Public Perspectives Around Prenatal Screening of Chromosomal Abnormalities: A Focus Group Study Comparing Metropolitan and Rural/Regional Areas in Australia.

Abstract

Background: The widespread and rapid adoption of private payments for non-invasive prenatal testing (NIPT) in Australia has introduced complexities to the decision-making process for the public regarding prenatal screening. NIPT has the potential to be a useful screening tool, but concerns have been raised about its cost, the psychological consequences of testing and the information available to support informed decision-making.

Objective: To explore the attitudes, values and beliefs around prenatal screening in Australia, and how perspectives may differ between people living in metropolitan locations versus rural/regional locations.

Materials and methods: Three focus groups were conducted in New South Wales (NSW), Australia. Participants (N = 25) were recruited by a market research group. Focus groups took place face-to-face in metropolitan and rural/regional areas, and online via videoconference. Discussions were transcribed and analysed thematically.

Results: Participants generally expressed interest in undertaking prenatal screening but held misconceptions about the purpose of NIPT (i.e. screening, not diagnosis) and the conditions assessed. There were varied opinions among participants on expanding the scope of screening: some felt additional information provided reassurance, whilst others thought it would increase stress due to the decreased accuracy. People living in rural/regional areas had greater concerns over access to screening (cost, wait times and distance) than people living in metropolitan areas.

Conclusion: Our findings demonstrate different approaches are needed to improve understanding of NIPT (to ensure informed consent), and to improve access to NIPT for people living in rural/regional areas. The pre-test information needs to account for the range of perspectives observed across geographic locations.