Abstract
260 Implementing telehealth decision coaching delivered by patient navigators for lung cancer screening
BMJ evidence-based medicine, Vol.29(Suppl 1), pp.A123-A123
07/01/2024
DOI: 10.1136/bmjebm-2024-SDC.259
Abstract
IntroductionTo overcome barriers to implementing mandated shared decision-making (SDM) visits for lung cancer screening (LCS), we evaluated telehealth decision coaching delivered by trained lay navigators in a cluster randomized trial. Delivering SDM with high fidelity is essential to ensuring that patients make informed LCS decisions.MethodsRecordings of coaching sessions were coded for fidelity by two independent raters. A checklist was used to evaluate navigators’ skills in three areas – 1) telehealth technical skills (4 items coded as Yes/No, e.g., shared/stopped sharing their screen), 2) content of SDM conversations (16 items coded as Yes/No, e.g., addressed benefits and harms), and 3) decision coaching skills (6 items coded as Not at All, Somewhat, or Very, e.g., following-up on patient’s concerns, checking patient’s understanding of content).ResultsWe analyzed 30 decision coaching sessions conducted by eight navigators. Navigators initially had technical problems that required additional training, such as not sharing the correct screen. In most sessions (n=28), navigators accurately covered the content. However, 2 navigators skipped information resulting in omission of key facts (e.g. importance of not smoking). In 56.7% of the sessions (n=17), navigators accomplished all decision coaching skills. Common weaknesses included not validating patient’s concerns, not probing for information, and not presenting a balance of benefits and harms. Navigators sometimes relied on conventional wisdom (e.g., early detection is always best) rather than following the script when answering questions.DiscussionLay navigators can educate patients on key facts of LCS with good fidelity as long as they followed the script. There was more variation in decision coaching skills. Training navigators to present a balance of benefits and harms for LCS is essential to overcome conventional wisdom about screening.ConclusionsLay navigators can deliver telehealth decision coaching with high fidelity using a script with support and training.
Details
- Title: Subtitle
- 260 Implementing telehealth decision coaching delivered by patient navigators for lung cancer screening
- Creators
- Naomi TanElisa DouglasRichard HoffmanAnita KinneyRobert VolkLisa Lowenstein
- Resource Type
- Abstract
- Publication Details
- BMJ evidence-based medicine, Vol.29(Suppl 1), pp.A123-A123
- Publisher
- BMJ Publishing Group LTD
- DOI
- 10.1136/bmjebm-2024-SDC.259
- ISSN
- 2515-446X
- eISSN
- 2515-4478
- Language
- English
- Date published
- 07/01/2024
- Academic Unit
- General Internal Medicine; Internal Medicine
- Record Identifier
- 9984699050802771
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