ArticleImplementation science : IS2019
Investigation of factors influencing the implementation of two shared decision-making interventions in contraceptive care: a qualitative interview study among clinical and administrative staff.
Article in Implementation science : IS, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
20 citing papers in PubMed, 53 citations in OpenAlex.
- Implementation and sustainability factors of two early-stage breast cancer conversation aids in diverse practices.Implementation science : IS · 2021Trial
- Patient Decision Aids into Routine Orthopedic Care: Results from an Implementation Study at 12 Sites.Medical decision making : an international journal of the Society for Medical Decision Making · 2026Article
- Barriers to contraception access and use among youth: A scoping review in high-income countries.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Mapping policies, regulations, and practice supports for medical office assistants in primary care: a scoping review.BMC primary care · 2026Article
- Challenges and coping practices of frontline health workers in newly created districts in Uganda: an exploratory qualitative study.BMJ open · 2025Article
- Article
- Provider perspectives on a point-of-care tool to facilitate patient-centered contraceptive care among Latina/x patients in Baltimore, MD.PEC innovation · 2023Article
- Moving behavioral interventions in nursing homes from planning to action: a work system evaluation of a urinary tract infection toolkit implementation.Implementation science communications · 2023Article
- The Implementation in Context (ICON) Framework: A meta-framework of context domains, attributes and features in healthcare.Health research policy and systems · 2023Article
- Strategies to improve interpersonal communication along the continuum of maternal and newborn care: A scoping review and narrative synthesis.PLOS global public health · 2023Article
- When opinions differ: the development of a reflection tool for youth professionals to support shared decision-making with parents.European journal of social work · 2023Article
- Acceptability and perceived feasibility of adapted encounter decision aids on contraceptive methods: An interview study with healthcare providers and Chinese migrant women.PEC innovation · 2022Article
- Community pharmacists' views on providing a reproductive health service to women receiving opioid substitution treatment: A qualitative study using the TDF and COM-B.Exploratory research in clinical and social pharmacy · 2021Article
- Contraceptive counselling experiences in Spain in the process of creating a web-based contraceptive decision support tool: a qualitative study.Reproductive health · 2021Article
- Article
- What Works in Implementing Patient Decision Aids in Routine Clinical Settings? A Rapid Realist Review and Update from the International Patient Decision Aid Standards Collaboration.Medical decision making : an international journal of the Society for Medical Decision Making · 2021Review
- Contraception and Reproductive Planning for Women With Cardiovascular Disease: JACC Focus Seminar 5/5.Journal of the American College of Cardiology · 2021Review
- Article
- How Shared Is Shared Decision Making? Reaching the Full Potential of Patient-Clinician Collaboration in Mental Health.Harvard review of psychiatryArticle
- The SHARED Project: A Novel Approach to Engaging African American Men to Address Lung Cancer Disparities.American journal of men's healthArticle
Corrections and comments
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Authors and funding
18 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is limited evidence on how to implement shared decision-making (SDM) interventions in routine practice. We conducted a qualitative study, embedded within a 2 × 2 factorial cluster randomized controlled trial, to assess the acceptability and feasibility of two interventions for facilitating SDM about contraceptive methods in primary care and family planning clinics. The two SDM interventions comprised a patient-targeted intervention (video and prompt card) and a provider-targeted intervention (encounter decision aids and training).
methodsParticipants were clinical and administrative staff aged 18 years or older who worked in one of the 12 clinics in the intervention arm, had email access, and consented to being audio-recorded. Semi-structured telephone interviews were conducted upon completion of the trial. Audio recordings were transcribed verbatim. Data collection and thematic analysis were informed by the 14 domains of the Theoretical Domains Framework, which are relevant to the successful implementation of provider behaviour change interventions.
resultsInterviews (n = 29) indicated that the interventions were not systematically implemented in the majority of clinics. Participants felt the interventions were aligned with their role and they had confidence in their skills to use the decision aids. However, the novelty of the interventions, especially a need to modify workflows and change behavior to use them with patients, were implementation challenges. The interventions were not deeply embedded in clinic routines and their use was threatened by lack of understanding of their purpose and effect, and staff absence or turnover. Participants from clinics that had an enthusiastic study champion or team-based organizational culture found these social supports had a positive role in implementing the interventions.
conclusionsVariation in capabilities and motivation among clinical and administrative staff, coupled with inconsistent use of the interventions in routine workflow contributed to suboptimal implementation of the interventions. Future trials may benefit by using implementation strategies that embed SDM in the organizational culture of clinical settings.
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