Research

Welcome to the Informed Medical Decisions Foundation library of research studies related to the topic areas we care about most. In our collection you will find the following resources:

  • Shared Decision-Making® Program Research: This resource includes studies that evaluate and test our suite of decision aids developed in conjunction with Health Dialog.
  • Foundation Perspectives: This resource includes succinct white papers, written by our senior scientific advisor, Floyd J. Fowler, PhD, that look at common questions about the shared decision making process and provide our best answers based on the current available research.
  • Funded Research: This resources includes summaries of past Foundation-funded research projects that evaluate various aspects of medical decision making. In our report, Foundation-funded Research Highlights (PDF 811 kb), we provide an overview of the major contributions to shared decision making research.

Our Library

Below you will find samples of our most recent acquisitions, grouped by resource type.

Enhancing Comprehension of Graphically Presented Medical Data: Designs to Help People with Low Graph Literacy

In order to make informed medical decisions, patients need to understand information about risks, benefits and drawbacks of different treatments. However, research on health literacy and medical decision making has shown that patients in different cultures have severe problems grasping a host of numerical concepts that are prerequisites for understanding health-relevant statistical information. Graphical displays -- including line plots, bar charts or icon arrays -- often facilitate the communication of numerical information, and can help overcome some of these difficulties.…  Continue reading
Posted in George Bennett Grants, Literacy and Numeracy, Risk Communication | Tagged data displays, graphic comprehension, graphical displays, health care, health literacy, informed decision making, low graph literacy, medical decisions, patients, shared decision making Permalink

Effects of Decision Ambiguity on Shared Medical Decision Making

To evaluate the impact of ambiguity on shared medical decision making using scenarios on future medicine and unconventional medicine. To develop and test a decision aid tool to help patients and physicians understand ambiguity and to encourage a shared medical decision making process that is applicable to ambiguous decisions that involve future medicine and unconventional medicine. …  Continue reading
Posted in George Bennett Grants, Investigator-Initiated Research, Patient Involvement, SDM Implementation | Tagged decision aids, shared decision making Permalink

Barriers and Facilitators to Implementing Decision Boxes in Primary Healthcare Interdisciplinary Teams to Facilitate Shared Decision Making

Our primary aim is to explore the barriers and facilitators influencing primary healthcare interdisciplinary teams' use of decision boxes in clinical practice. …  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Research, Robert Derzon Grants, SDM Implementation | Tagged health care, primary care, shared decision making Permalink

Using Cardio-metabolic Risk Information in Health Decisions: Barriers from the Perspective of Low Literate Consumers

The aim of the proposed study is to investigate how consumers with low levels of health literacy understand, evaluate and use current risk information in the Dutch national cardio-metabolic health check in order to identify barriers for an effective use from the perspective of these consumers. A further goal of the study is to develop an adapted version of the existing risk communication tool, which will be further tested in a continued study.…  Continue reading
Posted in Investigator-Initiated Research, Literacy and Numeracy, Risk Communication, Robert Derzon Grants | Tagged cardio-metabolic, communicating risk, health literacy Permalink

Overdiagnosis in Screening Mammography: Examination of Women's Attitudes and Responses to Information about Overdiagnosis

The overall purpose of this research is to contribute to improving communication with the community about screening mammography. The research involves developing and evaluating educational materials and strategies to meet the important ethical objective of providing balanced information about screening outcomes in order to support screening decisions.…  Continue reading
Posted in Decision Quality, George Bennett Grants, Investigator-Initiated Research, Patient Involvement, Patient Knowledge, Patient Preferences | Tagged mammography, overdiagnosis Permalink

Facilitating Shared Decision Making in Lynch Syndrome: Notification of Relatives of Hereditary

At the foundation of genetic counseling is shared decision making. During the decision to undergo genetic testing, familial implications of results and notification are often not discussed extensively due to time constraints.…  Continue reading
Posted in Investigator-Initiated Research, Patient Involvement, Robert Derzon Grants, SDM Implementation | Tagged Lynch Syndrome, shared decision making Permalink

Decision Making on the Go: A Mobile App Interpretation of a Prostate Cancer Decision Aid

The objectives are to 1) Survey mobile use around health issues in men newly eligible for prostate cancer screening, and 2) to develop a mobile PSA decision aid prototype based on the previously validated internet-based Prosdex decision support intervention (DESI) in preparation for subsequent field testing.…  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Research, Robert Derzon Grants | Tagged decision aids, decision making, DESI, mobile app, prostate cancer, PSA Permalink

Using Video-Enhanced, Internet-Based Vignette Experiments to Study Patient Decisions Regarding Knee Replacement for Osteoarthritis

Our substantive research aim is to examine how patients make difficult decisions about surgical treatment for knee osteoarthritis, a serious chronic condition affecting many middle aged and old people. We will be concerned specifically with the effects of: 1) level of pain; 2) opportunity costs associated with treatment; 3) physician recommendations; 4) supplementary outcome projections; and 5) testimonials of other patients on patient decisions.…  Continue reading
Posted in Decision Aid Components, Investigator-Initiated Grants, Investigator-Initiated Research | Tagged knee osteoarthritis, knee replacement Permalink

Using Decision Analytic Modeling to Guide the ACCP Guideline Development Process for Antithrombotic Therapy in Atrial Fibrillation

We propose integrating the development of decision analytic (DA) models into the process organized by the ACCP for guideline development and dissemination of antithrombotic therapy in patients with atrial fibrillation (AF).…  Continue reading
Posted in Health Care Policy, Investigator-Initiated Grants, Investigator-Initiated Research, SDM Implementation | Tagged antithrombotic therapy, atrial fibrillation, decision making Permalink

How do Patients Decide about Angioplasty for Chronic Stable Angina? A Content Analysis of Patient-Physician Discussions

The objective of this study is to evaluate the content and character of PCI discussions between cardiologists and patients to determine how often recommended elements of informed decision making are included, to understand why many patients perceive a mortality benefit and to evaluate the effect of informed decision making on patients’ decisions. …  Continue reading
Posted in Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement | Tagged angioplasty, chronic stable angina Permalink

Cutting Through the Misguided Conventional Wisdom about Healthcare: How Can We Help the Public Believe Medical Evidence

This study will investigate public perceptions of breast, prostate and colorectal cancer screening by contrasting popular media messages with evidence based information.…  Continue reading
Posted in Health Care Policy, Investigator-Initiated Grants, Investigator-Initiated Research | Tagged cancer screening, decision making, health care, medical evidence Permalink

The Impact of Decision Aids about Prostate Cancer Screening for Men Accessing Healthcare in a Community Setting: DVD vs. Web

The overarching goal of this study is to compare the impact on knowledge and acceptability of a prostate screening decision aid delivered via either DVD or Web format. We have considerable experience and expertise in developing and comparing format-related differences in impact and uptake of patient education programs, with a particular interest in incorporating literacy levels into our research.…  Continue reading
Posted in Decision Aid Components, Directed Research | Tagged decision aids, prostate cancer screening, web-based Permalink

Evaluation of DVD and Internet Decision Aids for Hip and Knee Osteoarthritis: Focus on Health Literacy

This study will advance the evidence base regarding best methods for facilitating informed decisions among patients with knee and hip osteoarthritis (OA) by comparing DVD and Crossroads online formats of decision aids (DAs) for these conditions. …  Continue reading
Posted in Decision Aid Components, Directed Research | Tagged decision aids, health literacy, hip osteoarthritis, knee osteoarthritis Permalink

A Randomized Mixed-Methods Cross-Over Study to Compare the Performance of Traditional DVD and Web-Based Patient Decision Support

To date, few randomized trials have directly compared the same Decision Support Interventions (DESIs) delivered through different media. While earlier efforts focused principally on booklets and videos, more recently the majority of DESI development efforts have focused on creating interactive electronic tools that can be delivered through the internet. However, very little is known about how web-based DESIs perform in comparison to more traditional video DESIs, such as those developed and distributed by the Informed Medical Decisions Foundation.…  Continue reading
Posted in Decision Aid Components, Directed Research | Tagged decision support, DESis, PAMF, web-based Permalink

Understanding the Experience of Early Stage Breast Cancer Diagnosis and Surgical Treatment among Jordanian Women

To understand the experience of being diagnosed with and undergoing surgical treatment for early stage breast cancer among Jordanian women. Study specific aims are to: 1) gain an understanding of women’s knowledge of breast cancer treatment and how their treatment awareness has been informed; 2) explore women’s awareness of their right to be informed and involved in their own medical care; 3) explore women’s preferences for involvement; and 4) identify the extent to which these women perceived that they had surgical treatment options.…  Continue reading
Posted in Decision Quality, George Bennett Grants, Investigator-Initiated Research, Patient Involvement, Patient Preferences, SDM Implementation, Special Populations | Tagged breast cancer treatment, early stage breast cancer Permalink

A National Survey of Urologists and Radiation Oncologists on Prostate Cancer and Shared Decision-Making

Here, we propose to fill this important knowledge gap regarding recent trends in both the evidence in prostate cancer and the role of shared decision-making tools in specialty practice that will form the basis for future shared decision-making implementation research. …  Continue reading
Posted in Health Care Policy, Investigator-Initiated Research, Robert Derzon Grants, SDM Implementation | Tagged prostate cancer, radiation oncology, shared decision making, urology Permalink

The Effect of a Decision Aid on the Quality of Colon Cancer Screening

The primary goal of this study is to determine whether the decision aid increases patient knowledge about colon cancer screening. The secondary goal of the study is to assess the degree to which use of the decision aid affects participants’ values and actual choice of particular screening tests.…  Continue reading
Posted in Decision Aid Effectiveness, George Bennett Grants, Investigator-Initiated Research | Tagged colon cancer screening, decision aids, values concordance Permalink

Intuitive and Deliberative Processing in Patient Decision Aids

The present research will attempt to shed light on this issue by asking participants to read a prostate cancer decision aid and then engage in either a deliberative or intuitive decision making strategy prior to making a treatment decision. Decision quality will be measured using value-decision correspondence, feelings about the decision (e.g., confidence) and cancer-related anxiety.…  Continue reading
Posted in Decision Aid Effectiveness, Decision Quality, Investigator-Initiated Research, Patient Knowledge, Patient Preferences, Robert Derzon Grants | Tagged decision aids, prostate cancer Permalink

Video Images of Disease for Ethical Outcomes: The VIDEO STUDY

In previous work, the Principal Investigator successfully demonstrated that a video of the goals of care in advanced cancer improved understanding and decision making in a small group of patients with advanced brain cancer. The video presents end-of-life options within the framework of the patient’s primary goals of care (i.e., life prolongation, maintenance of function, or comfort care). Building on this earlier work, the main goal of this study is to conduct a randomized controlled trial of the video decision support tool (vs. a verbal narrative) to test the hypothesis that the video improves the decision-making process among persons with advanced cancer. …  Continue reading
Posted in Decision Aid Components, Investigator-Initiated Grants, Investigator-Initiated Research, Special Populations | Tagged decision making, decision support, end of life, medical ethics, The VIDEO STUDY Permalink

Prostate Education Project ("PEP Talk"): Cutting through the Uncertainty of Prostate Cancer for Black Men Using Barbershop Outreach

The goal of this research is to provide pilot data aimed at a rigorous randomized clinical trial in assessing the effectiveness of barbershop-based health promotion in order to improve the quality of decisions made by AA men about PrCA screening. …  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement, SDM Implementation, Special Populations | Tagged PEP Talk, prostate cancer Permalink

Development and Feasibility Testing of a "Consumer Questions" Program to Increase Health Literacy and Empower Consumers to Participate in Decisions about their Health

To explore feasibility and implementation issues of a program to train consumers to use the consumer questions.…  Continue reading
Posted in Investigator-Initiated Grants, Investigator-Initiated Research, Literacy and Numeracy, Patient Involvement, SDM Implementation | Tagged decision making, health care, health literacy Permalink

[FUSION] Investigating the Doctor-Patient-Family Triad to Gain An Understanding of Shared Decision Making

To improve understanding of this critical, yet neglected area of DM, the current project will elucidate the doctor-patient-family triadic relationship through an exploration of cancer consultations. It will expand the conceptual framework of the meaning and characteristics of shared decision making (SDM) to incorporate the doctor-patient-family triad. The newly developed conceptual framework will provide a basis for future theoretical and empirical research into triadic DM across a variety of medical and professional encounters. Thus, through its novel conceptual contribution, this project has the potential to transform the field of SDM.…  Continue reading
Posted in Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement | Tagged doctor-patient-family triad, shared decision making Permalink

Using Multimedia Approaches to Communicate Probabilities in Patient Decision Aids for Low-Literacy Populations

The broad, long-term goal of this project is to determine the value of enhanced multimedia approaches to communicating probabilities in patient decision support tools when applied to patients with low health literacy/numeracy.…  Continue reading
Posted in Decision Aid Components, Directed Research, Literacy and Numeracy, Risk Communication | Tagged communicating risk, decision aids, health literacy Permalink

Personalized Cardiovascular Risk Information to Initiate and Maintain Health Behavior Changes

We propose an evaluation that will assess three important components of risk communication: 1) provide patients with personalized risk communication using the risk calculator developed by the Informed Medical Decisions Foundation and health information taken from the Living with Coronary Artery Disease program; 2) provide personalized tailored patient feedback to help initiate and maintain specific cardiovascular CVD-related behaviors (e.g., medication adherence, exercise, diet, smoking cessation) to reduce risks; and 3) evaluate how this feedback can be incorporated into clinical care by examining 3-month patient outcomes and provider responses to the risk information.…  Continue reading
Posted in Decision Aid Effectiveness, Directed Research, Literacy and Numeracy, Risk Communication | Tagged cardiovascular disease, communicating risk Permalink

Identifying Components of Decision Aid Interventions that Enable Informed Decision Making about Dialysis Modality

This research aims to assess the effectiveness of component parts within patient decision aids (pDAs) on patient’s informed decisions about dialysis modality.…  Continue reading
Posted in Decision Aid Components, Directed Research | Tagged chronic kidney disease, decision aids, shared decision making Permalink

How the Valence and Content of Narratives Influence Information Search

In the proposed research, we will explore how two dimensions of narratives influence impact on health care decisions: content and emotional valence. Across two studies, the proposed research will focus on the mechanisms through which narratives influence decision processes, a dimension which has been largely ignored in the literature.…  Continue reading
Posted in Decision Aid Components, Directed Research | Tagged decision aids, narratives Permalink

Understanding the Information Processing of a Colorectal Cancer Screening Decision Aid Among Latino Patients with Limited English Proficiency

The objectives are: 1) to adapt existing key English-language IP measures for use in assessing how LEP Latino patients perceive and process information presented in a Spanish CRC screening decision aid (DA); and 2) to determine the relationship between key IP domains and the ability to state preferences regarding CRC screening, intentions to discuss with a clinician and screen for CRC.…  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Research, Patient Involvement, Robert Derzon Grants, SDM Implementation, Special Populations | Tagged colorectal cancer screening, decision aids, health literacy, Latinos Permalink

Measuring Gender Bias in Physicians' Decision Making Regarding Total Knee Arthroplasty Surgery

To develop effective interventions to redress physicians’ contributions to the gender disparity in TKA utilization and develop tools to measure the effectiveness of these interventions.…  Continue reading
Posted in Investigator-Initiated Research, Robert Derzon Grants, SDM Implementation, Special Populations | Tagged arthroplasty, decision making, gender bias Permalink

Development and Evaluation of a Dynamic Interactive Interface for Values Exploration and Clarification

The overall long-term goal of this research program is to develop values clarification exercises that improve decision quality. The research funded by this grant aims to establish the feasibility of the development and evaluation of a dynamic interactive tool that explicitly encourages values exploration and clarification. …  Continue reading
Posted in Decision Aid Components, Decision Quality, Investigator-Initiated Research, Patient Knowledge, Patient Preferences, Risk Communication, Robert Derzon Grants | Tagged values concordance Permalink

A Mixed-Method Examination of Older Adults' Decision to Initiate Treatment for Depression

The main goal of the project was to determine how older adults weigh their experience with mental health treatment against provided outcome data about the effectiveness of psychotherapy among older adults.…  Continue reading
Posted in Investigator-Initiated Research, Patient Involvement, Robert Derzon Grants, Special Populations | Tagged depression, mental health, psychotherapy Permalink

The Unintended Consequences of Biomedical Advances: Social Inequalities in Health Behaviors Among Pregnant Women

This study combines an emerging approach in medical sociology that focuses on the importance of new health information and disease preventability with the bedrock of literature that describes the influence of social relationships on medical decision-making. …  Continue reading
Posted in George Bennett Grants, Investigator-Initiated Research, Patient Involvement | Tagged health inequality, pregnancy Permalink

Process Variables in the Communication Model of Shared Decision Making in the Context of Medical Rehabilitation

The preliminary analysis of data showed a reasonable fit of the original framework and supported the hypothesis that certain process variables (e.g., empathy) are important mediating factors between SDM and positive outcomes such as higher patient satisfaction.…  Continue reading
Posted in George Bennett Grants, Investigator-Initiated Research, SDM Implementation | Tagged shared decision making Permalink

Does it Matter Whether Physicians' Recommendations are Given Early or Late in the Decision-Making Process?

The study aims to investigate what influence the time at which a physician's recommendation is given has on the patient's treatment decisions.…  Continue reading
Posted in Investigator-Initiated Research, Patient Involvement, Robert Derzon Grants | Tagged decision making Permalink

The Impact of a Decision Aid for Hormone Therapy for Prostate Cancer Recurrence on Patients' Anxiety, Decisional Conflict and Knowledge: A Randomized Trial

Specific Aims: The overall goal is to improve decision-making regarding the initiation of androgen-deprivation therapy (ADT) for men with biochemical recurrence (BCR) of prostate cancer (PCA). We will do this through lowering patients’ anxiety, decreasing decision conflict, improving patient knowledge and, thereby, influencing the shared decision about the timing of ADT initiation.…  Continue reading
Posted in Decision Aid Effectiveness, Decision Quality, Investigator-Initiated Grants, Investigator-Initiated Research, Patient Preferences | Tagged cancer-specific anxiety, decision aids, hormone therapy, prostate cancer Permalink

The Impact of Visuals and an Interactive, Personalized Risk Calculator on Knowledge, Comprehension and Decision Quality Related to the Carotid Endarterectomy Decision Aid

This proposal aims to leverage the existing investment by the Informed Medical Decisions Foundation in a CEA decision aid (DA) to answer two applied research questions with implications for both the CEA DA and future (new and/or revised or cross-nationally adapted) DAs.…  Continue reading
Posted in Decision Aid Components, Decision Quality, Investigator-Initiated Grants, Investigator-Initiated Research, Patient Knowledge, Patient Preferences | Tagged carotid endarterectomy, decision aids, personalized risk Permalink

The Impact of Patient Activation on Preparation for Shared Decision Making Among Lower Socioeconomic and Minority Populations

This proposal initiates a larger research effort aimed at identifying methods to improve the ability of patients of lower socioeconomic position or minority status to share in decision making about health and health care, and to study the impact of shared decision making (SDM) on patient satisfaction and health outcomes.…  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement, SDM Implementation, Special Populations | Tagged DSE, PAM, PPC, shared decision making, socioeconomic Permalink

The Effect of Testimonials in Patient Decision Aids: The Role of Numeracy, Literacy and Decision Making Style

Researchers want to understand what the effects of including testimonials and statistical information are, and how patient numeracy, literacy and decision making style interact with the type of information presented.…  Continue reading
Posted in Decision Aid Components, Investigator-Initiated Research, Literacy and Numeracy, Patient Involvement, Risk Communication | Tagged decision aids, decision making, health literacy, health numeracy, testimonials Permalink

Increasing Self-Management in Chronic Illness: Using Videos and Coaching to Engage Patients

Specific aim 1: To leverage existing staff resources to increase the Informed Medical Decisions Foundation diabetes video distribution. Specific aim 2: To increase video viewing rates by patients. Specific aim 3: To assess physician & patient behavior subsequent to video viewing.…  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement, SDM Implementation | Tagged decision aids, diabetes, patient engagement Permalink

Impact of a Decision Aid on Patient Participation in Decision Making and Resource Use in Low Risk Chest Pain Patients: A Randomized Trial

Clinicians in the U.S. may miss two of every 100 patients with acute myocardial infarction or unstable angina (i.e., acute coronary syndromes, or ACS) presenting to the emergency department (ED) even after considering the history, physical examination, initial electrocardiogram and cardiac biomarkers (troponin levels). …  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement | Tagged angina, chest pain, decision aids, decision making, patient participation Permalink

Feasibility of a Decision Aid for Patients with Serious Illness: A Pilot Study Among Patients and Physicians

This study examined the effects of a decision aid for patients facing a serious illness entitled, “Looking Ahead: Choices for Medical Care when You’re Seriously Ill (MCSI)©" Health Dialog.…  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Grants, Investigator-Initiated Research | Tagged decision aids, Health Dialog, serious illness Permalink

Enhancing Physician Competencies for Shared Decision Making in Primary Care

The purpose of this study is to develop and validate an online educational program to promote shared decision making (SDM) for primary care physicians in their clinical practices. While the study aims to improve physician SDM skills for any kind of diagnostic or treatment decision, prostate cancer screening is used as the decision making model in the educational program.…  Continue reading
Posted in Investigator-Initiated Grants, Investigator-Initiated Research, SDM Implementation | Tagged DAC software, primary care, shared decision making Permalink

BESI. From Theories to Interventions: The Conceptualisation and Development of Complex Interventions for Supporting Behaviour Change

Specific aim 1: To conduct a literature search to develop a ‘meta’ theory for interventions that would help patients adapt to living with a chronic condition. Specific aim 2: To compare and contrast behavior support interventions (BESIs) produced by a range of providers, analyzing their fit to a proposed meta theory of behavior support intervention design.…  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Grants, Investigator-Initiated Research | Tagged behavior change, shared decision making Permalink

Examining the Relationship Between Decision Support Interventions and Outcome Measurements: Applying the IPDAS Instrument to the Results of the Cochrane Systematic Review of Patient Decision Aids

The International Patient Decision Aid Standards (IPDAS) Collaboration has led to the development of a quality checklist and, more recently, an instrument to assess the quality of decision support interventions. We recognize that further work is required to examine the relationships between International Patient Decision Aid Standards instrument (IPDASi) scores and the outcomes achieved in clinical trials.…  Continue reading
Posted in Decision Aid Effectiveness, Directed Research | Tagged Cochrane Review, decision aids, decision support, IPDAS, IPDASi Permalink

Developing Measures of Decision Quality

The field tests in the last year show that the items on the whole are performing as intended, and patients find the surveys acceptable and feasible. There is growing interest in the research community to use these instruments, and we have been exploring interest in clinical community to extend their use.…  Continue reading
Posted in Decision Quality, Directed Research, Patient Knowledge, Patient Preferences | Tagged breast cancer, colorectal cancer screening, decision quality instruments, depression, herniated disc, hip osteoarthritis, knee osteoarthritis, menopause, MGH Permalink

Appealing to Males At-Risk for Testicular Cancer: Defining 'Control Identity' Typology and Modeling Perceptions of Testicular Self-Examination (TSE)

This study theoretically argued that an individual’s attitude toward cancer screening is a derivative of one’s “Control Identity;” specifically, how one views his control over health outcomes. A series of factor and cluster analyses in fact demonstrated that four distinct groupings of individuals as defined by the tenets of 'control identity' theory does in fact (at least) preliminarily exist. More testing is needed.…  Continue reading
Posted in George Bennett Grants, Investigator-Initiated Research, Patient Involvement | Tagged control identity typology, testicular cancer, Testicular Self-Examination (TSE) Permalink

A Smoking Cessation Decision Aid for People with Serious Mental Illness

Because the Decision Support Website is newly designed, the aims of this grant are to pilot-test each module in order to evaluate usability, ease of use and comprehensibility.…  Continue reading
Posted in Investigator-Initiated Research, Patient Decision Aids, Patient Involvement, Robert Derzon Grants, SDM Implementation, Special Populations | Tagged decision aids, mental illness, smoking cessation Permalink

A Decisional Needs Assessment Related to Implantable Cardioverter-Defibrillators for the Primary Prevention of Sudden Cardiac Death

The goal of this research is to determine the factors important to patients and physicians in making decisions about Implantable Cardioverter-Defibrillators (ICDs) for the primary prevention of sudden cardiac death.…  Continue reading
Posted in Investigator-Initiated Research, Patient Involvement, Robert Derzon Grants | Tagged cardiac, ICDs Permalink

Creation and Implementation of a Decision Aid to Support Patients Making Prenatal Screening Decisions

Due to the complexity of prenatal screening, researchers are creating a decision aid tool (a DVD and booklet) that can be mailed to patients prior to a first prenatal visit, making it accessible, private, and able to be shared with all decision makers. This project aims to provide a decision aid to pregnant women and their families, in order to decrease decisional tension and improve communication between patient and provider. We believe that a DVD format is the most effective communication medium to reach the target audience of all women receiving prenatal care at DHMC.…  Continue reading
Posted in Decision Quality, Investigator-Initiated Research, Patient Decision Aids, Patient Knowledge, Patient Preferences, Robert Derzon Grants, SDM Implementation, Special Populations | Tagged decision support, DHMC, pregnancy, prenatal care, prenatal screening Permalink

Patient Participation in Decision Making in Medication Adherence in Osteoporosis

It is hypothesized that the introduction of decision aids will improve the quality of treatment decisions regarding fracture by leading to bisphosphonate start eliciting patient involvment in the decision making process. It is hypothesized that patients will become more involved in the decision making process and decisions will be more consistent with patients' lifestyles--decision aids (DAs) will lead to bisphosphonate start and adherence in patients at high risk of fracture and to patients stopping medication or not starting in patients at low risk.…  Continue reading
Posted in Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement, SDM Implementation | Tagged bisphosphonate, decision making, osteoporosis, patient engagement, patient participation Permalink

Novel Methods for Risk Communication Among Patients with Low Numeracy Skills--Application in Prostate Cancer Decision Support

This study is fielding a series of 50 structured interviews in our practice based research network of four clinics serving large populations of African American men with low literacy and low numeracy skills.…  Continue reading
Posted in Decision Aid Effectiveness, Decision Quality, Investigator-Initiated Grants, Investigator-Initiated Research, Literacy and Numeracy, Patient Involvement, Patient Knowledge, Patient Preferences, Risk Communication | Tagged decision aids, low numeracy, prostate cancer Permalink

Learning by Doing: Improving Risk Communication through Active Processing of Interactive Pictographs

This project aims to develop and pilot test Flash-based web widgets that enable users to fill in a pictograph (with dynamic visual and textual feedback) to the risk level of their choice in hopes that a pictograph increases comprehension, satisfaction and/or reliance on information. …  Continue reading
Posted in Investigator-Initiated Grants, Investigator-Initiated Research, Risk Communication | Tagged interactive pictographs, risk perception Permalink

Developing and Testing Educational Materials to Improve Decision Making for Patients with Advanced Chronic Kidney Disease

The ultimate mission of the project is to develop audiovisual and computer-based resources to enhance shared decision making regarding choice of kidney replacement therapies, and perform a pilot randomized controlled trial comparing the relative effectiveness of resources in improving patient-provider shared decision making. It is hypothesized that resources will improve shared decision-making compared to usual care.…  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement, Patient Knowledge, Patient Preferences | Tagged chronic kidney disease, decision aids, decision making, health education, shared decision making Permalink

Testing Multimedia and Print Health Materials Across Literacy Levels

We propose two complementary investigations to address the effectiveness of optimally designed multimedia and print materials in different contexts. The first addresses knowledge dissemination for preventive services and disease self-management. The second explores best practices for conveying information about risks and benefits of treatment.…  Continue reading
Posted in Decision Aid Effectiveness, Directed Research, Literacy and Numeracy | Tagged decision aids, health literacy Permalink

Patient Use of Health Outcomes Calculators Based Upon the Results of Complex Longitudinal Clinical Trials to Enhance Decision Making: The Spine Patient

Initial plans for a new calculator were developed. Following, an expert panel reviewed the plans and provided detailed recommendations for the calculator design. Feedback was also solicited from clinicians, potential users in one-on-one sessions and a small focus group. …  Continue reading
Posted in Decision Aid Effectiveness, Directed Research, Patient Involvement, Risk Communication | Tagged outcomes calculator, shared decision making Permalink

What is the Role of Decision Support Software in the Decision Making Process for Men with Early Stage Prostate Cancer? A Mixed-Methods Approach to Understanding Personal Characteristics that Influence Use and the Decision Making Process

Specific CAPtDA components were highly utilized while other components were rarely used. The “Men’s Stories,” which included actual men’s stories about diagnoses, treatment decisions and challenges, was viewed by 77% of the men. Results showed that the percentage of men who viewed “Men’s Stories” spent almost half of their time (46%) here.…  Continue reading
Posted in Decision Aid Effectiveness, George Bennett Grants, Investigator-Initiated Research, Patient Involvement | Tagged decision aids, decision support, early stage prostate cancer, prostate cancer, shared decision making Permalink

Implementing Shared Decision Making in Nutrition Clinical Practice: A Theory-Based Approach and Feasibility Study

The objectives of this study are twofold: 1) to explore the integration of shared decision making within real nutritional consultations; and 2) to design a questionnaire to assess dietitians’ intention and underlying psychosocial determinants to adopt two SDM-specific behaviors using the Theory of Planned Behavior (TPB). …  Continue reading
Posted in Investigator-Initiated Research, Robert Derzon Grants, SDM Implementation | Tagged Decisional Conflict Scale, nutrition, shared decision making Permalink

Development and Evaluation of an Intervention to Engage Inter-Professional Health Care Teams, Patients and Families in Shared Decision Making about the Level of Care in the Intensive Care Unit

The research aims to develop and evaluate an intervention to engage interprofessional health care teams, patients and families in shared decision making about the level of care in the Intensive Care Unit.…  Continue reading
Posted in George Bennett Grants, Investigator-Initiated Research, Patient Involvement, SDM Implementation | Tagged decision aids, end of life, ICU, shared decision making Permalink

Using Testimonials to Improve Decision Outcomes

This study aims to examine three types of testimonials that have the potential to improve decision aid (DA) outcomes and test the mediators through which these testimonials may be effective. The goal of this proposal is to examine whether specific types of testimonials have a beneficial influence on knowledge, satisfaction, interest in shared decision making and intentions. Social cognitive theory, social comparison theory and risk processing perspectives guide hypotheses about testimonials.…  Continue reading
Posted in Decision Aid Components, Investigator-Initiated Research, Robert Derzon Grants | Tagged decision aids, testimonials Permalink

Treatment Decision Making in Localized Prostate Cancer: The Role of Functional Health Literacy and Cancer-Related Distress

The proposed study will examine predictors of informed decision making in men considering treatment for localized prostate cancer. Specifically, we will evaluate the ability of functional health literacy and cancer-related anxiety to predict indices of effective decision making in a population of veterans with prostate cancer. Measure of prostate cancer knowledge, decisional conflict, and eventual treatment choice will be used to assess these three components of effective decisions.…  Continue reading
Posted in Investigator-Initiated Research, Literacy and Numeracy, Patient Involvement, Risk Communication, Robert Derzon Grants | Tagged decision making, health literacy, prostate cancer, prostate cancer treatment Permalink

Decision Making About Colonoscopy Use among Survivors of Colorectal Cancer

This project addresses the risk perceptions, surveillance intentions and surveillance behaviors of CRC survivors. Researchers found that risk perception varies widely but that geographic region is a major predictor and that colonoscopy use may reflect better access to care. The Cancer Care Outcomes Research and Surveillance (CanCORS) study is a national multi-site cohort study of CRC patients. …  Continue reading
Posted in George Bennett Grants, Investigator-Initiated Research, Patient Involvement, Special Populations | Tagged CanCORS, colonoscopy, colorectal cancer, CRC, decision making Permalink

Randomized Trial of a Patient Decision Aid for Bariatric Surgery

The specific aims of this randomized control trial are to formally evaluate the impact of the “Weight loss surgery: Is it right for you?” Shared Decision-Making® program on decision quality in primary care and bariatric specialty practice settings, following the approach recommended in the Cochrane CREDIBLE Criteria for Decision Aids among morbidly obese adults enrolled at Group Health.…  Continue reading
Posted in Decision Aid Effectiveness, Decision Quality, Investigator-Initiated Research, Patient Knowledge, Patient Preferences | Tagged bariatric surgery, decision aids, NIH Permalink

Quality of Decision Making Communication and Outcomes of Care for African Americans with Depression Study

This study will increase understanding of the role of SDM in improving outcomes for patients with depression and in reducing racial disparities in mental health care.…  Continue reading
Posted in Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement, SDM Implementation, Special Populations | Tagged African Americans, decision making, depression, mental health, racial disparities, shared decision making Permalink

Informed Choice Assistance for Patient Decision-Making

To test the feasibility of systematically offering Informed Choice Assistance (ICA) during the diagnostic evaluation process to at least 80% of patients facing decisions about the management of uterine fibroids.…  Continue reading
Posted in Decision Aid Effectiveness, Decision Quality, Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement, Patient Knowledge, Patient Preferences, SDM Implementation | Tagged decision making, informed choice, uterine fibroids Permalink

Helping People with Low Numeracy Understand Medical Information

Studies conducted to examine how people from two countries (USA and Germany) understand numerical and graphical information, which presentation formats help them understand it better and how they use the data to make medical decisions. Aim is to study ways to communicate quantitative medical information to people with low numeracy skills and to propose formats that promote better understanding and proper use of such information. …  Continue reading
Posted in Investigator-Initiated Grants, Investigator-Initiated Research, Literacy and Numeracy, Risk Communication | Tagged health numeracy Permalink

Effects of Combining Decision Aids on Breast Cancer Adjuvant Treatment Expectations

The main goals of this study, using breast cancer patients stages IA to IIIB, are to assess: 1) the degree to which an alternative method of visually presenting and summarizing the numerical data provided by “Adjuvant” influence realistic treatment expectations; 2) the degree to which numeracy affects treatment expectation and through what mechanisms and; 3) whether methods of presenting and summarizing the “Adjuvant” data differentially influence treatment expectations as a function of numeracy.…  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Grants, Investigator-Initiated Research, Risk Communication | Tagged adjuvant treatment, breast cancer, decision aids Permalink

Are Patient Decision Aids for Total Joint Replacement Cost-Effective and Do They Optimize the Surgical Referral Process from Primary Care

The overall goal of this study is to evaluate the effects of patient decision aids (pDAs) on improving decision quality and reducing length of surgical consults for TJA, and their cost-effectiveness. …  Continue reading
Posted in Cost, Decision Aid Effectiveness, Decision Quality, Health Care Policy, Investigator-Initiated Grants, Investigator-Initiated Research, Patient Decision Aids, Patient Knowledge, Patient Preferences, SDM Implementation | Tagged decision aids, joint replacement, primary care Permalink

An Assessment of Shared Decision Aids in Latinas with Breast Cancer

Our primary hypothesis is that participants who utilize the “Early Breast Cancer: Chemotherapy and Hormone Therapy are They Right for You?” (translated) DA in shared decision- making will experience more value-congruent decisions than the control group. The specific aims of the proposed work are to: 1) determine the utility of the DA in decision-making; 2) evaluate satisfaction with the DA; and 3) assess and compare the participant’s satisfaction with and value-congruence of her decision after exposure to the DA with those of the control group.…  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Grants, Investigator-Initiated Research, Patient Decision Aids, Patient Involvement, Special Populations | Tagged breast cancer, decision aids, Latinas, shared decision making Permalink

Activating Seniors to Improve Chronic Disease Care

Chronic conditions are the primary sources of disease and disability among older Americans. Better patient self-management for chronic conditions has the potential to improve patient quality of life and reduce associated health care costs. Many older Americans, who are often hard to reach with health interventions, use publicly funded multi-purpose senior centers to access social services and seek social support.…  Continue reading
Posted in Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement, SDM Implementation, Special Populations | Tagged aging, chronic conditions, decision aids Permalink

A Randomized Controlled Trial of Consumers Asking Questions to Prompt Clinicians to Discuss and Apply Evidence to their Care

To test a brief consumer-led intervention consisting of three generic “Consumer Questions” designed to encourage doctors to discuss evidence related to treatment options with their patients. They are: 1) “What are my options?” 2) “What are the possible outcomes of those options?”and 3) “How likely is each of the outcomes to occur?”…  Continue reading
Posted in Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement | Tagged evidence-based medicine, OPTION scale Permalink

Understanding Comparative Effectiveness Research: Would Observational Data Have Predicted Results Found in Randomized Controlled Trials of Coronary Revascularization?

Contemporary randomized controlled trials (RCT) of coronary revascularization have not found any survival advantage from aggressive intervention, while observational data suggest otherwise. We aim to compare outcomes predicted from observational data without strict exclusion criteria with results from patients who would have been eligible for RCTs.…  Continue reading
Posted in Directed Research, SDM Implementation | Tagged comparative effectiveness research, coronary revascularization Permalink

The National Survey of Medical Decisions (The DECISIONS Study)

The National Survey of Medical Decisions was designed to collect nationally representative data from adults age 40 and above on a variety of medical decisions from the patient perspective, using a random digit dial (RDD) telephone survey. …  Continue reading
Posted in Decision Quality, Directed Research, Patient Involvement, Patient Knowledge, Patient Preferences, SDM Implementation | Tagged DECISIONS Study, medical decisions Permalink

Pathways to Revascularization

Project seeks to assess utility of administrative claims data to characterize indication and urgency of revascularization procedures, and to assess care preceding, the geographic variation of, and the temporal trends of such procedures. Project also wants to assess care preceding a revascularization procedure (indication and urgency, and pathways to revascularization) and assess geographic variation and temporal trends with respect to the characteristics of revascularization procedures.…  Continue reading
Posted in Directed Research, Health Care Policy, SDM Implementation, Special Populations | Tagged CABG, cardiac revascularization, geographic variation, PCI Permalink

History of Decision-Making in Cardiac Revascularization

Research seeks to look at the relationship between disease models and therapeutic practice and examine the history of the recognition that CABG and, to a lesser extent, PCI could cause severe neuro-cognitive side effects.…  Continue reading
Posted in Directed Research, Patient Involvement | Tagged CABG, cardiac revascularization Permalink

Can a Customized Quantitative Informed Consent Document Improve Decision Quality and Be Integrated into the Care Process?

Project developed and tested a customized quantitative informed consent document IC, including risks, benefits and alternatives, for those considering CABG surgery or PCI.…  Continue reading
Posted in Decision Quality, Directed Research, Patient Involvement, Risk Communication | Tagged informed consent, patient-centered care Permalink

Development and Evaluation of a Shared Decision Making Dashboard

This study will begin to address the hypothesis that patient decision aids based on decision dashboards will be more effective than decision aids based on other formats by: a) creating an interactive decision dashboard to help patients make decisions about non-opiod pain medications to treat osteoarthritis; and b) conducting a preliminary analysis of its ease of use, patient acceptability, effect on decision making process and decisions reached. …  Continue reading
Posted in Decision Aid Components, Decision Aid Effectiveness, Investigator-Initiated Research, SDM Implementation | Tagged AHRQ, decision aids, shared decision making Permalink

Abdominal Aortic Aneurysm Repair: Facilitating Collaborative Decision-Making

Ultimately, in order to test the effectiveness of this tool, we performed a randomized controlled trial. Attention was be paid to levels of anxiety and regret among patients in the two different treatment groups, and validated measures of decisional process and decisional quality were used. By seeking the opinion of vascular surgeons nationwide, we anticipated that they be invested in this research agenda and more likely to support the intervention trial and subsequent dissemination efforts. …  Continue reading
Posted in Investigator-Initiated Research, Patient Involvement, Robert Derzon Grants | Tagged abdominal aortic aneurysm, informed consent, shared decision making Permalink

Using Video Images of Dementia in Advance Care Planning

Researchers are exploring the difference in elderly patients' preferences for the level of medical care in advanced dementia and their health literacy when given a video as opposed to a verbal narrative on dementia. They will evaluate whether videos of other diseases can serve as a tool to assist clinicians in discussions of complex information with patients with low health literacy. Researchers propose to conduct a randomized trial studying ACP for elderly subjects using a video depiction of a patient with dementia compared to the traditional verbal narrative.…  Continue reading
Posted in Decision Aid Components, Investigator-Initiated Research, Patient Involvement, Robert Derzon Grants, Special Populations | Tagged dementia, end of life, health literacy Permalink

The Effect of the Institutionalization of Medical Care on Patient Informed Consent

To determine the association between the process of obtaining informed consent and the three constructs of informed consent: intentionality, understanding and freedom from controlling influence.…  Continue reading
Posted in George Bennett Grants, Health Care Policy, Investigator-Initiated Research, SDM Implementation | Tagged decision making, informed consent Permalink

Efficacy of a Training Intervention on the Quality of Case Managers Nurses Decision Support for Patients Deciding about the Place of Care at the End-of-Life: A Randomized Control Study & Efficacy of an Evidence Informed, Theory-based Training Intervention on the Quality of Clinicians' Decision Support for Patients Deciding about Place of End-of-Life Care: A Randomized Control Trial

To evaluate the efficacy of a theory driven, framework-based, multifaceted training intervention designed to enhance the quality of nurses decision support skills regarding end-of-life place of care for adults with terminal cancer. This study aims to determine whether the quality of nurses decision support can be improved with a theory-based skills-building intervention.…  Continue reading
Posted in Health Care Policy, Investigator-Initiated Research, SDM Implementation | Tagged decision support, end of life, terminal cancer Permalink

Determinants of HPV Testing in an Undeserved Population (The Effect of Direct-to-Consumer Advertising on Clinical Decision Quality: A Two-Part Analysis of a Cervical Cancer Screening Test Campaign)

Study found HPV test use increased over study period and appropriate use doubled to 60%-75% of total use.…  Continue reading
Posted in Decision Quality, George Bennett Grants, Investigator-Initiated Research, Patient Involvement, Special Populations | Tagged DTC, HPV testing, underserved population Permalink

Changes in Professional Norms and Physicians' Practice with Patients (Physician Decision-Making Around Treatment Innovations: Influences of Patients, Colleagues, and Practice Context)

This project will reveal the strategies used by patients that enable successful input into their treatments and indicate the conditions under which physician decisions are based on influences from colleagues or scientific research. Consequent interventions can potentially proceed in a fashion unhampered by obstacles that otherwise would have prevented successful implementation. The project seeks to indicate what conditions cause physicians to acquiese to their patients' requests for particular treatments and evaluate to what extent clinical research and evidence-based medical resources are used.…  Continue reading
Posted in George Bennett Grants, Investigator-Initiated Research, SDM Implementation | Tagged shared decision making Permalink

Shared Decision Making in Hispanics with Muscoloskeletal Disorders: A Qualitative Study

Our findings suggest striking commonalities across the clinical conditions (back vs. knee), sociodemographic strata (high vs. low vulnerability) and ethnic groups (Hispanics vs. non-Hispanics whites). Experienced across anatomic, socioeconomic and ethnic strata, pain and functional limitation are the central experiences of these musculoskeletal disorders.…  Continue reading
Posted in Investigator-Initiated Grants, Investigator-Initiated Research, Patient Involvement, SDM Implementation, Special Populations | Tagged Hispanics, muscoloskeletal disorder, shared decision making Permalink

Impact of Health Literacy on Outcomes and Effectiveness of Shared Decision-Making® Programs in Patients with Chronic Diseases

In conjunction with study aims, researchers hypothesize, in patients with coronary heart disease, a video version of a shared decision making program will result in greater knowledge about CAD, its associated risks and life style changes when compared to the use of a booklet alone. …  Continue reading
Posted in Decision Aid Effectiveness, Investigator-Initiated Grants, Investigator-Initiated Research, Literacy and Numeracy, Patient Involvement | Tagged CAD, chronic disease, decision aids, health literacy, shared decision making Permalink

Shared Decision Making for People with Severe and Persistent Mental Illness

The proposed research will assess the decision making needs of people with SMI and their clinicians, and create a model decision aid that meets the local needs of clients and clinicians. This study will contribute to the development of interventions for persons with SMI by: 1) identifying decision support needs gaps; 2) identifying moderating variables of needs gaps; and 3) building and assessing the feasibility of decision aids to fill decision support needs gaps in this population.…  Continue reading
Posted in Directed Research, George Bennett Grants, Patient Involvement, SDM Implementation, Special Populations | Tagged decision aids, mental illness, shared decision making Permalink