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Browsing by Subject "patient decision aid"
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Item Development and Usability Testing of a Computer-Tailored Decision Support Tool for Lung Cancer Screening: Study Protocol(JMIR, 2017) Carter-Harris, Lisa; Comer, Robert Skipworth; Goyal, Anurag; Vode, Emilee Christine; Hanna, Nasser; Ceppa, DuyKhanh; Rawl, Susan M.; School of NursingBackground: Awareness of lung cancer screening remains low in the screening-eligible population, and when patients visit their clinician never having heard of lung cancer screening, engaging in shared decision making to arrive at an informed decision can be a challenge. Therefore, methods to effectively support both patients and clinicians to engage in these important discussions are essential. To facilitate shared decision making about lung cancer screening, effective methods to prepare patients to have these important discussions with their clinician are needed. Objective: Our objective is to develop a computer-tailored decision support tool that meets the certification criteria of the International Patient Decision Aid Standards instrument version 4.0 that will support shared decision making in lung cancer screening decisions. Methods: Using a 3-phase process, we will develop and test a prototype of a computer-tailored decision support tool in a sample of lung cancer screening-eligible individuals. In phase I, we assembled a community advisory board comprising 10 screening-eligible individuals to develop the prototype. In phase II, we recruited a sample of 13 screening-eligible individuals to test the prototype for usability, acceptability, and satisfaction. In phase III, we are conducting a pilot randomized controlled trial (RCT) with 60 screening-eligible participants who have never been screened for lung cancer. Outcomes tested include lung cancer and screening knowledge, lung cancer screening health beliefs (perceived risk, perceived benefits, perceived barriers, and self-efficacy), perception of being prepared to engage in a patient-clinician discussion about lung cancer screening, occurrence of a patient-clinician discussion about lung cancer screening, and stage of adoption for lung cancer screening. Results: Phases I and II are complete. Phase III is underway. As of July 15, 2017, 60 participants have been enrolled into the study, and have completed the baseline survey, intervention, and first follow-up survey. We expect to have results by December 31, 2017 and to have data analysis completed by March 1, 2018. Conclusions: Results from usability testing indicate that the computer-tailored decision support tool is easy to use, is helpful, and provides a satisfactory experience for the user. At the conclusion of phase III (pilot RCT), we will have preliminary effect sizes to inform a future fully powered RCT on changes in (1) knowledge about lung cancer and screening, (2) perceived risk of lung cancer, (3) perceived benefits of lung cancer screening, (4) perceived barriers to lung cancer screening, (5) self-efficacy for lung cancer screening, and (6) perceptions of being adequately prepared to engage in a discussion with their clinician about lung cancer screening.Item Development of a Theory-Informed Patient Decision Aid to Facilitate Consent to Genetic Testing in the Neonatal Intensive Care Unit(2024-05) Higley, Keeley; Head, Katharine J.; Brann, Maria; Bute, Jennifer J.Genetic testing is an essential diagnostic tool in the neonatal intensive care unit (NICU) that can shorten infants’ stays, improve accuracy and effectiveness of medical care, and overall improve quality of life. However, there are challenges involved in the process of recommending life-saving and care-changing genetic testing in the NICU, including parental concerns around issues of paternity, guardians’ decisional anxiety, low health literacy, limited understanding of genetic testing, and receiving conflicting information from different healthcare providers. These challenges are exacerbated by the urgency guardians face in the NICU; guardians’ first exposure to genetic testing often occurs immediately before they are asked to decline or consent to it while in an extremely emotional state and fraught environment, creating a sense of urgency that affects decision-making. Current patient-provider communication practices in the NICU could benefit from improved, streamlined communication tools to help guardians make thoughtful decisions about genetic testing for their hospitalized infants. One potential strategy to streamline communication about genetic testing in the NICU is incorporating self-determination theory into patient decision aids. A series of three iterative interview rounds with NICU guardians and new guardians of infants younger than three years old were conducted. Following each round of interviews, recordings were transcribed, and feedback from participants was used to revise a patient decision aid guided by self-determination theory. After completing all three rounds of interviews and revisions, thematic analysis was conducted on all transcribed interviews to identify salient themes to NICU genetic testing decision-making. The final version of the patient decision aid developed from this study will serve as a starting point for integrating this important tool into the NICU.