TY - JOUR
T1 - Co-designing a theory-informed intervention to increase shared decision-making in maternity care
AU - Waddell, Alex
AU - Spassova, Gerri
AU - Sampson, Louise
AU - Jungbluth, Lena
AU - Dam, Jennifer Louise
AU - Bragge, Peter
N1 - Funding Information:
A.W. is supported by a research higher degree scholarship jointly funded by the Australian Government Research Training Program and Safer Care Victoria. Beyond funding support, the funders had no direct role in the study design, data collection, analysis, interpretation or writing of the manuscript. L.S. was employed by the Royal Women’s Hospital at the time of the study, but they were not involved in data analysis. All other authors declare no competing interests.
Funding Information:
The authors gratefully acknowledge the participants of this study. The authors would like to thank Royal Women’s Hospital for their ongoing support, especially the clinicians and staff in maternity care. We would like to thank Lidia Horvat for her useful discussion and support and Safer Care Victoria. We would also like to thank the reviewers for their comments and suggestions.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/1/31
Y1 - 2023/1/31
N2 - Background: Shared decision-making (SDM) has been shown to improve healthcare outcomes and is a recognized right of patients. Policy requires health services to implement SDM. However, there is limited research into what interventions work and for what reasons. The aim of the study was to develop a series of interventions to increase the use of SDM in maternity care with stakeholders. Methods: Interventions to increase the use of SDM in the setting of pregnancy care were developed using Behaviour Change Wheel and Theoretical Domains Framework and building on findings of an in-depth qualitative study which were inductively analysed. Intervention development workshops involved co-design, with patients, clinicians, health service administrators and decision-makers, and government policy makers. Workshops focused on identifying viable SDM opportunities and tailoring interventions to the local context (the Royal Women’s Hospital) and salient qualitative themes. Results: Pain management options during labour were identified by participants as a high priority for application of SDM, and three interventions were developed including patient and clinician access to the Victorian Government’s maternity record via the patient portal and electronic medical records (EMR); a multi-layered persuasive communications campaign designed; and clinical champions and SDM simulation training. Factors identified by participants for successful implementation included having alignment with strategic direction of the service, support of leaders, using pre-standing resources and workflows, using clinical champions, and ensuring equity. Conclusion: Three interventions co-designed to increase the use of SDM for pain management during labour address key barriers and facilitators to SDM in maternity care. This study exemplifies how health services can use behavioural science and co-design principles to increase the use of SDM. Insights into the co-design of interventions to implement SDM in routine practice provide a framework for other health services, policy makers and researchers.
AB - Background: Shared decision-making (SDM) has been shown to improve healthcare outcomes and is a recognized right of patients. Policy requires health services to implement SDM. However, there is limited research into what interventions work and for what reasons. The aim of the study was to develop a series of interventions to increase the use of SDM in maternity care with stakeholders. Methods: Interventions to increase the use of SDM in the setting of pregnancy care were developed using Behaviour Change Wheel and Theoretical Domains Framework and building on findings of an in-depth qualitative study which were inductively analysed. Intervention development workshops involved co-design, with patients, clinicians, health service administrators and decision-makers, and government policy makers. Workshops focused on identifying viable SDM opportunities and tailoring interventions to the local context (the Royal Women’s Hospital) and salient qualitative themes. Results: Pain management options during labour were identified by participants as a high priority for application of SDM, and three interventions were developed including patient and clinician access to the Victorian Government’s maternity record via the patient portal and electronic medical records (EMR); a multi-layered persuasive communications campaign designed; and clinical champions and SDM simulation training. Factors identified by participants for successful implementation included having alignment with strategic direction of the service, support of leaders, using pre-standing resources and workflows, using clinical champions, and ensuring equity. Conclusion: Three interventions co-designed to increase the use of SDM for pain management during labour address key barriers and facilitators to SDM in maternity care. This study exemplifies how health services can use behavioural science and co-design principles to increase the use of SDM. Insights into the co-design of interventions to implement SDM in routine practice provide a framework for other health services, policy makers and researchers.
KW - Co-design
KW - Health policy research
KW - Health service research
KW - Hospital accreditation
KW - Maternity care
KW - Shared decision-making
UR - http://www.scopus.com/inward/record.url?scp=85147140487&partnerID=8YFLogxK
U2 - 10.1186/s12961-023-00959-x
DO - 10.1186/s12961-023-00959-x
M3 - Article
C2 - 36721156
AN - SCOPUS:85147140487
SN - 1478-4505
VL - 21
JO - Health Research Policy and Systems
JF - Health Research Policy and Systems
IS - 1
M1 - 15
ER -