Using decision aids in community-based primary care: a theory-driven evaluation with ethnically diverse patients.
OBJECTIVE
To assess the effects of informational brochures and video decision aids about cancer screening on patient intention to engage in shared decision-making and its predictors in a racially diverse sample.


METHODS
Participants were recruited from 13 community-based primary care practices serving racially and ethnically diverse patients in predominately economically disadvantaged neighborhoods. Participants completed theory-based measures assessing attitudes, perceived social norms, self-efficacy and intentions for working with their physician to make a cancer screening decision after reviewing a brochure or video decision aid, but before seeing the physician. A post-questionnaire assessed screening decisions and participant knowledge.


RESULTS
Participants who reviewed a video decision aid had higher knowledge and were more likely to want to be the primary decision-maker. They reported lower perceived social norms, self-efficacy and intentions to work with their physicians than participants who reviewed a brochure. Participants who decided against cancer screening reported lower intentions to work with their physician in making a decision and were less likely to report having spoken with their physician about screening.


CONCLUSIONS
Participants who opted against cancer screening after reviewing a brochure or decision aid were less likely to discuss their decision with their physician. The tendency toward autonomous decision-making was stronger among participants who reviewed a video decision aid.
Frosch
Dominick L
DL
Department of Medicine, Division of General Internal Medicine & Health Services Research, University of California, Los Angeles, CA 90024, United States. dfrosch@mednet.ucla.edu
Légaré
France
F
Mangione
Carol M
CM
D000368:Aged; D018864:Cultural Diversity; D003661:Decision Support Techniques; D004521:Educational Measurement; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015141:Los Angeles; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000523:psychology; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D011204:Poverty Areas; D011320:Primary Health Care; D011582:Psychological Theory; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D014743:Videotape Recording / Q000592:standards*
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