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Development and Evaluation of an Instrument to Measure Shared Decision-Making in Pediatrics

Award Number: R01HS029142
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2023
PERIOD OF PERFORMANCE END DATE: 05/31/2028

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Development and Evaluation of an Instrument to Measure Shared Decision-Making in Pediatrics - PROJECT SUMMARY Shared decision-making (SDM) is an active process of clinician and patient interaction that is intended to produce a joint decision. Critical to the implementation of SDM and the evaluation of its effect on health outcomes is the availability of valid and reliable instruments to measure SDM. Though several instruments have been designed to measure the process of arriving at a shared decision in the clinical encounter, few have been deemed high quality and none have been specifically designed to measure the process of SDM in pediatrics. Furthermore, most instruments measure the SDM process from a singular perspective (e.g., patient self-report or observer) despite increasing recognition that clinician perspectives are also needed to accurately capture the dyadic interaction and inherently bidirectional process of SDM. The primary goal of this project is to develop and evaluate a dyadic instrument to measure the process of SDM with parents of young children that includes both parent and clinician perspectives. We will anchor the development of this instrument to a 4-step process for implementing SDM in pediatrics that we developed and validated in preliminary work using a diverse set of decision-making scenarios across multiple pediatric disciplines and varied clinical settings. The first 3 steps of this process involve recognition of [>1] medically reasonable option (Step 1); clinician assessment of the medical benefit-burden ratios of options (Step 2); and parent expression of preferences regarding options (Step 3). Step 4 encourages a parent- or clinician-guided SDM based on Steps 1-3 that can be further modified based on the presence of other decisional features. Our specific aims are to (1) develop a dyadic instrument for measuring the SDM process with parents of young children using a standard, iterative process that includes item generation, augmentation of the item pool, item reduction through expert review, and pretesting with parents and clinicians, with a sub-aim to develop an observer-coded version of the instrument to explore its correlation with the final dyadic instrument in Aim 3; (2) assess the [internal consistency], construct validity and reliability of the preliminary dyadic instrument in a controlled, simulated setting by conducting an online experiment in which [parent (N=600) and clinician (N=600) participants] complete our preliminary dyadic instrument after being randomized to view one of 4 different pairs of standardized video vignettes that portray a high-quality and low-quality SDM encounter of a unique decision in pediatrics; and (3) evaluate the construct validity and feasibility of the final dyadic instrument in the clinical setting by administering the instrument to parent and clinician participants after [problem-based encounters (N=127)] across a range of pediatric settings and specialties at two pediatric institutions, [with a sub-aim to develop a Spanish version of the final dyadic instrument.] This R01 application will yield a valid and reliable instrument to feasibly measure the process of SDM with parents of young children and will enable follow-on evaluation of SDM on child health outcomes.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $386,987 )
2025	2025	SEATTLE CHILDREN'S HOSPITAL	4800 SAND POINT WAY NE	SEATTLE	WA	98105	KING	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	6/6/2025	NON-COMPETING CONTINUATION	$386,987
														Subtotal = $386,987

Issue Date FY: 2024 ( Subtotal = $396,382 )
2024	2024	SEATTLE CHILDREN'S HOSPITAL	4800 SAND POINT WAY NE	SEATTLE	WA	98105	KING	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	5/10/2024	NON-COMPETING CONTINUATION	$396,382
														Subtotal = $396,382

Issue Date FY: 2023 ( Subtotal = $395,990 )
2023	2023	SEATTLE CHILDREN'S HOSPITAL	4800 SAND POINT WAY NE	SEATTLE	WA	98105	KING	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	7/26/2023	NEW	$395,990
														Subtotal = $395,990

Grand Total All Awards = $1,179,359

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Development and Evaluation of an Instrument to Measure Shared Decision-Making in Pediatrics

Award Number: R01HS029142

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2023

PERIOD OF PERFORMANCE END DATE: 05/31/2028

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