Education Events Patient Care

Researchers Seek to Improve How Patients and Care Teams Make Decisions

Mary Politi by staircase in Farrell Teaching and Learning Center at Washington University in St. Louis

The Center for Collaborative Care Decisions (CCCD) is home to a team of researchers and community collaborators with an admirable mission: to improve the quality of health decisions and advance health equity. Led by members of the Division of Public Health Sciences at Washington University School of Medicine in St. Louis, the Center engages patients and the public using clear communication, quality evidence and patient-centered goals of care.

The Center further advocates for these causes by educating and training physicians and researchers in the latest approaches to delivering and evaluating decision support, most recently in a bootcamp conducted by CCCD leadership and supported by the Institute for Public Health and the Foundation for Barnes-Jewish Hospital.

Shared Decision Making

The bootcamp, titled “Shared Decision Making: From Public Health to Clinical Care,” was a milestone event for the program.

William Powderly, MD, who is the Larry J. Shapiro Director of the Institute for Public Health at Washington University, opened the bootcamp with a statement about the program. “We get better outcomes and long-term evaluation and impact on patient’s health by having the community and the patients involved in decision making.”

Keynote presentations were given by Paul Han, MD, MA, MPH, from the National Cancer Institute, and Angela Fagerlin, PhD, of the University of Utah School of Medicine and the Salt Lake City VA. Han researches the understanding and improvement of communication of uncertainty in health care. His seminar discussed uncertainty management as a new direction in shared decision making. Fagerlin studies the factors that affect people’s perception of risks and improving risk communication as well as decision aids. During the bootcamp, her lecture focused on communicating about relevant public health issues including influenza and COVID-19.

The bootcamp attracted attendees from across Washington University, Barnes-Jewish Hospital, regional, national and international institutions.

Leadership in Collaborative Care

Mary C. Politi, PhD, who serves as director of the Center for Collaborative Care Decisions, is a health psychologist and behavioral scientist with research focused on health communication and shared decision-making. Politi’s work helps patients and the public understand health information, explore what is important to them when making health decisions and collaborate to make evidence-informed decisions that meet their needs.

“Most people are frequently faced with health choices and have to navigate through the vast amount of information available on the Internet, from their social networks, and from their health care team,” says Politi. “Our goal is to help make that process easier and more transparent so people feel confident in the choices they make.”

Ashley Housten, OTD, MSCI, OTR/L, serves as CCCD co-director and specializes in shared decision making through the lens of occupational therapy. Housten’s research focuses on the dissemination and implementation of decision support tools to improve health behaviors and outcomes, particularly among populations that experience health-related inequity.

Clinical and research advisors also make up part of the team at the Center. The Community Advisory Board (CAB) further contributes to decisions and administration.

“Engaging with our CAB has helped our Center shape and advance our research questions in a way that is meaningful and relevant to our community partner,” says Housten.

Stakeholder engagement is a core principle of the Center’s work. Including end users like patients and clinicians when designing, testing, implementing and disseminating work ensures that the tools and resources meet the needs of all involved. Collaborators at the Center include stakeholders of broad representation and diverse backgrounds. They also work to compensate stakeholder communities for their time and engagement in way that is fair, equitable and consistent across people.

The Mission

From clinical to public health projects, members of the center have developed numerous projects to improve health equity and health decision making. The Center provides research and clinical resources related to shared decision making and patient decision aids.

Collaborative projects are at the crux of the learning and knowledge-making at the Center. Current projects include shared decision making about stage I lung cancer treatment, shared decision making about early stage rectal cancer, implementing shared decision making for breast cancer and understanding the financial burden of care among black men making prostate cancer treatment choices. These research endeavors seek to improve the way that health decisions are made and thus increase positive outcomes over a range of clinical and public health issues.

The Center has multiple cutting-edge resources for training, development and implementation that are valuable to both clinicians and patients. It offers training programs and external resources for providers seeking to better understand or implement the process of shared decision-making into their practice. The Center also provides research guidance for those looking to develop their own projects on the impact of shared decision making, decision aids, or other measures of patient-centered care intervention and education.

Learn more about the Center for Collaborative Care Decisions here.