Can patients be trained to expect shared decision making in clinical consultations? Feasibility study of a public library program to raise patient awareness

Abstract

IntroductionShared decision making (SDM) is a process whereby decisions are made together by patients and/or families and clinicians. Nevertheless, few patients are aware of its proven benefits. This study investigated the feasibility, acceptability and impact of an intervention to raise public awareness of SDM in public libraries.Materials and methodsA 1.5 hour interactive workshop to be presented in public libraries was co-designed with Quebec City public library network officials, a science communication specialist and physicians. A clinical topic of maximum reach was chosen: antibiotic overuse in treatment of acute respiratory tract infections. The workshop content was designed and a format, whereby a physician presents the information and the science communication specialist invites questions and participation, was devised. The event was advertised to the general public. An evaluation form was used to collect data on participants’ sociodemographics, feasibility and acceptability components and assess a potential impact of the intervention. Facilitators held a post-workshop focus group to qualitatively assess feasibility, acceptability and impact.ResultsAll 10 planned workshops were held. Out of 106 eligible public participants, 89 were included in the analysis. Most participants were women (77.6%), retired (46.1%) and over 45 (59.5%). Over 90% of participants considered the workshop content to be relevant, accessible, and clear. They reported substantial average knowledge gain about antibiotics (2.4, 95% Confidence Interval (CI): 2.0–2.8; P < .001) and about SDM (4.0, 95% CI: 3.4–4.5; P < .001). Self-reported knowledge gain about SDM was significantly higher than about antibiotics (4.0 versus 2.4; P < .001). Knowledge gain did not vary by sociodemographic characteristics. The focus group confirmed feasibility and suggested improvements.ConclusionsA public library intervention is feasible and effective way to increase public awareness of SDM and could be a new approach to implementing SDM by preparing potential patients to ask for it in the consulting room.

Autonomy, power dynamics and antibiotic use in primary healthcare: A qualitative study

“…Allowing service users to become subjective and reliable experts of their bodies, as well as active agents of their health, could ease the powerlessness and uncertainty that some service users experience towards improving their health. These findings are consistent with previous research on the need to improve health professionals-service users' communication [26][27][28][29]79], to foster two-way communication in clinical consultations [74], and to promote shareddecision making [20,30,31,[80][81][82][83] to improve health outcomes and reduce antibiotic prescribing [30,83]. Based on the concept of translation in sociology [84], Efforts to improve communication within healthcare should also consider the variance in the languages used by different agents in healthcare (e.g., service users and doctors) [79].…”

Shared Decision-Making for a Dialysis Modality

“…75 It has been suggested that raising awareness of SDM through public campaigns may help prepare individuals seeking healthcare to ask for SDM during consultations and subsequently increase uptake. 76 HCPs should actively encourage pre-dialysis individuals with kidney failure to participate in SDM to ensure that treatment decisions are not made without the participation of the individual and/or their family/caregiver.…”

Citizen workshops in public libraries to disseminate and discuss primary care research results: a scaling-up study

“…Second, adopting an IKT approach improved our scaling up results in the following ways: (a) the involvement of library network stakeholders in identifying participating libraries could explain the high coverage of our scaling-up project; (b) prioritizing the public's perspective to identify the results to be disseminated, adopting a co-constructive approach to designing the workshops, and holding preparatory meetings to allow the workshop moderators to make the content of the message their own are all reasons that could explain our positive results in terms of acceptability and appropriateness among the public; These positive ndings are also consistent with those of our (non-IKT) pilot project. But interestingly, they also turned out to be of equal magnitude (19) despite the differences between the pilot project and the scaling up project. This last observation held also true for the increase in knowledge.…”

“…These pilot workshops, designed to raise awareness of new knowledge in primary care research, took place across nine public libraries in Quebec City. We demonstrated evidence of their effectiveness through measuring the acquisition of knowledge among participants (19). We hypothesized that rst among the reasons for our pilot's positive results was the library setting.…”

“…The main outcome of the intervention was knowledge gain as perceived by participants about the health problem addressed. To assess this, we adapted the self-administered questionnaire used in our pilot study (19). This questionnaire was given to participants at the beginning of the workshop and they were invited to complete it at the end (See Additional le 2).…”