Abstract
BackgroundThere is considerable interest today in shared decision-making (SDM), defined as a decision-making process jointly shared by patients and their health care provider. However, the data show that SDM has not been broadly adopted yet. Consequently, the main goal of this proposal is to bring together the resources and the expertise needed to develop an interdisciplinary and international research team on the implementation of SDM in clinical practice using a theory-based dyadic perspective.MethodsParticipants include researchers from Canada, US, UK, and Netherlands, representing medicine, nursing, psychology, community health and epidemiology. In order to develop a collaborative research network that takes advantage of the expertise of the team members, the following research activities are planned: 1) establish networking and on-going communication through internet-based forum, conference calls, and a bi-weekly e-bulletin; 2) hold a two-day workshop with two key experts (one in theoretical underpinnings of behavioral change, and a second in dyadic data analysis), and invite all investigators to present their views on the challenges related to the implementation of SDM in clinical practices; 3) conduct a secondary analyses of existing dyadic datasets to ensure that discussion among team members is grounded in empirical data; 4) build capacity with involvement of graduate students in the workshop and online forum; and 5) elaborate a position paper and an international multi-site study protocol.DiscussionThis study protocol aims to inform researchers, educators, and clinicians interested in improving their understanding of effective strategies to implement shared decision-making in clinical practice using a theory-based dyadic perspective.
Highlights
There is considerable interest today in shared decision-making (SDM), defined as a decision-making process jointly shared by patients and their health care provider
SDM is defined as a decision-making process jointly shared by patients and their health care provider [3], and is said to be the crux of patient-centered care [4]
In a systematic review of barriers and facilitators to implementing SDM and patient decision aids in clinical practice as perceived by health professionals [16], among 28 unique studies that had collected data from 15 countries, the three most often reported barriers were: time constraints, lack of applicability due to patient characteristics, and lack of applicability due to the clinical situation. These results suggest that health professionals might be selecting, a priori, certain patients for whom they believe that SDM is feasible or functional
Summary
Participants Participants include researchers from Canada, US, UK, and Netherlands representing medicine, nursing, psychology, community health, and epidemiology. Other collaborators from the US are the two key invited presenters at the two-day workshop Together, they will bring extensive expertise on the theoretical underpinnings of implementing behavioral change [44,45,46], the study of interpersonal influences [28] and the analysis of dyadic data [47]. 1) Foster ongoing communication among members of this international research network At the outset of the project, using internet-based forum or conference calls hosted by the group at Université Laval, all participants discuss a similar definition of the problems and challenges with implementing SDM, including methodological issues with analysis of dyadic data. 3) Perform secondary analyses of existing dyadic datasets One of the purposes of the workshop is to use existing dyadic datasets to explore the research questions presented above This will ensure that the team's discussions are grounded in data. Based on the strong record of research excellence of all co-investigators and on existing dyadic data sets to be analyzed during the workshop, our research team is firmly convinced that it will attract funding for future projects
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