Evaluation of the Choosing Wisely Australia 5 Questions resource and a shared decision-making preparation video: protocol for an online experiment

Danielle Marie Muscat; Edward Hoi-Fan Chang; Rachel Thompson; Erin Cvejic; Marguerite Tracy; Joshua Zadro; Jessica Kathleen Smith; Robyn Lindner; Kirsten McCaffery

doi:10.1136/bmjopen-2019-033126

Evaluation of the Choosing Wisely Australia 5 Questions resource and a shared decision-making preparation video: protocol for an online experiment

BMJ Open. 2019 Nov 14;9(11):e033126. doi: 10.1136/bmjopen-2019-033126.

Authors

Danielle Marie Muscat¹, Edward Hoi-Fan Chang², Rachel Thompson³, Erin Cvejic³, Marguerite Tracy², Joshua Zadro⁴, Jessica Kathleen Smith², Robyn Lindner⁵, Kirsten McCaffery³

Affiliations

¹ Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia danielle.muscat@sydney.edu.au.
² School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
³ Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
⁴ Institute for Musculoskeletal Health, School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia.
⁵ NPS Medicinewise, Strawberry Hills, New South Wales, Australia.

Abstract

Introduction: Choosing Wisely, an international effort to reduce low value care worldwide, considers communication between clinicians and patients during routine clinical encounters a key mechanism for change. In Australia, Choosing Wisely has developed a 5 Questions resource to facilitate better conversations. The primary aim of this study is to evaluate the impact of the Choosing Wisely Australia 5 Questions resource and a video designed to prepare patients for question-asking and participation in shared decision-making on (a) self-efficacy to ask questions and participate in shared decision-making, (b) intention to participate in shared decision-making and (c) a range of secondary outcomes. The secondary aim of this study is to determine whether participants' health literacy modifies the effects of the interventions.

Methods and analysis: We will use 2×2×2 between-subjects factorial design (preparation video: yes, no × Choosing Wisely 5 Questions resource: yes, no × health literacy: adequate, inadequate). Participants will be recruited by an online market research company, presented with a hypothetical non-specific low back pain scenario, and randomised to study groups stratified by health literacy. Quantitative primary and secondary outcome data will be analysed as intention-to-treat using appropriate regression models (ie, linear regression for continuous outcomes, logistic regression for dichotomous categorical outcomes).

Ethics and dissemination: Ethical approval for this study was obtained from the University of Sydney Human Research Ethics Committee (protocol number: 2018/965). The results from this work will be disseminated through peer-reviewed international journals, conferences and updates with collaborating public health bodies. Resources developed for this study will be made available to patients and clinicians following trial completion.

Trial registration number: This trial has been registered with the Australia New Zealand Clinical Trials Registry (trial number: 376477) and the stage is Pre-results.

Keywords: decision making; health literacy; medical overuse; patient participation; question prompt list; shared decision making.

Publication types

Clinical Trial Protocol
Research Support, Non-U.S. Gov't

MeSH terms

Australia
Communication*
Decision Making, Shared*
Health Literacy / methods*
Health Resources*
Humans
Randomized Controlled Trials as Topic
Telecommunications
Unnecessary Procedures