Supporting shared decision-making about cardiopulmonary resuscitation using a video-based decision-support intervention in a hospital setting: a multisite before–after pilot study

Background Parents and caregivers are generally recognized by literature and the law as key to child and adolescent mental health decisions. Digital interventions are increasingly being used to support care and treatment in child and adolescent mental health services (CAMHS). However, evidence of the design and development process is generally not made available. Objective In light of calls for more transparency, this paper aims to describe the development of an evidence-based, theoretically informed digital decision support intervention for parents and caregivers of young people accessing CAMHS. Methods The intervention was developed in line with the UK Medical Research Council framework for developing complex interventions. The process incorporated the steps for developing patient decision aids, as follows: assessing need, assessing feasibility; defining objectives; identifying the framework of decision support; and selecting the methods, designs, and dissemination approach. We synthesized theory, research, international guidelines, and input from relevant stakeholders using an iterative design approach. Results The development steps resulted in Power Up for Parents, a decision support intervention, with five key features (ie, decisions, goals, journey, support, and resources). The intervention aims to encourage discussion, allow parents to ask questions during sessions or seek further information between sessions, and allow service providers to tailor the shared decision-making process to accommodate the needs of the parent and child. Conclusions We confirmed that it is possible to use input from end users—integrated with theory and evidence—to create digital interventions to be used in CAMHS. Key lessons with implications for practice, policy, and implementation science, along with preliminary findings, are presented. International Registered Report Identifier (IRRID) RR2-10.2196/14571

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A Caregiver Digital Intervention to Support Shared Decision Making in Child and Adolescent Mental Health Services: Development Process and Stakeholder Involvement Analysis (Preprint)

10.2196/preprints.24896 ◽

2020 ◽

Author(s):

Shaun Liverpool ◽

Julian Edbrooke-Childs

Keyword(s):

Mental Health ◽

Decision Making ◽

Decision Support ◽

Development Process ◽

Adolescent Mental Health ◽

Child And Adolescent ◽

Shared Decision ◽

Support Intervention ◽

Decision Support Intervention ◽

Digital Interventions

BACKGROUND Parents and caregivers are generally recognized by literature and the law as key to child and adolescent mental health decisions. Digital interventions are increasingly being used to support care and treatment in child and adolescent mental health services (CAMHS). However, evidence of the design and development process is generally not made available. OBJECTIVE In light of calls for more transparency, this paper aims to describe the development of an evidence-based, theoretically informed digital decision support intervention for parents and caregivers of young people accessing CAMHS. METHODS The intervention was developed in line with the UK Medical Research Council framework for developing complex interventions. The process incorporated the steps for developing patient decision aids, as follows: assessing need, assessing feasibility; defining objectives; identifying the framework of decision support; and selecting the methods, designs, and dissemination approach. We synthesized theory, research, international guidelines, and input from relevant stakeholders using an iterative design approach. RESULTS The development steps resulted in Power Up for Parents, a decision support intervention, with five key features (ie, decisions, goals, journey, support, and resources). The intervention aims to encourage discussion, allow parents to ask questions during sessions or seek further information between sessions, and allow service providers to tailor the shared decision-making process to accommodate the needs of the parent and child. CONCLUSIONS We confirmed that it is possible to use input from end users—integrated with theory and evidence—to create digital interventions to be used in CAMHS. Key lessons with implications for practice, policy, and implementation science, along with preliminary findings, are presented. INTERNATIONAL REGISTERED REPORT RR2-10.2196/14571

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Current Status and Future Prospects for Shared Decision Making before and after Total Knee Replacement Surgery—A Scoping Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020668 ◽

2021 ◽

Vol 18 (2) ◽

pp. 668

Author(s):

Geert van der Sluis ◽

Jelmer Jager ◽

Ilona Punt ◽

Alexandra Goldbohm ◽

Marjan J. Meinders ◽

...

Keyword(s):

Decision Making ◽

Decision Support ◽

Total Knee Replacement ◽

Shared Decision Making ◽

Knee Replacement ◽

Study Design ◽

Scoping Review ◽

Decision Aids ◽

Shared Decision ◽

Total Knee

Background. To gain insight into the current state-of-the-art of shared decision making (SDM) during decisions related to pre and postoperative care process regarding primary total knee replacement (TKR). Methods. A scoping review was performed to synthesize existing scientific research regarding (1) decisional needs and preferences of patients preparing for, undergoing and recovering from TKR surgery, (2) the relation between TKR decision-support interventions and SDM elements (i.e., team talk, option talk, and decision talk), (3) the extent to which TKR decision-support interventions address patients’ decisional needs and preferences. Results. 2526 articles were identified, of which 17 articles met the inclusion criteria. Of the 17 articles, ten had a qualitative study design and seven had a quantitative study design. All included articles focused on the decision whether to undergo TKR surgery or not. Ten articles (all qualitative) examined patients’ decisional needs and preferences. From these, we identified four domains that affected the patients’ decision to undergo TKR: (1) personal factors, (2) external factors, (3) information sources and (4) preferences towards outcome prediction. Seven studies (5) randomized controlled trials and 2 cohort studies) used quantitative analyses to probe the effect of decision aids on SDM and/or clinical outcomes. In general, existing decision aids did not appear to be tailored to patient needs and preferences, nor were the principles of SDM well-articulated in the design of decision aids. Conclusions. SDM in TKR care is understudied; existing research appears to be narrow in scope with limited relevance to established SDM principles and the decisional needs of patients undertaking TKR surgery.

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A multicenter trial of a shared DECision Support Intervention for Patients offered implantable Cardioverter-DEfibrillators: DECIDE-ICD rationale, design, Medicare changes, and pilot data

American Heart Journal ◽

10.1016/j.ahj.2020.04.010 ◽

2020 ◽

Vol 226 ◽

pp. 161-173

Author(s):

Bryan C. Wallace ◽

Larry A. Allen ◽

Christopher E. Knoepke ◽

Russell E. Glasgow ◽

Carmen L. Lewis ◽

...

Keyword(s):

Decision Support ◽

Multicenter Trial ◽

Implantable Cardioverter Defibrillators ◽

Shared Decision ◽

Support Intervention ◽

Pilot Data ◽

Decision Support Intervention ◽

Cardioverter Defibrillators

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Creation of a Community-Driven Decision Support Tool for Caregivers of Children With Developmental Concerns

American Journal of Speech-Language Pathology ◽

10.1044/2021_ajslp-21-00072 ◽

2021 ◽

pp. 1-11

Author(s):

Dawn M. Magnusson ◽

Irena Shwayder ◽

Natalie J. Murphy ◽

Lindsay Ollerenshaw ◽

Michele Ebendick ◽

...

Keyword(s):

Decision Making ◽

Decision Support ◽

Shared Decision Making ◽

Service Use ◽

Decision Support Tool ◽

Cultural Humility ◽

Shared Decision ◽

Plain Language ◽

Support Tool ◽

Key Aspects

Purpose Despite increasing standardization of developmental screening and referral processes, significant early intervention service disparities exist. The aims of this article are to: (a) describe methods used to develop a decision support tool for caregivers of children with developmental concerns, (b) summarize key aspects of the tool, and (c) share preliminary results regarding the tool's acceptability and usability among key stakeholders. Method Content and design of the decision support tool was guided by a systematic process outlined by the International Patient Decision Aid Standards (IPDAS) Collaborative. Three focus group interviews were conducted with caregivers ( n = 7), early childhood professionals ( n = 28), and a mix of caregivers and professionals ( N = 20) to assess caregiver decisional needs. In accordance with the IPDAS, a prototype of the decision support tool was iteratively cocreated by a subset of caregivers ( n = 7) and early child health professionals ( n = 5). Results The decision support tool leverages images and plain language text to guide caregivers and professionals along key steps of the early identification to service use pathway. Participants identified four themes central to shared decision making: trust, cultural humility and respect, strength-based conversations, and information-sharing. End-users found the tool to be acceptable and useful. Conclusions The decision support tool described offers an individualized approach for exploring beliefs about child development and developmental delay, considering service options within the context of the family's values, priorities, and preferences, and outlining next steps. Additional research regarding the tool's effectiveness in optimizing shared decision-making and reducing service use disparities is warranted.

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