Background: Shared decision making (SDM) has been advocated by health researchers and policy-makers as a model to provide patient-centered care and increase patient knowledge, satisfaction, and adherence. Little is known about ethnic differences in SDM preferences, and no research has examined Hispanics' SDM preferences in the transplant context. We present preliminary findings from a multi-site study assessing Hispanic potential kidney transplant recipients' and living donors' preferences and experiences of SDM, and their associations with acculturation and ethnic identity.

Methods: Telephone surveys were conducted with Hispanic potential kidney transplant recipients and donors at Northwestern Memorial in Chicago, IL and Baylor University Medical Center in Dallas, TX. Validated surveys measured SDM using the Control Preference Scale (CPS) and the 9-item Shared Decision Making Questionnaire (SDM-Q-9). Acculturation and ethnic identity were measured using the Brief Acculturation Survey for Hispanics (BASH) and Scale of Ethnic Experience (SEE). Correlations assessed the relationship between SDM preferences and perceived SDM provided by the transplant surgeon, acculturation, and ethnic identity measures.

Results: To date, 11 potential recipients and 2 potential living donors participated (76% participation rate). Most participants were male (54%), of Mexican descent (85%), and were, on average, 55 years old. The mean scores for the CPS, SDM-Q-9, and BASH were 3.6 (1-5), 66 (0-100), and 6 (4-20). The SEE's scores (1-5) for the four factors (ethnic identity, perceived discrimination, mainstream comfort, and social affiliation) were 3.3, 3.2, 3.0, and 3.9, respectively. Most participants preferred a lesser role (69%) than the doctor in the decision making process, compared to an equal (15%) or greater role (23%). Preference for a lesser role in the SDM process was not associated with perceived SDM by the transplant surgeon (p=0.65), acculturation (p=0.86), ethnic identity (p=0.49), perceived discrimination (p=0.46), mainstream comfort (p=0.83), or social affiliation (p=0.92).

Conclusions: Our findings suggest that most Hispanics prefer to have a smaller role in SDM in the transplant context, irrespective of acculturation and ethnic experience. Transplant providers should assess patients' SDM preferences early in clinical care to provide optimal patient-centered care, facilitate decision making, and improve patient satisfaction.

CITATION INFORMATION: Alhalel N., Caicedo J., Ruiz R., Salazar A., Primeaux S., Gordon E. Hispanics' Perceptions of Shared Decision Making in the Transplant Context: A Mixed Methods Study Am J Transplant. 2017;17 (suppl 3).

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