Outcomes measures
Primary outcome in this study was the change in knowledge scores. Secondary outcomes were attitudes toward positive screening test, levels of satisfaction with counseling, and screening acceptance rates.After the pretest counseling and on the same day as the counseling, all the participants completed the same questionnaires and gauged their levels of satisfaction by using five-point Likert-type scale.In the second section of questionnaires, true, false, I don’t know questionnaire, if the participants chose correct answer, they would be given a score of “1”, in contrast if the participants chose incorrect answer or “I don’t know,” they would be given a score of “0” for that question. In the three multiple-choice questions with one best response, the score of “1” and “0” was given for a correct and incorrect answer, respectively. In sum, the maximum score was 18/18.Results from the attitude towards positive results and satisfaction were dichotomized by combining level of concerning or level of satisfaction of “strongly concerned/very satisfied” and “concerned/satisfied” into one category labeled “Concerned/Satisfied”; and “neutral/average”, “unconcerned/slightly satisfied” and “strongly unconcerned/not satisfied” into another category labeled “Unconcerned/Not satisfied”.The women were then told that they could request additional explanations from the counselors to ensure that they clearly understood the information about cell-free DNA screening and were able to make their own decisions about whether to accept this screening option. Finally, the educational levels of the counselors were documented, and the time between the pre- and post-counseling test was measured.