107 Improving shared decision making for underserved groups: a qualitative study to inform interventions for surgery

ALPACA Study team, Christin Hoffmann*, Zille Huma, Jennifer Hall, Leila Rooshenas, Kerry N L Avery, Christie L Cabral, Hilary L Bekker, Val Snelgrove, Jane Blazeby, Angus G K McNair

*Corresponding author for this work

Research output: Contribution to conferenceConference Abstract

Abstract

Introduction:
Improving shared decision making(SDM) for surgery is important for 310million patients worldwide undergoing treatment annually.1 SDM interventions are often information-rich and sophisticated,2 benefitting educated, health literate and socioeconomically advantaged people.3 The ALPACA study aims to co-develop an inclusive decision support intervention that uses digital real-time monitoring and feedback of patients’ experience of SDM to achieve improvements in SDM before surgery. This study aims to better understand how the intervention can be optimised for under-served groups who are disproportionately affected by poor SDM.

Methods:
A qualitative study design employed face-to-face/remote data collection in two UK regions, selected to reach socio-economically diverse populations. Semi-structured interviews and focus groups were conducted with adult public members (starting October 2023). Recruitment purposively sampled individuals from under-served groups: economically disadvantaged, minority ethnic groups, older age. Transcripts were thematically analysed using inductive coding approaches.

Results:
Preliminary results from seven interviews revealed themes relevant to design of intervention components and potential impact of the intervention. Specifically, results suggest adaptations to real- time monitoring should include different language and non-digital (telephone, paper) options. Importance of the intervention’s mechanisms of change (building trust through community involvement) and assumptions (preference for anonymised feedback) were elicited. Detailed results will be shared in July 2024.

Discussion:
We have provided evidence of how to design interventions to improve SDM that maximises inclusivity. Results will inform programme theory development to articulate how, why, for whom and in what context intervention components work.

Conclusion(s):
A qualitative investigation explored views of under-served groups on the design and impact of SDM interventions that use real-time monitoring and feedback of patients’ experience of SDM. Findings will inform future co-development of a decision support intervention to improve SDM before surgery.
Original languageEnglish
DOIs
Publication statusPublished - 10 Jul 2024
Event12th International Shared Decision Making Conference 2024 (ISDM 2024) - Lausanne, Switzerland
Duration: 7 Jul 202410 Jul 2024
https://unisante-events.com/isdm2024/

Conference

Conference12th International Shared Decision Making Conference 2024 (ISDM 2024)
Abbreviated titleISDM2024
Country/TerritorySwitzerland
CityLausanne
Period7/07/2410/07/24
Internet address

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.

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