title: The Role of Patient Activation in Preferences for Shared Decision Making: Results From a National Survey of U.S. Adults.
abstract: Studies investigating preferences for shared decision making (SDM) have focused on associations with sociodemographic variables, with few investigations exploring patient factors. We aimed to investigate the relationship between patient activation and preferences for SDM in 6 common medical decisions among a nationally representative cross-sectional survey of American adults. Adults older than 18 were recruited online (n = 2,700) and by telephone (n = 700). Respondents completed sociodemographic assessments and the Patient Activation Measure. They were also asked whether they perceived benefit (yes/no) in SDM in 6 common medical decisions. Nearly half of the sample (45.9%) reached the highest level of activation (Level 4). Activation was associated with age (p < .001), higher income (p = .001), higher education (p = .010), better self-rated health (p < .001), and fewer chronic conditions (p = .050). The proportion of people who agreed that SDM was beneficial varied from 53.1% (deciding the necessity of a diagnostic test) to 71.8% (decisions associated with making lifestyle changes). After we controlled for participant characteristics, higher activation was associated with greater perceived benefit in SDM across 4 of the 6 decisions. Preferences for SDM varied among 6 common medical scenarios. Low patient activation is an important barrier to SDM that could be ameliorated through the development of behavioral interventions.
authors: a Division of General Internal Medicine , Feinberg School of Medicine, Northwestern University , Chicago , Illinois , USA.|b Wolfson Institute of Preventive Medicine , Queen Mary University of London , London , United Kingdom.
authors: Samuel G
authors: SG
authors: Smith
authors: a Division of General Internal Medicine , Feinberg School of Medicine, Northwestern University , Chicago , Illinois , USA.
authors: Anjali
authors: A
authors: Pandit
authors: c United Healthcare , Minneapolis , Minnesota , USA.
authors: Steven R
authors: SR
authors: Rush
authors: a Division of General Internal Medicine , Feinberg School of Medicine, Northwestern University , Chicago , Illinois , USA.
authors: Michael S
authors: MS
authors: Wolf
authors: d Optum Institute , Minneapolis , Minnesota , USA.
authors: Carol J
authors: CJ
authors: Simon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000706:statistics & numerical data*; D057240:Patient Preference / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult