaluated the decision aid positively with an overall grade of 8.0 out of 10 (SD=1.01). In total, 38.9% of participants indicated that the decision aid helped them with MPV decision-making.
Conclusions:
The reach of the decision aid was successful with 79.0%, and participants were very positive about the decision aid. Use of the intervention leaves room for improvement and should be improved to maximize intervention effects. Clinical Trial: https://onderzoekmetmensen.nl/en/trial/25018
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