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Evaluating Interventions to Support Child-Parent Involvement in Health Decisions

This systematic review explores interventions that support children in making health-related decisions and evaluates their effectiveness. It also includes a pilot study on decision coaching for children and parents considering insulin options for type 1 diabetes management.

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Evaluating Interventions to Support Child-Parent Involvement in Health Decisions

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  1. Evaluating Interventions to Support Child-Parent Involvement in Health Decisions Bryan G. Feenstra, RN, MScN Committee: Dawn Stacey Margaret Lawson Denise Harrison

  2. Systematic Review Feenstra et al., 2014, BMC Pediatrics Objective To explore the characteristics and effectiveness of interventions that support the decision making needs of children who are actively considering a health-related decision.

  3. Feenstra et al., 2014, BMC Pediatrics

  4. Systematic Review: Results Feenstra et al., 2014, BMC Pediatrics Study Selection

  5. Systematic Review: Studies included Feenstra et al., 2014, BMC Pediatrics

  6. Pilot Study Objective To evaluate the feasibility and acceptability of decision coaching for children and parents considering insulin options for type 1 diabetes management. Insulin pump vs. standard insulin therapy, vs. multiple daily injections for management of type 1 diabetes

  7. What is decision coaching? • Develops patients’ skills in: - thinking/deliberating about options - preparing for a consultation - implementing change • Coaches are trained to be supportive but non-directive (O’Connor et al., 2008; Stacey et al., 2008; 2013)

  8. Medical Decision Making, 2012 Coaching (n=10 trials): • improved knowledge compared to usual care • improved knowledge similar to decision aid group • improved or no difference on other outcomes (values-choice agreement, satisfaction, participation, costs)

  9. Pilot Study: Results

  10. Pilot Study: Results

  11. Summary of findings • Decision Support studies with children • Few available studies compared to adult population • First intervention to support multiple stakeholders • Complexities of dyad/triad relationship • Differences between parents and children • Success of interventions with younger participants • Minimal missing info • Children as young as 9 years • BUT must target them sooner in the decision making process

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