Cultural challenges to engaging patients in shared decision making

Area of Science:

• Health Services Research
• Health Disparities
• Patient Engagement

Background:

• Shared decision-making (SDM) is a priority in healthcare, aiming to involve patients in their treatment choices.
• Existing SDM initiatives often overlook challenges faced by patients from diverse racial, ethnic, and cultural backgrounds.
• Research indicates disparities in how minority patients perceive the decision-making process compared to the majority population.

Purpose of the Study:

• To summarize challenges in engaging diverse patient populations in shared decision-making.
• To propose considerations for developing culturally appropriate SDM approaches.
• To highlight the need for foundational and empirical work on culture in healthcare utilization.

Main Methods:

• Commentary synthesizing existing literature and research findings.
• Identification and discussion of barriers to SDM in diverse populations.
• Formulation of recommendations for improved patient engagement and provider training.

Main Results:

• Patients from diverse backgrounds report less positive experiences with shared decision-making compared to white, U.S.-born patients.
• Preliminary conceptual frameworks exist but require further empirical validation.
• Significant gaps remain in understanding and addressing cultural nuances in SDM.

Conclusions:

• Foundational and empirical research is crucial to understand the role of race/ethnicity and culture in healthcare decisions.
• Recommendations include early patient involvement and maximizing decision-making in personally meaningful ways.
• Innovative and sustained efforts are needed to train providers in culturally competent communication for effective SDM.