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047 Reframing SDM: is it an intervention or a strategy?
  1. Marla Clayman1,
  2. Rani Elwy2,
  3. Jason Vassy1
  1. 1Choir, Veterans Affairs – United States of America
  2. 2Brown University – United States of America

Abstract

Introduction Implementation science is a research field concerned with how to best ensure adoption and sustained integration of evidence-based practices into health systems. Shared decision making (SDM) researchers and practitioners have increasingly turned to implementation science to foster its widespread adoption. However, SDM initiatives can also be seen as strategies to increase patient engagement in care or implementation of other evidence-based practices, such as vaccinations or cancer screenings.

Methods In implementation science, ‘strategies’ can be complex and multi-faceted, such as capacity- building, skills trainings, and leadership initiatives. In projects aimed at implementing patient-centered, evidence-based care, components that are typically seen as SDM interventions may be reframed as strategies that encourage uptake of guidelines or policies that recommend patient engagement.

Results In this presentation, we will delineate and describe how and when researchers might want to consider SDM as an implementation strategy rather than an intervention itself. Much as a variable can be independent or dependent in a statistical analysis, according to the research question at hand, we will use examples from implementation science frameworks to advance our understanding of the roles SDM can play in larger implementation efforts.

Among these, we will present a current project that utilizes Intervention Mapping as a framework for iteratively developing implementation and evaluation plans for introducing precision cancer screening in the form of polygenic risk scores.

Discussion/Conclusions Implementation science can help SDM become more widely adopted and should be used more frequently in larger-scale SDM work. Moreover, SDM can be thought of as a strategy rather than an intervention on its own, and this may accelerate achievement of patient- centered decisions into the mainstream.

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