SHARE Approach Evaluation

Completed

• Conditions: Shared Decision Making
• Interventions: Behavioral: SHARE Approach

• Registration Number: NCT06062940
• Lead Sponsor: University of Colorado, Denver

Brief Summary

The SHARE Approach Evaluation study was meant to evaluate the SHARE Approach, designed by AHRQ and updated by UCD. The SHARE Approach is a training program for clinicians on shared decision making.

Detailed Description

This research group has been selected by the Agency for Healthcare Research and Quality (AHRQ) to evaluate its SHARE Approach Model. This model is designed to improve shared-decision making (SDM) between providers and patients, and teaches clinicians skills that are applicable to SDM in the context of preference-sensitive treatment choice and problem-solving. It remains one of the only freely available SDM toolkits that provides clinician-facing resources for comprehensive SDM training. This study will assess the effectiveness of the SHARE model training using training evaluation surveys, card survey data with providers who have received the SHARE training, and their patients, and audio recordings of clinician/patient encounters. The training and evaluations will be done at a total of 12 health care practices (10 primary care practices and 2 cardiology practices). All research data will be de-identified and kept confidential.

Study Timeline

• Study Start: 2019-08-01
• Primary Completion: 2023-03-30
• Study First Submitted: 2023-09-07
• Study First Submitted QC: 2023-09-25
• Study First Posted: 2023-10-02
• Study Completion: 2023-11-30
• Status Verified: 2024-08
• Last Update Submitted: 2024-08-08
• Last Update Posted: 2024-08-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 176

Inclusion Criteria

• Population to be enrolled include clinicians and any practice staff who participate in the SHARE Approach training in 12 practices to be recruited across Colorado.
• Patients will also be enrolled for the card surveys and audio recordings if they are meeting with a clinician who has taken the SHARE Approach training.
• 18 to 89 years old

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Exclusion Criteria

• Children
• Decisionally challenged
• Prisoners

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Cardiology Practice	SHARE Approach	We recruited 2 cardiology practices from across Colorado, from all regions of the state (e.g., Eastern Plains, Mountain West, Front Range), and a mix of rural and urban practices of varying sizes. We recruited both practice staff and patients for this cohort.
Primary Care Practice	SHARE Approach	We recruited 10 primary care practices from across Colorado, from all regions of the state (e.g., Eastern Plains, Mountain West, Front Range), and a mix of rural and urban practices of varying sizes. We recruited both practice staff and patients for this cohort.

Primary Outcome Measures

Name	Time	Method
Card survey: Clinician satisfaction with encounter	pre-training, 1 month post-training, 6 month follow-up	Clinician satisfaction with encounter was measured by a brief card survey question with a 5 point Likert scale. Possible scores range from 1 to 5, with lower scores indicating less usefulness and higher scores indicating more usefulness.
Clinician training evaluation: Confidence in understanding what shared decision making is	pre-training, post-training	Clinician confidence in understanding shared decision making was measured by a brief card survey question with a 5 point Likert scale. Possible scores range from 1 to 5, with lower scores indicating less usefulness and higher scores indicating more usefulness.
Clinician training evaluation: Confidence in ability to do shared decision making	pre-training, post-training, 2-month follow-up	Clinician confidence in doing shared decision making was measured by a brief card survey question with a 5 point Likert scale. Possible scores range from 1 to 5, with lower scores indicating less usefulness and higher scores indicating more usefulness.
Card survey: Patient shared decision making (self-reported)	pre-training, 1 month post-training, 6 month follow-up	After clinician/patient encounters, patients were asked to fill out a brief card survey rating their experiences with shared decision making during the encounter. These included questions modified from the Dyadic OPTION (observing patient involvement in decision making) scale. Higher scores reflected better experiences of shared decision making, whereas lower scores reflected poorer experiences of shared decision making.
Clinician training evaluation: Overall evaluation of the SHARE training	post-training	clinicians answered the question: Overall, what was your experience of the training you received today. Likert rating scale was "Very positive" to "Very negative"
Card survey: Patient satisfaction with encounter	pre-training, 1 month post-training, 6 month follow-up	Patient satisfaction with encounter was measured by a brief card survey question with a 5 point Likert scale. Possible scores range from 1 to 5, with lower scores indicating less usefulness and higher scores indicating more usefulness.
Card survey: Clinician shared decision making (self-reported)	pre-training, 1 month post-training, 6 month follow-up	After clinician/patient encounters, clinicians were asked to fill out a brief card survey rating shared decision making that occurred during the encounter. These include questions from the Dyadic OPTION (observing patient involvement in decision making) scale. Higher scores reflected better experiences of shared decision making, whereas lower scores reflected poorer experiences of shared decision making.
Audio recordings: Shared Decision Making (highest score of topics discussed)	pre-training, 1 month post-training, 6 month follow-up	A subset of clinician/patient encounters were audio recorded, and then coded using a modified OPTION (observing patient involvement in decision making) 12 coding schema for elements of shared decision making occurring within the encounter. As a primary outcome, we selected the highest-scored topic discussed in each encounter. Higher scores reflected better experiences of shared decision making, whereas lower scores reflected poorer experiences of shared decision making.

Secondary Outcome Measures

Name	Time	Method
Shared Decision Making (total score)	pre-training, 1 month post-training, 6 month follow-up	Clinician/patient encounters were audio recorded, and then coded using a modified OPTION (observing patient involvement in decision making) 12 coding schema for different elements of shared decision making within the encounter.; The secondary outcome was the total score for each encounter, which averaged across scores for all topics discussed. Higher scores reflected better experiences of shared decision making, whereas lower scores reflected poorer experiences of shared decision making.

Trial Locations

Locations (1)

University of Colorado; 🇺🇸 Aurora, Colorado, United States