Multiethnic Perspectives of Shared Decision-Making in Hypertension: A Mixed-Methods Study

Area of Science:

• Cardiovascular Health
• Health Equity
• Health Services Research

Background:

• Shared decision-making (SDM) can enhance hypertension care quality and equity.
• Limited research exists on how race and ethnicity influence SDM in hypertension management.

Purpose of the Study:

• To explore the impact of race and ethnicity on SDM in hypertension management.
• To identify factors influencing SDM and blood pressure outcomes in hypertensive patients.

Main Methods:

• Explanatory sequential mixed-methods design using quantitative (n=1212) and qualitative (n=36) data.
• Analysis of baseline and 12-month follow-up data from the RICH LIFE study.
• Multinomial logistic regression to identify predictors of SDM scores and blood pressure reduction.

Main Results:

• Race and ethnicity were significant predictors of SDM scores and blood pressure outcomes (RRR, 1.64; P=0.029).
• Other predictors included age, education, patient activation, and hypertension knowledge.
• Provider-patient communication and relationship dynamics were identified as key facilitators and barriers to SDM.

Conclusions:

• Determinants of decision-making and contextual factors influencing SDM vary among patients with different SDM scores and blood pressure outcomes.
• Findings offer novel, actionable insights into SDM in hypertension care.
• Understanding these factors can help improve hypertension management strategies.