TY - JOUR
T1 - The role of patient activation in preferences for shared decision making
T2 - Results from a national survey of U.S. Adults
AU - Smith, Samuel G.
AU - Pandit, Anjali
AU - Rush, Steven R.
AU - Wolf, Michael S.
AU - Simon, Carol J.
N1 - Publisher Copyright:
© 2016 Samuel G. Smith, Anjali Pandit, Steven R. Rush, Michael S. Wolf, and Carol J. Simon.
PY - 2016/1/2
Y1 - 2016/1/2
N2 - Studies investigating preferences for shared decision making (SDM) have focused on associations with sociodemographic variables, with few investigations exploring patient factors. We aimed to investigate the relationship between patient activation and preferences for SDM in 6 common medical decisions among a nationally representative cross-sectional survey of American adults. Adults older than 18 were recruited online (n = 2,700) and by telephone (n = 700). Respondents completed sociodemographic assessments and the Patient Activation Measure. They were also asked whether they perceived benefit (yes/no) in SDM in 6 common medical decisions. Nearly half of the sample (45.9%) reached the highest level of activation (Level 4). Activation was associated with age (p <.001), higher income (p =.001), higher education (p =.010), better self-rated health (p <.001), and fewer chronic conditions (p =.050). The proportion of people who agreed that SDM was beneficial varied from 53.1% (deciding the necessity of a diagnostic test) to 71.8% (decisions associated with making lifestyle changes). After we controlled for participant characteristics, higher activation was associated with greater perceived benefit in SDM across 4 of the 6 decisions. Preferences for SDM varied among 6 common medical scenarios. Low patient activation is an important barrier to SDM that could be ameliorated through the development of behavioral interventions.
AB - Studies investigating preferences for shared decision making (SDM) have focused on associations with sociodemographic variables, with few investigations exploring patient factors. We aimed to investigate the relationship between patient activation and preferences for SDM in 6 common medical decisions among a nationally representative cross-sectional survey of American adults. Adults older than 18 were recruited online (n = 2,700) and by telephone (n = 700). Respondents completed sociodemographic assessments and the Patient Activation Measure. They were also asked whether they perceived benefit (yes/no) in SDM in 6 common medical decisions. Nearly half of the sample (45.9%) reached the highest level of activation (Level 4). Activation was associated with age (p <.001), higher income (p =.001), higher education (p =.010), better self-rated health (p <.001), and fewer chronic conditions (p =.050). The proportion of people who agreed that SDM was beneficial varied from 53.1% (deciding the necessity of a diagnostic test) to 71.8% (decisions associated with making lifestyle changes). After we controlled for participant characteristics, higher activation was associated with greater perceived benefit in SDM across 4 of the 6 decisions. Preferences for SDM varied among 6 common medical scenarios. Low patient activation is an important barrier to SDM that could be ameliorated through the development of behavioral interventions.
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U2 - 10.1080/10810730.2015.1033115
DO - 10.1080/10810730.2015.1033115
M3 - Article
C2 - 26313690
AN - SCOPUS:84955170589
SN - 1081-0730
VL - 21
SP - 67
EP - 75
JO - Journal of Health Communication
JF - Journal of Health Communication
IS - 1
ER -