Using decision aids in community-based primary care: a theory-driven evaluation with ethnically diverse patients

Patient Educ Couns. 2008 Dec;73(3):490-6. doi: 10.1016/j.pec.2008.07.040. Epub 2008 Sep 3.

Abstract

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.

Conclusion: 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.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cultural Diversity*
  • Decision Support Techniques*
  • Educational Measurement
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Los Angeles
  • Male
  • Mass Screening / methods
  • Mass Screening / psychology
  • Middle Aged
  • Neoplasms / diagnosis
  • Pamphlets
  • Patient Education as Topic / methods*
  • Patient Participation* / methods
  • Patient Participation* / psychology
  • Poverty Areas
  • Primary Health Care
  • Psychological Theory*
  • Self Efficacy
  • Surveys and Questionnaires
  • Videotape Recording / standards*