A Consent Support Resource with Benefits and Harms of Vaccination Does Not Increase Hesitancy in Parents—An Acceptability Study

It is unclear whether information given about the benefits and risks of routine childhood vaccination during consent may cue parental vaccine hesitancy. Parents were surveyed before and after reading vaccine consent information at a public expo event in Sydney, Australia. We measured vaccine hesitancy with Parent Attitudes about Childhood Vaccine Short Scale (PACV-SS), informed decision-making with Informed Subscale of the Decisional Conflict Scale (DCS-IS), items from Stage of Decision Making, Positive Attitude Assessment, Vaccine Safety and Side Effect Concern, and Vaccine Communication Framework (VCF) tools. Overall, 416 parents showed no change in vaccine hesitancy (mean PACV-SS score pre = 1.97, post = 1.94; diff = −0.02 95% CI −0.10 to 0.15) but were more informed (mean DCS-IS score pre = 29.05, post = 7.41; diff = −21.63 95% CI −24.17 to −18.56), were more positive towards vaccination (pre = 43.8% post = 50.4%; diff = 6.5% 95% CI 3.0% to 10.0%), less concerned about vaccine safety (pre = 28.5%, post = 23.0%, diff = −5.6% 95% CI −2.3% to −8.8%) and side effects (pre = 37.0%, post = 29.0%, diff = −8.0% 95% CI −4.0% to −12.0%) with no change in stage of decision-making or intention to vaccinate. Providing information about the benefits and risks of routine childhood vaccination increases parents’ informed decision-making without increasing vaccine hesitancy.

Download Full-text

Knowledge and Informed Decision-Making about Population-Based Colorectal Cancer Screening Participation in Groups with Low and Adequate Health Literacy

Gastroenterology Research and Practice ◽

10.1155/2016/7292369 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 10

Author(s):

M. L. Essink-Bot ◽

E. Dekker ◽

D. R. M. Timmermans ◽

E. Uiters ◽

M. P. Fransen

Keyword(s):

Colorectal Cancer ◽

Decision Making ◽

Health Literacy ◽

Decisional Conflict ◽

Informed Decision ◽

Informed Decision Making ◽

Crc Screening ◽

Adequate Health Literacy ◽

Screening Participation ◽

Intention To Participate

Objective. To analyze and compare decision-relevant knowledge, decisional conflict, and informed decision-making about colorectal cancer (CRC) screening participation between potential screening participants with low and adequate health literacy (HL), defined as the skills to access, understand, and apply information to make informed decisions about health.Methods. Survey including 71 individuals with low HL and 70 with adequate HL, all eligible for the Dutch organized CRC screening program. Knowledge, attitude, intention to participate, and decisional conflict were assessed after reading the standard information materials. HL was assessed using the Short Assessment of Health Literacy in Dutch. Informed decision-making was analyzed by the multidimensional measure of informed choice.Results. 64% of the study population had adequate knowledge of CRC and CRC screening (low HL 43/71 (61%), adequate HL 47/70 (67%),p>0.05). 57% were informed decision-makers (low HL 34/71 (55%), adequate HL 39/70 (58%),p>0.05). Intention to participate was 89% (low HL 63/71 (89%), adequate HL 63/70 (90%)). Respondents with low HL experienced significantly more decisional conflict (25.8 versus 16.1;p=0.00).Conclusion. Informed decision-making about CRC screening participation was suboptimal among both individuals with low HL and individuals with adequate HL. Further research is required to develop and implement effective strategies to convey decision-relevant knowledge about CRC screening to all screening invitees.

Download Full-text

Mobile Audio Recording Technology to Promote Informed Decision Making in Advanced Prostate Cancer

JCO Oncology Practice ◽

10.1200/op.21.00480 ◽

2021 ◽

Author(s):

Daniel H. Kwon ◽

Sneha Karthikeyan ◽

Alison Chang ◽

Hala T. Borno ◽

Vadim S. Koshkin ◽

...

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Treatment Decision ◽

Decisional Conflict ◽

Informed Decision ◽

Informed Decision Making ◽

Castration Resistant Prostate Cancer ◽

Software Application ◽

Castration Resistant ◽

Patient Reported

PURPOSE Men with metastatic castration-resistant prostate cancer increasingly encounter complex treatment decisions. Consultation audio recordings and summaries promote patient informed decision making but are underutilized. Mobile recording software applications may increase access. Little is known regarding the feasibility of implementation in clinical encounters. METHODS We conducted a mixed-methods pilot study in men with progressive metastatic castration-resistant prostate cancer. We instructed patients to use a mobile software application to record an oncology visit. Patients could share the recording with our patient scribing program to receive a written summary. We assessed feasibility and acceptability with postvisit surveys. We measured patient-reported helpfulness of the intervention in decision making and change in Decisional Conflict Scale–informed subscale. We conducted semistructured interviews to explore implementation and analyzed transcripts using thematic analysis. RESULTS Across 20 patients, 18 (90%) recorded their visits. Thirteen of 18 (72%) listened to the recording, and 14 of 18 (78%) received a summary. Eighteen of 20 (90%) visits were telehealth. Fourteen patients (70% of all 20; 78% of 18 question respondents) found the application easy to use. Nine patients (50% of 18 recording patients; 90% of 10 question respondents) reported that the recording helped treatment decision making. Decisional conflict decreased from baseline to 1-week postvisit (47.4-28.5, P < .001). Interviews revealed benefits, facilitators, contextual factors, and technology and patient-related barriers to recordings and summaries. CONCLUSION In this single-institution academic setting, a mobile application for patients to record consultations was a feasible, acceptable, and potentially valued intervention that improved decision making in the telehealth setting. Studies in larger, diverse populations are needed.

Download Full-text

Evaluating a web-based MMR decision aid to support informed decision-making by UK parents: A before-and-after feasibility study

Health Education Journal ◽

10.1177/0017896910363146 ◽

2010 ◽

Vol 69 (1) ◽

pp. 74-83 ◽

Cited By ~ 21

Author(s):

Cath Jackson ◽

Francine M Cheater ◽

Rose Peacock ◽

Julie Leask ◽

Lyndal Trevena

Keyword(s):

Decision Making ◽

Feasibility Study ◽

Decision Aid ◽

Informed Decision ◽

Informed Decision Making ◽

Web Based ◽

Before And After

Download Full-text

The Role of Health Literacy in Explaining the Relation between Educational Level and Decision Making about Colorectal Cancer Screening

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16234644 ◽

2019 ◽

Vol 16 (23) ◽

pp. 4644

Author(s):

Anke J. Woudstra ◽

Ellen M. A. Smets ◽

Mathilde G. E. Verdam ◽

Mirjam P. Fransen

Keyword(s):

Colorectal Cancer ◽

Decision Making ◽

Health Literacy ◽

Structural Equation ◽

Decisional Conflict ◽

Informed Decision ◽

Informed Decision Making ◽

Descriptive Norm ◽

Injunctive Norm ◽

Crc Screening

Little is known about why educational inequalities exist in informed decision making in colorectal cancer (CRC) screening. Insight into the role and impact of health literacy is essential for intervention development. This study investigates associations between health literacy and informed decision making in CRC screening and explores to what extent health literacy mediates the association between education and informed decision making in CRC screening. In total, 696 individuals eligible for CRC screening (55–75 years of age) were recruited from online panels and filled in an online questionnaire at T0 (n = 696), T1 (n = 407) and T2 (n = 327). A hypothetical mediation model was tested using structural equation modelling. Outcomes included CRC knowledge, CRC screening knowledge, attitude, injunctive norm, descriptive norm, risk perception, self-efficacy, decisional conflict and decisional certainty. Health literacy domains included Comprehension, Application, Numeracy and Communication. Comprehension, Application and Numeracy, were found to mediate the association between education and knowledge about CRC and CRC screening, injunctive norm, descriptive norm, decisional conflict and decisional certainty. In light of these findings, targeting multiple health literacy domains in decision-support interventions is essential for facilitating informed decision making in CRC screening.

Download Full-text

A deliberate choice? Exploring factors related to informed decision-making about childhood vaccination among acceptors, refusers, and partial acceptors

Vaccine ◽

10.1016/j.vaccine.2019.07.060 ◽

2019 ◽

Vol 37 (37) ◽

pp. 5637-5644 ◽

Cited By ~ 3

Author(s):

Kim A.G.J. Romijnders ◽

Stephne L. van Seventer ◽

Manon Scheltema ◽

Liesbeth van Osch ◽

Hein de Vries ◽

...

Keyword(s):

Decision Making ◽

Informed Decision ◽

Childhood Vaccination ◽

Informed Decision Making

Download Full-text

Development of a “Patient Rights” Subscale to Measure Informed Decision-Making Within the Dyadic Decisional Conflict Scale for Obstetric Care

Journal of Nursing Measurement ◽

10.1891/1061-3749.26.3.523 ◽

2018 ◽

Vol 26 (3) ◽

pp. 523-543

Author(s):

Holly B. Goldberg ◽

Allison Shorten ◽

Brett Shorten ◽

Dheeraj Raju

Keyword(s):

Decision Making ◽

Decisional Conflict ◽

Patient Rights ◽

Informed Decision ◽

Unique Contribution ◽

Informed Decision Making ◽

Internal Reliability ◽

Targeted Interventions ◽

Decisional Conflict Scale ◽

Conflict Scale

Background and Purpose: A modified Dyadic Decisional Conflict Scale (D-DCS) and new Patient Rights subscale to measure perceptions of informed decision-making regarding use of epidural analgesia during childbirth are tested. Methods: Thirty-five primiparous women and 52 providers from three hospitals tested the modified instrument. Cronbach’s α coefficient assessed reliability. Mokken scale, principal components, and correlation analyses assessed unidimensionality of subscales. Results: Internal reliability was demonstrated for the D-DCS-Patient (Cronbach’s α = 0.846) and D-DCS-Provider (α = 0.888). Further analyses suggest the Patient Rightssubscale has potential to make a unique contribution to the D-DCS. Conclusions: The modified D-DCS and Patient Rights subscale allow for a more comprehensive study of informed healthcare decision-making that includes legal and ethical elements, which may aid development of targeted interventions to improve decision-making.

Download Full-text

Prostate Cancer Education in African American Barbershops

American Journal of Men s Health ◽

10.1177/1557988316630952 ◽

2016 ◽

Vol 10 (6) ◽

pp. 533-536 ◽

Cited By ~ 1

Author(s):

John S. Luque ◽

Levi Ross ◽

Clement K. Gwede

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

African American ◽

Cancer Screening ◽

African American Men ◽

Prostate Cancer Screening ◽

Decisional Conflict ◽

Informed Decision ◽

Informed Decision Making ◽

Psa Test

There have been very few studies to rigorously evaluate the potential of African American barbers to educate men about prostate cancer in the barbershop setting. This research brief presents baseline data from a cross-sectional survey identifying differences in decisional conflict and stage of decision making by screening status from an efficacy trial to educate African American men about informed decision making for prostate cancer screening. Those men who had already received the prostate-specific antigen (PSA) test were more advanced in their stage of decision making and had less decisional conflict about the PSA test than those men who had never received a PSA test. Educational interventions to increase informed decision making with prostate cancer screening must consider previous PSA test history as a mediating variable affecting decision self-efficacy.

Download Full-text

Differences Between Patient and Provider Perceptions of Informed Decision Making About Epidural Analgesia Use During Childbirth

The Journal of Perinatal Education ◽

10.1891/1058-1243.23.2.104 ◽

2014 ◽

Vol 23 (2) ◽

pp. 104-112 ◽

Cited By ~ 4

Author(s):

Holly Bianca Goldberg ◽

Allison Shorten

Keyword(s):

Decision Making ◽

Epidural Analgesia ◽

Decisional Conflict ◽

Informed Decision ◽

Decision Making Process ◽

Informed Decision Making ◽

Provider Perceptions ◽

Legal Principles ◽

First Time ◽

Mutual Agreement

The objective of this study was to determine whether differences exist between patient and provider perceptions regarding the decision-making process around use of epidural analgesia during childbirth. The dyadic patient–provider Decisional Conflict Scale was modified to measure first-time mother (n = 35) and maternity care provider (n = 52) perceptions. Providers perceived a greater degree of informed decision making than patients (84.97 vs. 79.41, p = .04) and were more likely to recall they upheld patients’ rights to make informed choices than patients were to perceive their rights had been upheld (85.95 vs. 71.73, p < .01). This incongruity highlights the need to align legal principles with practice to create mutual agreement between stakeholder perceptions of informed decision making.

Download Full-text