Refining a primary care shared decision-making aid for lifestyle change: a mixed-methods study

Neil Heron, Seán R O'Connor, Frank Kee, David R Thompson, Margaret Cupples, Michael Donnelly

Research output: Contribution to journalArticlepeer-review


BACKGROUND: The important role of primary care in promoting healthy lifestyle behaviours needs informed support.

AIM: To elicit views on a 39-item shared decision-making (SDM) aid (SHARE-D) for lifestyle change and refine it to improve implementation.

DESIGN & SETTING: Mixed-methods study.

METHOD: Health professionals, patients, and support workers, with experience of managing or a history of cardio- or cerebrovascular disease, were purposively recruited based on age, sex, and urban/rural location (n = 34). Participants completed a survey, rating the importance of including each item in a decision-aid, designed for use by patients with health professionals, and suggesting modifications. Semi-structured interviews (n = 30/34) were conducted and analysed thematically.

RESULTS: Substantial agreement was observed on rating item inclusion. Based on survey and interview data, 9/39 items were removed; 13 were amended. Qualitative themes were: 1) core content of the decision-aid; 2) barriers to use; 3) motivation for lifestyle change; and 4) primary care implementation. 'Self-reflective' questions and goal setting were viewed as essential components. The paper-based format, length, clarity, and time required were barriers to its use. Optional support considered within the aid was seen as important to motivate change. A digital version, integrated into patient record systems was regarded as critical to implementation. A revised 30-item aid was considered suitable for facilitating brief conversations and promoting patient autonomy.

CONCLUSION: The SHARE-D decision aid for healthy lifestyle change appears to have good content validity and acceptability. Survey and interview data provided in-depth information to support implementation of a refined version. Further studies should examine its effectiveness.

Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalBritish Journal of General Practice Open (BJGP Open)
Issue number1
Publication statusPublished (in print/issue) - 22 Mar 2022

Bibliographical note

Copyright © 2022, The Authors.


  • decision making
  • shared
  • lifestyle
  • primary care
  • general practice


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