title: Enhancing Shared Decision Making Through Carefully Designed Interventions That Target Patient And Provider Behavior.
abstract: Patient-provider communication and shared decision making are essential for primary care delivery and are vital contributors to patient experience and health outcomes. To alleviate communication shortfalls, we designed a novel, multidimensional intervention aimed at nudging both patients and primary care providers to communicate more openly. The intervention was tested against an existing intervention, which focused mainly on changing patients' behaviors, in four primary care clinics involving 26 primary care providers and 300 patients. Study results suggest that compared to usual care, both the novel and existing interventions were associated with better patient reports of how well primary care providers engaged them in shared decision making. Future research should build on the work in this pilot to rigorously examine the comparative effectiveness and scalability of these interventions to improve shared decision making at the point of care.
authors.affiliation: Ming Tai-Seale (tai-sealem@pamfri.org) is a senior scientist in health policy research at the Palo Alto Medical Foundation Research Institute, in Mountain View, California.
authors.forename: Ming
authors.initials: M
authors.lastname: Tai-Seale
authors.affiliation: Glyn Elwyn is a professor at the Dartmouth Center for Health Care Delivery Science, in Hanover, New Hampshire.
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
authors.affiliation: Caroline J. Wilson is a consulting quantitative research analyst at the Palo Alto Medical Foundation Research Institute.
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Wilson
authors.affiliation: Cheryl Stults is a research sociologist at the Palo Alto Medical Foundation Research Institute.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Stults
authors.affiliation: Ellis C. Dillon is a research sociologist at the Palo Alto Medical Foundation Research Institute.
authors.forename: Ellis C
authors.initials: EC
authors.lastname: Dillon
authors.affiliation: Martina Li is a project manager at the Palo Alto Medical Foundation Research Institute.
authors.forename: Martina
authors.initials: M
authors.lastname: Li
authors.affiliation: Judith Chuang is a research associate at the Palo Alto Medical Foundation Research Institute.
authors.forename: Judith
authors.initials: J
authors.lastname: Chuang
authors.affiliation: Amy Meehan is a research associate at the Palo Alto Medical Foundation Research Institute.
authors.forename: Amy
authors.initials: A
authors.lastname: Meehan
authors.affiliation: Dominick L. Frosch is a senior scientist and chief care delivery evaluation officer at the Palo Alto Medical Foundation and an associate professor in the Department of Medicine at the University of California, Los Angeles.
authors.forename: Dominick L
authors.initials: DL
authors.lastname: Frosch
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D003657:Decision Making; D005260:Female; D006282:Health Personnel / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010358:Patient Participation / Q000706:statistics & numerical data*; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care; D014481:United States
keywords: Consumer Issues; Patient Physician Communication; Physicians; Primary Care; Shared decision making