The Impact of Patient Activation on Preparation for Shared Decision Making Among Lower Socioeconomic and Minority Populations

Purpose

This proposal initiates a larger research effort aimed at identifying methods to improve the ability of patients of lower socioeconomic position or minority status to share in decision making about health and health care, and to study the impact of shared decision making (SDM) on patient satisfaction and health outcomes. The focus of this project is to study the impact of interventions directed at preparing patients for the active role that SDM requires. Specific aims are to:

1. Describe baseline levels of patient activation (PA) and desired role in decision making of users of community health centers (CHCs).
2. Determine the impact of diabetes on patients’ baseline activation levels.
3. Determine the relationship of patient’s baseline activation levels on their response to decision aids.
4. Determine the impact of decision aids on activation levels and decision self-efficacy.
5. Refine a brief PA intervention.
6. Study the impact of this brief PA intervention on response to decision aids.
7. Gain a better understanding of the performance characteristics of the Patient Activation Measure (PAM), the Patient Preference for Control (PPC) scale, and the Decision Self-Efficacy (DSE) scale, as outcome measures for future studies.