Using Option Grids: steps toward shared decision-making for neonatal circumcision.

OBJECTIVES

To assess the impact, acceptability and feasibility of a short encounter tool designed to enhance the process of shared decision-making and parental engagement.

METHODS

We analyzed video-recordings of clinical encounters, half undertaken before and half after a brief intervention that trained four clinicians how to use Option Grids, using an observer-based measure of shared decision-making. We also analyzed semi-structured interviews conducted with the clinicians four weeks after their exposure to the intervention.

RESULTS

Observer OPTION(5) scores were higher at post-intervention, with a mean of 33.9 (SD=23.5) compared to a mean of 16.1 (SD=7.1) for pre-intervention, a significant difference of 17.8 (95% CI: 2.4, 33.2). Prior to using the intervention, clinicians used a consent document to frame circumcision as a default practice. Encounters with the Option Grid conferred agency to both parents and clinicians, and facilitated shared decision-making. Clinician reported recognizing the tool's positive effect on their communication process.

CONCLUSIONS

Tools such as Option Grids have the potential to make it easier for clinicians to achieve shared decision-making.

PRACTICE IMPLICATIONS

Encounter tools have the potential to change practice. More research is needed to test their feasibility in routine practice.