Disparities in Shared Decision-Making Research and Practice: The Case for Black American Patients

Area of Science:

• Health Disparities
• Patient-Centered Care
• Primary Care

Background:

• Shared decision making (SDM) is underutilized in the care of Black patients.
• Limited research exists on SDM preferences among racial and ethnic minorities.

Purpose of the Study:

• To explore the preferences, needs, and challenges of Black patients regarding SDM.
• To develop recommendations for enhancing SDM in primary care for Black patients.

Main Methods:

• Interviews were conducted with 32 Black patients undergoing type 2 diabetes care.
• Participants were from safety-net primary care practices serving a predominantly Black population.

Main Results:

• Four key themes emerged: preference for humanistic communication, the importance of family in decision-making, the need for accessible medical information, and existing mistrust of clinicians.
• Patients favor triadic SDM (including family) over traditional dyadic models.
• A need to contextualize medical information through storytelling was identified.

Conclusions:

• Current SDM models may not adequately address the needs of diverse patient populations.
• Recommendations include incorporating storytelling and family involvement to improve SDM for Black patients.
• Revisiting the universalism assumption in SDM is crucial for equitable healthcare delivery.