Shared decision-making about colorectal cancer screening: a conceptual framework to guide research

Patient Educ Couns. 2013 Jun;91(3):310-7. doi: 10.1016/j.pec.2013.01.015. Epub 2013 Feb 15.


Objective: To develop a conceptual framework to guide research on shared decision-making about colorectal cancer (CRC) screening among persons at average risk and their providers.

Methods: Based upon a comprehensive review of empirical literature and relevant theories, a conceptual framework was developed that incorporated patient characteristics, cultural beliefs, provider/health care system variables, health belief/knowledge/stage of adoption variables, and shared decision-making between patients and providers that may predict behavior. Relationships among concepts in the framework, shared decision-making process and outcomes, and CRC screening behavior were proposed. Directions for future research were presented.

Results: Many of the concepts in the proposed framework have been examined in prior research. However, these elements have not been combined previously to explain shared decision-making about CRC screening.

Conclusion: Research is needed to test the proposed relationships and hypotheses and to refine the framework.

Practice implications: Findings from future research guided by the proposed framework may inform clinical practice to facilitate shared decision-making about CRC screening.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / therapy
  • Decision Making*
  • Diffusion of Innovation
  • Early Detection of Cancer / psychology*
  • Female
  • Guidelines as Topic*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Mass Screening / psychology
  • Outcome and Process Assessment, Health Care
  • Patient Participation / psychology*
  • Physician-Patient Relations*
  • Socioeconomic Factors