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How should we communicate information regarding birth choices to women?: An online randomised survey
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  • Victoria Bradley,
  • Alexandra Hunt,
  • Eve Bunni,
  • Carol Kingdon,
  • Leila Finikarides,
  • Laura Bonnett,
  • Caroline Cunningham,
  • Christy Burden,
  • Jo Ficquet,
  • William Parry-Smith,
  • Elena Oteroromero,
  • Arezou Rezvani,
  • Mairead Black,
  • Gemma Clayton,
  • Gordon Smith,
  • Debbie Lawlor,
  • Jon Heron,
  • Abi Merriel
Victoria Bradley
University of Liverpool Department of Women's and Children's Health
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Alexandra Hunt
University of Liverpool Department of Health Data Science
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Eve Bunni
University of Liverpool Department of Women's and Children's Health
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Carol Kingdon
University of Liverpool Department of Women's and Children's Health
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Leila Finikarides
Former WInton Centre for Risk Communication
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Laura Bonnett
University of Liverpool Department of Health Data Science
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Caroline Cunningham
Liverpool Women's NHS Foundation Trust
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Christy Burden
University of Bristol Medical School
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Jo Ficquet
Royal United Hospitals Bath NHS Foundation Trust
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William Parry-Smith
Keele University
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Elena Oteroromero
Cambridge University Hospitals NHS Foundation Trust
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Arezou Rezvani
University College London Hospitals NHS Foundation Trust
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Mairead Black
University of Aberdeen Aberdeen Centre for Women's Health Research
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Gemma Clayton
University of Bristol Medical School
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Gordon Smith
University of Cambridge Department of Obstetrics and Gynaecology
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Debbie Lawlor
University of Bristol Medical School
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Jon Heron
University of Bristol Medical School
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Abi Merriel
University of Liverpool Department of Women's and Children's Health

Corresponding Author:abi.merriel@liverpool.ac.uk

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Abstract

Objective: To identify which risk communication graphics are easiest to understand when communicating risks surrounding birth; and investigate the effect of numeracy and health literacy on understanding. Design: Online survey with randomised content Setting: UK Population: Women and their partners, healthcare professionals and stakeholders in the UK. Methods: Seven candidate graphics (’10-person’, ‘100-person’, ’10-circle’, ‘100-circle’ icon arrays, ‘bar charts’, ‘pie charts’ and ‘words’) were co-produced with a patient and public involvement group. These were used to develop seven online surveys. Participants were recruited using social media and adverts in participating hospitals. Each participant was randomised to see one of seven surveys, the survey questions remained the same, the graphics varied. Data were collected on risk perception, perceived ease of understanding and preference, alongside demographic factors, numeracy skills and health literacy. Main outcome measures: Objective comprehension and subjective preference for graphics. Results: There were 858 participants, 771 women/partners/parents and 87 healthcare professionals and stakeholders. 70% of participants answered all four numeracy questions correctly, and respondents reported high health literacy (76.5% can understand health material, 72.8% were comfortable completing medical forms). All graphics were understood; however, the ‘100-person’ icon array elicited the best score when comparing two risks (mean score 97.5% compared to next best performing graphic 95.8%), 41% believed it was the easiest to understand and 36% selected it as the preferred graphic. Conclusions: All graphics are well understood. The ‘100-person’ icon array scored best in terms of risk comparison and participant preference. Using this graphic may support high-quality communication of risk in maternity care.