title: Implementing shared decision-making in interprofessional home care teams (the IPSDM-SW study): protocol for a stepped wedge cluster randomised trial.
abstract: The frail elderly in Canada face a tough decision when they start to lose autonomy: whether to stay at home or move to another location. This study seeks to scale up and evaluate the implementation of shared decision-making (SDM) in interprofessional (IP) home care teams caring for elderly clients or their caregivers facing a decision about staying at home or moving elsewhere.
  
  
  
  A stepped wedge cluster randomised trial involving 8 Health and Social Service Centers (HSSCs) will be conducted with IP home care teams. HSSCs are the unit of randomisation. A decision guide will be passively distributed to all of the participating HSSCs at the beginning of the project. The participating HSSCs will then be randomised to 1 of 4 intervention start times, separated by 7-month intervals. The primary outcome is whether or not clients and caregivers assumed an active role in decision-making, assessed with a modified version of the Control Preferences Scale. The intervention, targeted at IP home care teams, consists of a 1.5 hour online tutorial and a 3.5 hour skills building workshop in IP SDM. Clients will be eligible for outcome assessment if they (1) are aged ≥65; (2) are receiving care from the IP home care team of the enrolled HSSCs; (3) have made a decision about whether to stay at home or move to another location during the recruitment periods; (4) are able to read, understand and write French or English; (5) can give informed consent. If clients are not able to provide informed consent, their primary caregiver will become the eligible participant.
  
  
  
  Ethics committee review approval has been obtained from the Multicenter Ethics Committee of CISSS-Laval. Results will be disseminated at conferences, on websites of team members and in peer-reviewed and professional journals intended for policymakers and managers.
  
  
  
  NCT02592525, Pre-results.
authors.affiliation: CHU de Québec Research Centre, Saint-François d'Assise Hospital, Quebec City, Quebec, Canada.|Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.
authors.forename: France
authors.initials: F
authors.lastname: Légaré
authors.affiliation: Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Direction des services multidisciplinaires, Quebec City, Quebec, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Brière
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.|School of Nursing, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Dawn
authors.initials: D
authors.lastname: Stacey
authors.affiliation: Faculty of Social Sciences, Université Laval, Quebec City, Quebec, Canada.
authors.forename: Guy
authors.initials: G
authors.lastname: Lacroix
authors.affiliation: CHU de Québec Research Centre, Saint-François d'Assise Hospital, Quebec City, Quebec, Canada.|School of Nutrition, Université Laval, Quebec City, Quebec, Canada.
authors.forename: Sophie
authors.initials: S
authors.lastname: Desroches
authors.affiliation: Faculty of Social Sciences, Université Laval, Quebec City, Quebec, Canada.|School of Nutrition, Université Laval, Quebec City, Quebec, Canada.|Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, CERSSPL-UL, Quebec City, Quebec, Canada.
authors.forename: Serge
authors.initials: S
authors.lastname: Dumont
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Kimberly D
authors.initials: KD
authors.lastname: Fraser
authors.affiliation: Faculty of Sciences and Engineering, Université Laval, Quebec City, Quebec, Canada.
authors.forename: Louis-Paul
authors.initials: LP
authors.lastname: Rivest
authors.affiliation: Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.|Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Direction des services multidisciplinaires, Quebec City, Quebec, Canada.
authors.forename: Pierre J
authors.initials: PJ
authors.lastname: Durand
authors.affiliation: CHU de Québec Research Centre, Saint-François d'Assise Hospital, Quebec City, Quebec, Canada.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Turcotte
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.|School of Nursing, University of Ottawa, Ottawa, Ontario, Canada.|Faculty of Social Sciences, Université Laval, Quebec City, Quebec, Canada.|School of Nutrition, Université Laval, Quebec City, Quebec, Canada.|Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, CERSSPL-UL, Quebec City, Quebec, Canada.|Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.|Faculty of Sciences and Engineering, Université Laval, Quebec City, Quebec, Canada.|School of Epidemiology, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Monica
authors.initials: M
authors.lastname: Taljaard
authors.affiliation: Caregivers' representative, CHU de Québec Research Centre, Saint-François d'Assise Hospital, Quebec City, Quebec, Canada.
authors.forename: Henriette
authors.initials: H
authors.lastname: Bourassa
authors.affiliation: Caregivers' representative, CHU de Québec Research Centre, Saint-François d'Assise Hospital, Quebec City, Quebec, Canada.
authors.forename: Lise
authors.initials: L
authors.lastname: Roy
authors.affiliation: CHU de Québec Research Centre, Saint-François d'Assise Hospital, Quebec City, Quebec, Canada.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Painchaud Guérard
mesh_terms: D000368:Aged; D002170:Canada; D017028:Caregivers; D003657:Decision Making; D016330:Frail Elderly; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D007400:Interprofessional Relations; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D010358:Patient Participation; D012107:Research Design
keywords: Frail elderly; Home care services; Interprofessional collaboration; Knowledge translation; Shared decision making