--- title: "Spreading decision aids in primary care. | Sutter Health" description: "This paper highlights that major structural and cultural changes in health care practice and policy are necessary to increase patient shared decision making." url: "https://www.sutterhealth.org/research/publications/effort-to-spread-decision-aids-in-5-pcp-practices-1055312691" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Spreading decision aids in primary care. # An effort to spread decision aids in five California primary care practices yielded low distribution, highlighting hurdles. Lin GA, Halley M, Rendle KA, Tietbohl C, May SG, Trujillo L, & Frosch DL. _Health Aff (Millwood). 32(2):311-20. doi: 10.1377/hlthaff.2012.1070_ 2013-02-01 ## Abstract Despite the proven efficacy of decision aids as interventions for increasing patient engagement and facilitating shared decision making, they are not used routinely in clinical care . Findings from a project designed to achieve such integration, conducted at five primary care practices in 2010-12, document low rates of distribution of decision aids to eligible patients due for colorectal cancer screening (9.3 percent) and experiencing back pain (10.7 percent). There were also no lasting increases in distribution rates in response to training sessions and other promotional activities for physicians and clinic staff. The results of focus groups, ethnographic field notes, and surveys suggest that major structural and cultural changes in health care practice and policy are necessary to achieve the levels of use of decision aids and shared decision making in routine practice envisioned in current policy. Among these changes are ongoing incentives for use, physician training, and a team-based practice model in which all care team members bear formal responsibility for the use of decision aids in routine primary care . [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/23381524) ## Research topics - [Health Policy](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Policy%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 ### [Physician practice participation in accountable care organizations: the emergence of the unicorn.](https://www.sutterhealth.org/research/publications/physician-practice-participation-in-acos-1055312896) Shortell SM, McClellan SR, Ramsay PP, Casalino LP, Ryan AM, Copeland KR. Health Serv Res. doi: 10.1111/1475-6773.12167. \[Epub ahead of print\] 2014 Mar 15 - Publication ### [Shared decision making as part of value based care: new U.S. policies challenge our readiness.](https://www.sutterhealth.org/research/publications/shared-decision-making-new-united-states-policies-1055312408) Spatz ES, Elwyn G, Moulton BW, Volk RJ, Frosch DL. Z Evid Fortbild Qual Gesundhwes. pii: S1865-9217(17)30087-9. doi: 10.1016/j.zefq.2017.05.012. \[Epub ahead of print\] 2017 May 20 - Publication ### [Does consumer satisfaction information matter? Evidence on member retention in FEHBP plans.](https://www.sutterhealth.org/research/publications/consumer-satisfaction-fehbp-plans-1055312559) Tai-Seale M. Med Care Res Rev. 61(2):171-86. 2004 Jun 01 - Publication ### [Does the frequency of pay-for-performance payment matter? Experience from a randomized trial.](https://www.sutterhealth.org/research/publications/frequency-of-pay-for-performance-payments-1055312614) Chung S, Palaniappan L, Wong E, Rubin HR, and Luft HS. Health Serv Res 45(2):553-64. doi: 10.1111/j.1475-6773.2009.01072.x. Epub 2009 Dec 31. 2010 Apr 01 - Publication ### [Health care for the working poor: from focus groups to state policy.](https://www.sutterhealth.org/research/publications/healthcare-wking-poor-focus-grps-state-policy-1055312329) Tierney WM, Kinney ED, Tai-Seale M, Greene JY, Murray R, Latondress T. J Investig Med. 46(7):279A. 1998 Jul 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/effort-to-spread-decision-aids-in-5-pcp-practices-1055312691#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":"Spreading decision aids in primary care."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/effort-to-spread-decision-aids-in-5-pcp-practices-1055312691#medicalscholarlyarticle","name":"An effort to spread decision aids in five California primary care practices yielded low distribution, highlighting hurdles.","headline":"Spreading decision aids in primary care.","abstract":"Despite the proven efficacy of decisionaids as interventions for increasing patient engagement and facilitating shared decision making, they are not used routinely in clinical care. Findings from a project designed to achieve such integration, conducted at fiveprimarycarepractices in 2010-12, document low rates of distribution of decisionaids to eligible patients due for colorectal cancer screening (9.3 percent) and experiencing back pain (10.7 percent). There were also no lasting increases in distribution rates in response to training sessions and other promotional activities for physicians and clinic staff. The results of focus groups, ethnographic field notes, and surveys suggest that major structural and cultural changes in health care practice and policy are necessary to achieve the levels of use of decisionaids and shared decision making in routine practice envisioned in current policy. 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