Refining a primary care shared decision-making aid for lifestyle change: a mixed-methods study.

Area of Science:

• Health Services Research
• Behavioral Science
• Primary Care Medicine

Background:

• Primary care plays a crucial role in promoting healthy lifestyle behaviors.
• Effective support for lifestyle change requires informed tools for healthcare professionals.

Purpose of the Study:

• To evaluate and refine the 39-item shared decision-making (SDM) aid, SHARE-D, for facilitating healthy lifestyle changes.
• To improve the implementation of the SDM aid in primary care settings.

Main Methods:

• A mixed-methods study involving health professionals, patients, and support workers (n=34) with cardiovascular or cerebrovascular disease history.
• Participants completed surveys to rate item importance and suggest modifications, followed by semi-structured interviews (n=30) analyzed thematically.

Main Results:

• High agreement on item inclusion; 9 items removed, 13 amended, resulting in a 30-item aid.
• Key themes included core content, barriers to use (format, length, clarity, time), motivation for change, and primary care implementation.
• A digital version integrated into patient records was deemed critical for implementation; 'self-reflective' questions and goal setting were essential.

Conclusions:

• The SHARE-D decision aid demonstrates good content validity and acceptability for healthy lifestyle change.
• Refinement based on user feedback enhances its suitability for brief consultations and promoting patient autonomy.
• Further research is recommended to evaluate the effectiveness of the revised SHARE-D aid.