Shared decision-making about colorectal cancer screening: A conceptual framework to guide research

Abstract Objective To develop a conceptual framework to guide research on shared decision-making about colorectal cancer (CRC) screening among persons at average risk and their providers. Methods Based upon a comprehensive review of empirical literature and relevant theories, a conceptual framework was developed that incorporated patient characteristics, cultural beliefs, provider/health care system variables, health belief/knowledge/stage of adoption variables, and shared decision-making between patients and providers that may predict behavior. Relationships among concepts in the framework, shared decision-making process and outcomes, and CRC screening behavior were proposed. Directions for future research were presented. Results Many of the concepts in the proposed framework have been examined in prior research. However, these elements have not been combined previously to explain shared decision-making about CRC screening. Conclusion Research is needed to test the proposed relationships and hypotheses and to refine the framework. Practice Implications Findings from future research guided by the proposed framework may inform clinical practice to facilitate shared decision-making about CRC screening.