Outlook: Newsletter of the Society of Behavorial Medicine

Fall 2018

Emerging Strategies for Promoting Health Decision Making

Alexander Young M.A. & Randi M. Williams, MPH, Health Decision Making SIG

There are many types of health decisions that one may consider ‘easy’ such as allowing blood pressure to be taken; however, other medical decisions like cancer screenings or developing a plan for managing type 2 diabetes may be more challenging. The many choices providers and patients navigate can often be difficult. So how do patients and providers navigate health decisions in a comprehensive manner while supporting a ‘good medical decision’?

Health Decision Strategies

There are many strategies for health decision promotion depending on the type of decision and the setting in which the decision is made. In general, health decisions should be made with a specific goal in mind. An example of this might be taking blood pressure medication to reduce blood pressure and stroke risk. When goals are present it allows the patient to see the end goal in a way that may be motivating and provide a better understanding of why the decision is important. One strategy to use, especially for serious health decisions may be the shared decision-making model or SDM. This type of approach allows a meaningful interaction between provider and patient. SDM has been shown to assist disadvantaged groups in making informed health decisions when their content is tailored and written in an easy and plain language. One way to enhance SDM is through the use of decision aids. Other techniques such as motivational can be used to complement SDM for promoting optimal, patient-centered care.  

Patient Decision Aids

Decision aids are helpful at providing patients with information about treatment or screening options, as well as the potential risks, benefits, and costs associated with each option. We often find these decision aids in our primary care provider’s or specialist’ office during a visit or online, but how often do we pay attention to the design, color, and overall construction of these aids? Color and message framing are important factors in the construction of decision aids. Patient decision aids allow for more informed choices when it comes to making health decisions in conjunction with physician information. Patients are not always aware they have a voice regarding healthcare and that health choices are ultimately in the hands of the patient.

Health Decisions in Primary Care

There are many uses of SDM and the integration of decision aids. A model of applying health decision aids in primary care has been developed to increase their effectiveness and potential action in the primary care setting. The use of decision aids with an SDM model may be advantageous in the primary care setting as many treatment options are discussed in this context including medication management, cancer screening, specialty care for chronic conditions like diabetes, and behavioral health consultant services

Other strategies to support decision making include use of patient navigators and decision coaches, values clarification methods, and interprofessional collaborations. For more information about health decision making, visit the Health Decision Making SIG page.