Grant: Travel Awards - Institute Community Support

Shared Decision Making (SDM) is a process whereby clinicians and patients relate to and influence each other to make healthcare choices that are informed by the best evidence and by what matters to the patient. Despite the potential that SDM offers there is a lack of evidence about effective integration into practice. Research recently completed by our team examining SDM literature provides insight into the complexity of this intervention through the design of a program theory. This program theory highlights 10 interconnected mechanisms that explain how SDM works and for whom that can be applied across a range of contexts. Through additional research Dr. Groot performed, it has become apparent that two of these mechanisms, trust and worldview, have an amplified importance with Indigenous patients. Interviews conducted by Dr. Groot indicates that issues of trust, stemming from Indigenous experiences with colonization and residential school experiences, often impact Indigenous people's ability and/or interest to engage with a health care provider in SDM. This analysis also confirms the existence of an identifiable Indigenous worldview (3) that includes, at minimum, the reality that Indigenous perspectives of health and healing are diverse and frequently combine components of both Western and traditional ways of healing. The purpose of this study is to reveal how, why, and under what circumstances patients from Indigenous backgrounds make decisions in complex medical situations. The principal objective of this study is to evaluate our decision-making framework about medical decision making between patients and health providers. This session will outline the initial development of our program theory, adaptation through our Indigenous interviews, and will outline how we will evaluate our decision framework in a naturalistic setting.