Shared decision making (SDM) between patients and providers has been associated with improved diabetes control, lowered blood pressure, and other positive health outcomes. However, most SDM studies have been conducted in majority populations in well-resourced clinical settings, and thus a major void exists about what SDM content and processes are most likely to improve outcomes for minority populations in under-resourced settings. Thus, this proposal's specific aims are: 1. To systematically review key issues in shared decision making around paradigmatic conditions or situations for racial and ethnic minority populations, children, older persons, surrogate decision makers, men who have sex with men, and transgender individuals. a. To explore what is known about these groups regarding the SDM domains of information sharing, deliberation, and decision making. b. To identify what tools have improved SDM in minority populations. c. To explore what is known about contextual factors affecting SDM in these populations 2. To obtain the input and feedback from diverse stakeholders (including organizations, community groups, health care delivery systems, clinicians, and patients) representing minority populations and under- resourced settings around desired shared decision making interventions. a. To determine desired content, presentation of information, and process for SDM. b. To tailor to traditional media, social media, and health information technology (HIT). c. To determine priorities for development and implementation of SDM products. d. To determine contextual factors affecting SDM such as design of clinic, incentives, and implementation issues 3. To develop tools to help stakeholders implement and evaluate SDM interventions in minority populations in under-resourced settings. The study team will systematically review the literature and perform interviews, focus groups, key stakeholder meetings, and community forums across diverse stakeholder groups to accomplish these goals. The project's tools will help create a culture conducive to effective SDM in minority populations, facilitate development and revision of existing SDM tools for minority populations, and provide templates to evaluate SDM interventions in under-resourced settings.
This project aims to determine what shared decision making content and processes are most likely to improve outcomes for minority populations in under-resourced settings. The study team will systematically review key issues in shared decision making for minority populations, obtain the input and feedback from diverse stakeholders around desired shared decision making interventions, and develop tools to help stakeholders implement and evaluate shared decision making interventions in minority populations in under-resourced settings. The study team will systematically review the literature and perform interviews, focus groups, key stakeholder meetings, and community forums across diverse stakeholder groups to accomplish these goals.
