What is the effect of a decision aid in potentially vulnerable parents? Insights from the head CT choice randomized trial.
decision aid
head trauma
paediatrics
shared decision making
Journal
Health expectations : an international journal of public participation in health care and health policy
ISSN: 1369-7625
Titre abrégé: Health Expect
Pays: England
ID NLM: 9815926
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
11
04
2019
revised:
24
07
2019
accepted:
28
08
2019
pubmed:
24
11
2019
medline:
23
4
2021
entrez:
24
11
2019
Statut:
ppublish
Résumé
To test the hypotheses that use of the Head CT Choice decision aid would be similarly effective in all parent/patient dyads but parents with high (vs low) numeracy experience a greater increase in knowledge while those with low (vs high) health literacy experience a greater increase in trust. This was a secondary analysis of a cluster randomized trial conducted at seven sites. One hundred seventy-two clinicians caring for 971 children at intermediate risk for clinically important traumatic brain injuries were randomized to shared decision making facilitated by the DA (n = 493) or to usual care (n = 478). We assessed for subgroup effects based on patient and parent characteristics, including socioeconomic status (health literacy, numeracy and income). We tested for interactions using regression models with indicators for arm assignment and study site. The decision aid did not increase knowledge more in parents with high numeracy (P for interaction [P Use of the Head CT Choice decision aid resulted in less decisional conflict in non-white parents and greater physician trust in socioeconomically disadvantaged parents. Decision aids may be particularly effective in potentially vulnerable parents.
Identifiants
pubmed: 31758633
doi: 10.1111/hex.12965
pmc: PMC6978876
doi:
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
63-74Informations de copyright
© 2019 The Authors Health Expectations published by John Wiley & Sons Ltd.
Références
Med Decis Making. 2007 Sep-Oct;27(5):672-80
pubmed: 17641137
Lancet. 2009 Oct 3;374(9696):1160-70
pubmed: 19758692
Health Commun. 2013;28(6):616-23
pubmed: 23050731
Med Decis Making. 1995 Jan-Mar;15(1):25-30
pubmed: 7898294
Patient Educ Couns. 2013 Oct;93(1):95-101
pubmed: 23669153
J Gen Intern Med. 2008 May;23(5):561-6
pubmed: 18335281
JAMA. 1999 Aug 11;282(6):583-9
pubmed: 10450723
Health Expect. 2020 Feb;23(1):63-74
pubmed: 31758633
N Engl J Med. 2007 Nov 22;357(21):2189-94
pubmed: 18032770
Cochrane Database Syst Rev. 2017 Apr 12;4:CD001431
pubmed: 28402085
Ann Intern Med. 2010 Jun 1;152(11):726-32
pubmed: 20335313
Health Expect. 2005 Mar;8(1):34-42
pubmed: 15713169
Circ Cardiovasc Qual Outcomes. 2014 May;7(3):360-7
pubmed: 24823953
Med Care. 1999 May;37(5):510-7
pubmed: 10335753
Fam Med. 2004 Sep;36(8):588-94
pubmed: 15343421
Arch Pediatr Adolesc Med. 2012 Aug;166(8):732-7
pubmed: 22869404
J Palliat Med. 2014 May;17(5):559-67
pubmed: 24720434
Fam Med. 2004 Sep;36(8):575-81
pubmed: 15343419
JAMA Netw Open. 2018 Sep 7;1(5):e182430
pubmed: 30646167
Circ Cardiovasc Qual Outcomes. 2012 May;5(3):251-9
pubmed: 22496116
Acad Pediatr. 2015 Nov-Dec;15(6):573-83
pubmed: 25983006
Med Decis Making. 2018 Jan;38(1):69-78
pubmed: 28525723
Trials. 2014 Jun 25;15:253
pubmed: 24965659