RT Journal Article
SR Electronic
T1 Disparities in Shared Decision-Making Research and Practice: The Case for Black American Patients
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 112
OP 118
DO 10.1370/afm.2943
VO 21
IS 2
A1 Yaara Zisman-Ilani
A1 Shely Khaikin
A1 Margot L. Savoy
A1 Anuradha Paranjape
A1 Daniel J. Rubin
A1 Regina Jacob
A1 Thomas H. Wieringa
A1 John Suarez
A1 Jin Liu
A1 Heather Gardiner
A1 Sarah Bauerle Bass
A1 Victor M. Montori
A1 Laura A. Siminoff
YR 2023
UL http://www.annfammed.org/content/21/2/112.abstract
AB OBJECTIVE The extent of shared decision making (SDM) use in the care of Black patients is limited. We explored preferences, needs, and challenges of Black patients to enhance SDM offerings.METHODS We performed interviews with 32 Black patients receiving type 2 diabetes care in safety-net primary care practices caring predominantly for Black people.RESULTS The following 4 themes emerged: preference for humanistic communication, need to account for the role of family in decision making, need for medical information sharing, and mistrust of clinicians.CONCLUSION Given the dearth of research on SDM among ethnic and racial minorities, this study offers patient-perspective recommendations to improve SDM offerings for Black patients in primary care settings. To enhance SDM with Black patients, acknowledgment of the importance of storytelling as a strategy, to place medical information in a context that makes it meaningful and memorable, is recommended. Triadic SDM, in which family members are centrally involved in decision making, is preferred over classical dyadic SDM. There is a need to reconsider the universalism assumption underlying contemporary SDM models and the relevancy of current SDM practices that were developed mostly without the feedback of participants of ethnic, racial, and cultural minorities.Annals “Online First” article