Supporting Shared Decision-making for Children’s Complex Behavioral Problems: Development and User Testing of an Option Grid™ Decision Aid
- 138 Downloads
There is a lack of research to guide collaborative treatment decision-making for children who have complex behavioral problems, despite the extensive use of mental health services in this population. We developed and pilot-tested a one-page Option Grid™ patient decision aid to facilitate shared decision-making for these situations. An editorial team of parents, child psychiatrists, researchers, and other stakeholders developed the scope and structure of the decision aid. Researchers included information about a carefully chosen number of psychosocial and pharmacological treatment options, using descriptions based on the best available evidence. Using semi-structured qualitative interviews (n = 18), we conducted user testing with four parents and four clinical prescribers and field testing with four parents, four clinical prescribers, and two clinic administrators. The researchers coded and synthesized the interview responses using mixed inductive and deductive methods. Parents, clinicians, and administrators felt the Option Grid had significant value, although they reported that additional training and other support would be required in order to successfully implement the Option Grid and achieve shared decision-making in clinical practice.
KeywordsBehavioral disorders Children Child psychiatry Shared decision making Children’s mental health Decision aid
This project was funded by the Department of Psychiatry, Geisel School of Medicine at Dartmouth, Gary Tucker Junior Investigator Research Award.
- Brinkman, W. B., Hartl Majcher, J., Poling, L. M., Shi, G., Zender, M., Sucharew, H., & Epstein, J. N. (2013). Shared decision-making to improve attention-deficit hyperactivity disorder care. Patient Education and Counseling, 93(1), 95–101. doi:10.1016/j.pec.2013.04.009.CrossRefPubMedPubMedCentralGoogle Scholar
- Connor, D. F., Carlson, G. A., Chang, K. D., Daniolos, P. T., Ferziger, R., & Findling, R. L. (2006). Juvenile maladaptive aggression: A review of prevention, treatment, and service configuration and a proposed research agenda. The Journal of Clinical Psychiatry, 67(5), 808–820.CrossRefPubMedGoogle Scholar
- Delman, J., Clark, J., Eisen, S., & Parker, V. (2015). Facilitators and barriers to the active participation of clients with serious mental illnesses in medication decision making: The perceptions of young adult clients. The Journal of Behavioral Health Services & Research, 42(2), 238–253. doi:10.1007/s11414-014-9431-x.CrossRefGoogle Scholar
- Durand, M. A., Alam, S., Grande, S. W., & Elwyn, G. (2016). ‘Much clearer with pictures’: Using community-based participatory research to design and test a Picture Option Grid for underserved patients with breast cancer. BMJ Open, 6(2), e010008. doi:10.1136/bmjopen-2015-010008.CrossRefPubMedPubMedCentralGoogle Scholar
- Elwyn, G., O’Connor, A., Stacey, D., Volk, R., Edwards, A., Coulter, A., & Whelan, T. (2006). Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ, 333(7565), 417. doi:10.1136/bmj.38926.629329.AE.CrossRefPubMedPubMedCentralGoogle Scholar
- Elwyn, G., Pickles, T., Edwards, A., Kinsey, K., Brain, K., Newcombe, R. G., & Wood, F. (2016). Supporting shared decision making using an Option Grid for osteoarthritis of the knee in an interface musculoskeletal clinic: A stepped wedge trial. Patient Education and Counseling, 99(4), 571–577. doi:10.1016/j.pec.2015.10.011.CrossRefPubMedGoogle Scholar
- Garland, A. F., Hough, R. L., McCabe, K. M., Yeh, M., Wood, P. A., & Aarons, G. A. (2001). Prevalence of psychiatric disorders in youths across five sectors of care. Journal of the American Academy of Child and Adolescent Psychiatry, 40(4), 409–418. doi:10.1097/00004583-200104000-00009.CrossRefPubMedGoogle Scholar
- Grim, K., Rosenberg, D., Svedberg, P., & Schon, U. K. (2016). Shared decision-making in mental health care-A user perspective on decisional needs in community-based services. International Journal of Qualitative Studies on Health and Well-being, 11, 30563. doi:10.3402/qhw.v11.30563.CrossRefGoogle Scholar
- Hansson, L., Jormfeldt, H., Svedberg, P., & Svensson, B. (2013). Mental health professionals’ attitudes towards people with mental illness: Do they differ from attitudes held by people with mental illness? The International Journal of Social Psychiatry, 59(1), 48–54. doi:10.1177/0020764011423176.CrossRefPubMedGoogle Scholar
- Lambert, L., Friedman, E., Jerz, M., & Hacker, K. (2008). Medications & choices: The perspectives of family and youth. What parents and children tell us about psychiatric medications. Cambridge MA: Institute for Community Health.Google Scholar
- Trevena, L. J., Zikmund-Fisher, B. J., Edwards, A., Gaissmaier, W., Galesic, M., Han, P. K., & Woloshin, S. (2013). Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers. BMC Medical Informatics and Decision Making, 13(2), S7. doi:10.1186/1472-6947-13-s2-s7.CrossRefPubMedPubMedCentralGoogle Scholar