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dc.contributor.authorSmith, SG
dc.contributor.authorPandit, A
dc.contributor.authorRush, SR
dc.contributor.authorWolf, MS
dc.contributor.authorSimon, CJ
dc.description.abstractStudies investigating preferences for shared decision making (SDM) have focused on associations with sociodemographic variables, with few investigations exploring patient factors. We aimed to investigate the relationship between patient activation and preferences for SDM in 6 common medical decisions among a nationally representative cross-sectional survey of American adults. Adults older than 18 were recruited online (n = 2,700) and by telephone (n = 700). Respondents completed sociodemographic assessments and the Patient Activation Measure. They were also asked whether they perceived benefit (yes/no) in SDM in 6 common medical decisions. Nearly half of the sample (45.9%) reached the highest level of activation (Level 4). Activation was associated with age (p <.001), higher income (p =.001), higher education (p =.010), better self-rated health (p <.001), and fewer chronic conditions (p =.050). The proportion of people who agreed that SDM was beneficial varied from 53.1% (deciding the necessity of a diagnostic test) to 71.8% (decisions associated with making lifestyle changes). After we controlled for participant characteristics, higher activation was associated with greater perceived benefit in SDM across 4 of the 6 decisions. Preferences for SDM varied among 6 common medical scenarios. Low patient activation is an important barrier to SDM that could be ameliorated through the development of behavioral interventions.
dc.description.sponsorshipFinancial support for this study was provided by a contract with UnitedHealthcare, Optum Institute. The funding agreement ensured our independence in designing the study, interpreting the data, and writing and publishing the report. Samuel G. Smith is supported by a Cancer Research UK Postdoctoral Fellowship (C42785=A17965). Carol J. Simon and Steven R. Rush are employed by the sponsor.en_US
dc.format.extent67 - 75
dc.rightsPublished with license by Taylor & Francis© Samuel G. Smith, Anjali Pandit, Steven R. Rush, Michael S. Wolf, and Carol J. Simon This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The moral rights of the named author(s) have been asserted.
dc.titleThe role of patient activation in preferences for shared decision making: Results from a national survey of U.S. Adults
dc.typeJournal Article
dc.relation.isPartOfJournal of Health Communication
dc.relation.isPartOfJournal of Health Communication
pubs.organisational-group/Queen Mary University of London
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry/Wolfson Institute of Preventive Medicine
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry/Wolfson Institute of Preventive Medicine/Centre for Cancer Prevention

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