--- title: "Asthma shared decision making in ambulatory care. | Sutter Health" description: "This paper describes the participatory approach used to adapt and implement an evidence-based asthma SDM intervention into primary care practices." url: "https://www.sutterhealth.org/research/publications/asthma-shared-decision-making-in-ambulatory-care-1055312730" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Asthma shared decision making in ambulatory care. # Adapting community based participatory research (CBPR) methods to the implementation of an asthma shared decision making intervention in ambulatory practices. Tapp H, Kuhn L, Alkhazraji T, Steuerwald M, Ludden T, Wilson S, Mowrer L, Mohanan S, & Dulin MF. _J Asthma. 51(4):380-90. doi: 10.3109/02770903.2013.876430. Epub 2014 Jan 24._ 2014-05-01 ## Abstract OBJECTIVE: Translating research findings into clinical practice is a major challenge to improve the quality of healthcare delivery. Shared decision making (SDM) has been shown to be effective and has not yet been widely adopted by health providers. This paper describes the participatory approach used to adapt and implement an evidence-based asthma SDM intervention into primary care practices. METHODS: A participatory research approach was initiated through partnership development between practice staff and researchers. The collaborative team worked together to adapt and implement a SDM toolkit. Using the RE-AIM framework and qualitative analysis, we evaluated both the implementation of the intervention into clinical practice, and the level of partnership that was established. Analysis included the number of adopting clinics and providers, the patients' perception of the SDM approach, and the number of clinics willing to sustain the intervention delivery after 1 year. RESULTS: All six clinics and physician champions implemented the intervention using half-day dedicated asthma clinics while 16% of all providers within the practices have participated in the intervention. Themes from the focus groups included the importance of being part the development process, belief that the intervention would benefit patients, and concerns around sustainability and productivity. One year after initiation, 100% of clinics have sustained the intervention, and 90% of participating patients reported a shared decision experience. CONCLUSIONS: Use of a participatory research process was central to the successful implementation of a SDM intervention in multiple practices with diverse patient populations. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/24350877) ## Research topics - [Asthma](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Asthma%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [The Breathe Easier through Weight Loss Lifestyle (BE WELL) Intervention: a randomized controlled trial.](https://www.sutterhealth.org/research/publications/asthma-management-through-weight-loss-1055312542) Ma J, Strub P, Camargo CA Jr, Xiao L, Ayala E, Gardner CD, Buist AS, Haskell WL, Lavori PW, Wilson SR. BMC Pulm Med. 10:16. doi: 10.1186/1471-2466-10-16. 2010 Mar 24 - Publication ### [DASH for asthma: a pilot study of the DASH diet in not-well-controlled adult asthma.](https://www.sutterhealth.org/research/publications/pilot-study-of-dash-diet-in-uncontrolled-asthma-1055312757) Ma J, Strub P, Lavori PW, Buist AS, Camargo CA Jr, Nadeau KC, Wilson SR, Xiao L. Contemp Clin Trials. 35(2):55-67. doi: 10.1016/j.cct.2013.04.008. Epub 2013 May 3. 2013 Jul 01 - Publication ### [Shared clinician-patient decision-making about treatment of pediatric asthma: what do we know and how can we use it?](https://www.sutterhealth.org/research/publications/shared-clinician-pt-decision-making-in-ped-asthma-1055312602) Rivera-Spoljaric K, Halley M, Wilson SR. Curr Opin Allergy Clin Immunol. 14(2):161-7. doi: 10.1097/ACI.0000000000000046. 2014 Apr 01 - Publication ### [American Thoracic Society and National Heart, Lung, and Blood Institute Implementation Research Workshop Report.](https://www.sutterhealth.org/research/publications/ats-nhlbi-implementation-research-wkshop-report-1055312327) Bender BG, Krishnan JA, Chambers DA, Cloutier MM, Riekert KA, Rand CS, Schatz M, Thomson CC, Wilson SR, Apter A, Carson SS, George M, Gerald JK, Gerald L, Goss CH, Okelo SO, Mularski RA, Nguyen HQ, Patel MR, Szefler SJ, Weiss CH, Wilson KC, Freemer M. Ann Am Thorac Soc. 2015 Dec;12(12):S213-21. doi: 10.1513/AnnalsATS.201506-367OT. 2015 Dec 12 - Publication ### [Behavioral weight loss and physical activity intervention in obese adults with asthma: a randomized trial.](https://www.sutterhealth.org/research/publications/behavioral-weight-loss-in-obese-asthmatic-adults-1055312842) Ma J, Strub P, Xiao L, Lavori PW, Camargo CA Jr, Wilson SR, Gardner CD, Buist AS, Haskell WL, Lv N. Ann Am Thorac Soc. 12(1):1-11. doi: 10.1513/AnnalsATS.201406-271OC. 2015 Jan 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/asthma-shared-decision-making-in-ambulatory-care-1055312730#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Asthma shared decision making in ambulatory care."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/asthma-shared-decision-making-in-ambulatory-care-1055312730#medicalscholarlyarticle","name":"Adapting community based participatory research (CBPR) methods to the implementation of an asthma shared decision making intervention in ambulatory practices.","headline":"Asthma shared decision making in ambulatory care.","abstract":"OBJECTIVE: Translating research findings into clinical practice is a major challenge to improve the quality of healthcare delivery. Shared decision making (SDM) has been shown to be effective and has not yet been widely adopted by health providers. This paper describes the participatory approach used to adapt and implement an evidence-based asthma SDM intervention into primary care practices. METHODS: A participatory research approach was initiated through partnership development between practice staff and researchers. The collaborative team worked together to adapt and implement a SDM toolkit. Using the RE-AIM framework and qualitative analysis, we evaluated both the implementation of the intervention into clinical practice, and the level of partnership that was established. Analysis included the number of adopting clinics and providers, the patients' perception of the SDM approach, and the number of clinics willing to sustain the intervention delivery after 1 year. RESULTS: All six clinics and physician champions implemented the intervention using half-day dedicated asthma clinics while 16% of all providers within the practices have participated in the intervention. Themes from the focus groups included the importance of being part the development process, belief that the intervention would benefit patients, and concerns around sustainability and productivity. One year after initiation, 100% of clinics have sustained the intervention, and 90% of participating patients reported a shared decision experience. 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