Abstract
BackgroundAlthough children can benefit from being included in health decisions, little is known about effective interventions to support their involvement. The objective of this study was to evaluate the feasibility and acceptability of decision coaching guided by the Ottawa Family Decision Guide with children and parents considering insulin delivery options for type 1 diabetes (insulin pump, multiple daily injections, or standard insulin injections).MethodsPre-/post-test field testing design. Eligible participants were children (≤18 years) with type 1 diabetes and their parents attending an ambulatory diabetes clinic in a tertiary children’s hospital. Parent–child dyads received decision coaching using the Ottawa Family Decision Guide that was pre-populated with evidence on insulin delivery options, benefits, and harms. Primary outcomes were feasibility of recruitment and data collection, and parent and child acceptability of the intervention.ResultsOf 16 families invited to participate, 12 agreed and 7 attended the decision coaching session. For the five missed families, two families were unable to attend the session or the decision coach was not available (N=3). Baseline and immediately post-coaching questionnaires were all completed and follow-up questionnaires two weeks post-coaching were missing from one parent–child dyad. Missing questionnaire items were 5 of 340 items for children (1.5%) and 1 of 429 for parents (0.2%). Decision coaching was rated as acceptable with higher scores from parents and their children who were in earlier stages of decision making.ConclusionDecision coaching with children and their parents considering insulin options was feasible implement and evaluate in our diabetes clinic and was acceptable to participants. Recruitment was difficult due to scheduling restrictions related to the timing of the study. Coaching should target participants earlier in the decision making process and be scheduled at times that are convenient for families and coaches. Findings were used to inform a full-scale evaluation that is currently underway.
Highlights
Children can benefit from being included in health decisions, little is known about effective interventions to support their involvement
Children are not consistently consulted or optimally involved in health decisions [3]. Interventions such as decision coaching and patient decision aids improve adult patients’ participation in health decisions, knowledge and decision quality but little is known about their ability to facilitate shared decision making with children [8,9]
While decision coaching with children and parents was feasible to provide and measure, the study encountered challenges with the overall participation rate due to limited decision coach availability and extra time required for children and parents to attend the session
Summary
Children can benefit from being included in health decisions, little is known about effective interventions to support their involvement. Children are not consistently consulted or optimally involved in health decisions [3]. Interventions such as decision coaching and patient decision aids improve adult patients’ participation in health decisions, knowledge and decision quality but little is known about their ability to facilitate shared decision making with children [8,9]. Decision coaching is a process of non-directive support by a trained facilitator to help patients develop skills in preparation for decision making with their physician [9]. Often provided by nurses, social workers, or other allied health professionals, alone or in conjunction with patient decision aids, improves knowledge, increases satisfaction, and reduces healthcare costs [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
