Laura Boland1, Margaret L Lawson2, Ian D Graham3, France Légaré4, Kristin Dorrance5, Allyson Shephard6, Dawn Stacey7. 1. Population Health, Faculty of Health Sciences; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. 2. CHEO and CHEO Research Institute. 3. School of Epidemiology and Public Health; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. 4. Hôpital Sainte-François d'Assise, CHU de Québec Research Centre, Université Laval, Quebec City, Quebec, Canada. 5. Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. 6. School of Epidemiology and Public Health. 7. School of Nursing, University of Ottawa; Hôpital Sainte-François d'Assise, CHU de Québec Research Centre, Université Laval, Quebec City, Quebec, Canada. Electronic address: dstacey@uottawa.ca.
Abstract
OBJECTIVE: To assess barriers to and facilitators of shared decision making (SDM) for pediatric healthcare providers (HCPs) after they have been trained in SDM. METHODS: A mixed methods study using triangulation of data sources. Pediatric HCPs with SDM training who worked at a Canadian tertiary care pediatric hospital were eligible. Participants completed a validated SDM barriers survey (n = 60) and a semi-structured interview (n = 11). We calculated descriptive statistics. Univariate and multivariable ordinary least squares linear regression models determined predictors of HCPs' intention to use SDM. Interviews were audiotaped and transcribed verbatim. We analyzed qualitative data using deductive and inductive content analyses and organized categories according to the Ottawa Model of Research Use. RESULTS: Intention to use SDM was high (mean score = 5.6/7, SD = 0.78) and positively correlated with SDM use (RR = 1.46, 95% CI 1.18-1.81). However, 52% of survey respondents reported not using SDM after training. HCPs identified factors influencing SDM at the levels of innovation, adopter, environment, and training. Insufficient time (barrier) and buy-in and agreement with SDM (facilitators) were most commonly cited. To improve SDM use, HCPs want a more team-based approach to SDM training, continuing education, and implementation. CONCLUSIONS: Despite training and positive intentions, many HCPs report not subsequently using SDM and identified numerous post-training barriers to its use. To overcome SDM barriers and improve uptake, HCPs recommend creating a socially supportive environment through a team-based approach to SDM training and implementation. These findings can inform SDM training and implementation interventions at pediatric health care centers.
OBJECTIVE: To assess barriers to and facilitators of shared decision making (SDM) for pediatric healthcare providers (HCPs) after they have been trained in SDM. METHODS: A mixed methods study using triangulation of data sources. Pediatric HCPs with SDM training who worked at a Canadian tertiary care pediatric hospital were eligible. Participants completed a validated SDM barriers survey (n = 60) and a semi-structured interview (n = 11). We calculated descriptive statistics. Univariate and multivariable ordinary least squares linear regression models determined predictors of HCPs' intention to use SDM. Interviews were audiotaped and transcribed verbatim. We analyzed qualitative data using deductive and inductive content analyses and organized categories according to the Ottawa Model of Research Use. RESULTS: Intention to use SDM was high (mean score = 5.6/7, SD = 0.78) and positively correlated with SDM use (RR = 1.46, 95% CI 1.18-1.81). However, 52% of survey respondents reported not using SDM after training. HCPs identified factors influencing SDM at the levels of innovation, adopter, environment, and training. Insufficient time (barrier) and buy-in and agreement with SDM (facilitators) were most commonly cited. To improve SDM use, HCPs want a more team-based approach to SDM training, continuing education, and implementation. CONCLUSIONS: Despite training and positive intentions, many HCPs report not subsequently using SDM and identified numerous post-training barriers to its use. To overcome SDM barriers and improve uptake, HCPs recommend creating a socially supportive environment through a team-based approach to SDM training and implementation. These findings can inform SDM training and implementation interventions at pediatric health care centers.
Authors: Kristina I Suorsa-Johnson; Melissa D Gardner; Alison Baskin; Larry D Gruppen; Angela Rose; Meilan M Rutter; Tara Schafer-Kalkhoff; Dawn Stacey; Kathleen D van Leeuwen; Erica M Weidler; David E Sandberg Journal: J Pediatr Urol Date: 2021-10-30 Impact factor: 1.830
Authors: Lysa Bergeron; Simon Décary; Codjo Djignefa Djade; Sam J Daniel; Martin Tremblay; Louis-Paul Rivest; France Légaré Journal: JMIR Med Educ Date: 2022-06-02
Authors: Laura Boland; Ian D Graham; France Légaré; Krystina Lewis; Janet Jull; Allyson Shephard; Margaret L Lawson; Alexandra Davis; Audrey Yameogo; Dawn Stacey Journal: Implement Sci Date: 2019-01-18 Impact factor: 7.327
Authors: Maria Helene Jacobsen; Cecilie Sommer; Siw Anna Wernberg; Helga Schultz; Sofie Charlotte Fage Hjortø; Maria Kristiansen Journal: BMC Health Serv Res Date: 2022-02-23 Impact factor: 2.655
Authors: Gloria Ayivi-Vinz; Felly Bakwa Kanyinga; Lysa Bergeron; Simon Décary; Évèhouénou Lionel Adisso; Hervé Tchala Vignon Zomahoun; Sam J Daniel; Martin Tremblay; Karine V Plourde; Sabrina Guay-Bélanger; France Légaré Journal: JMIR Med Educ Date: 2022-05-02
Authors: Tarsha Jones; Thomas Silverman; Ashlee Guzman; Julia E McGuinness; Meghna S Trivedi; Rita Kukafka; Katherine D Crew Journal: BMC Med Inform Decis Mak Date: 2022-08-04 Impact factor: 3.298