Parent Communication Prompt to Increase Shared Decision-Making: A New Intervention Approach
Lauren M Hubner1, Heidi M Feldman1, Lynne C Huffman1
1Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, Stanford University, Stanford, CA, United States.
Frontiers in Pediatrics
|April 5, 2018
Summary
A novel intervention promoting shared decision-making (SDM) in pediatric care showed high parent engagement. While no main effect was detected, the intervention improved parent-clinician alignment on SDM.
Area of Science:
- Pediatric Healthcare
- Health Communication
- Clinical Decision-Making
Background:
- Shared decision-making (SDM) is crucial for involving patients and parents in pediatric treatment choices.
- Effective SDM requires open communication about options, evidence, and personal values.
- This study introduces a new, universally applicable SDM intervention for parents in pediatric settings.
Purpose of the Study:
- To evaluate a novel SDM intervention designed to enhance parental engagement and participation in clinical decision-making.
- To assess the impact of the intervention on parents' and clinicians' perceptions of SDM.
- To examine the alignment between parent and clinician perceptions of SDM.
Main Methods:
- A two-arm randomized controlled trial compared an SDM-focused intervention prompt with a neutral prompt for parents of children (0-17 years) in a Developmental-Behavioral Pediatric (DBP) clinic.
- Parents received either the intervention prompt or a comparison prompt before their child's visit.
- SDM perception was assessed post-visit by both parents and DBP clinicians, with SDM defined as "strongly agree" to all related items. Logistic regression and Cohen's kappa were used for analysis.
Main Results:
- Fifty parents and their clinicians participated (intervention n=26; comparison n=24).
- High rates of parent-reported SDM were observed in both groups (76%), with no significant main intervention effect detected.
- The intervention group demonstrated greater alignment between parent and clinician perceptions of SDM compared to the comparison group.
Conclusions:
- The novel parent-directed SDM intervention approach is feasible for use in outpatient studies, evidenced by high enrollment and minimal data loss.
- While parents consistently reported high SDM participation, further research with larger, more diverse samples is needed to confirm the intervention's efficacy.
- The intervention shows promise in improving parent-clinician agreement on SDM, a key aspect of collaborative care.
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