Document Detail


Effect of adding a values clarification exercise to a decision aid on heart disease prevention: a randomized trial.
MedLine Citation:
PMID:  20484089     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Experts have called for the inclusion of values clarification (VC) exercises in decision aids (DAs) as a means of improving their effectiveness, but little research has examined the effects of such exercises.
OBJECTIVE: To determine whether adding a VC exercise to a DA on heart disease prevention improves decision-making outcomes.
DESIGN: Randomized trial.
SETTING: UNC Decision Support Laboratory.
PATIENTS: Adults ages 40 to 80 with no history of cardiovascular disease.
INTERVENTION: A Web-based heart disease prevention DA with or without a VC exercise.
MEASUREMENTS: Pre- and postintervention decisional conflict and intent to reduce coronary heart disease (CHD) risk and postintervention self-efficacy and perceived values concordance.
RESULTS: The authors enrolled 137 participants (62 in DA; 75 in DA + VC with moderate decisional conflict (DA 2.4; DA + VC 2.5) and no baseline differences among groups. After the interventions, they found no clinically or statistically significant differences between groups in decisional conflict (DA 1.8; DA + VC 1.9; absolute difference VC-DA 0.1, 95% confidence interval [CI]: -0.1 to 0.3), intent to reduce CHD risk (DA 98%; DA + VC 100%; absolute difference VC-DA: 2%, 95% CI: -0.02% to 5%), perceived values concordance (DA 95%; DA + VC 92%; absolute difference VC-DA -3%, 95% CI: -11% to +5%), or self-efficacy for risk reduction (DA 97%; DA + VC 92%; absolute difference VC-DA -5%, 95% CI: -13% to +3%). However, DA + VC tended to change some decisions about risk reduction strategies.
LIMITATIONS: Use of a hypothetical scenario; ceiling effects for some outcomes.
CONCLUSIONS: Adding a VC intervention to a DA did not further improve decision-making outcomes in a population of highly educated and motivated adults responding to scenario-based questions. Work is needed to determine the effects of VC on more diverse populations and more distal outcomes.
Authors:
Stacey L Sheridan; Jennifer M Griffith; Lindy Behrend; Ziya Gizlice; Jianwen Cai; Michael P Pignone
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-05-18
Journal Detail:
Title:  Medical decision making : an international journal of the Society for Medical Decision Making     Volume:  30     ISSN:  1552-681X     ISO Abbreviation:  Med Decis Making     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-07-16     Completed Date:  2010-11-01     Revised Date:  2014-04-25    
Medline Journal Info:
Nlm Unique ID:  8109073     Medline TA:  Med Decis Making     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E28-39     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Decision Making*
Female
Heart Diseases / prevention & control*
Humans
Internet
Male
Middle Aged
Grant Support
ID/Acronym/Agency:
1 K23 HL074375/HL/NHLBI NIH HHS; K05 CA129166/CA/NCI NIH HHS; K23 HL074375/HL/NHLBI NIH HHS
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