JMIR Publications

ABSTRACT

Background:

Women and girls around the world face significant barriers to participating in healthcare decisions, particularly in low- and middle-income countries. Despite growing interest in shared decision-making (SDM), little is known about its implementation in these countries and no rigorous assessment of the decision-making needs of women and girls in these contexts has been conducted. There is a lack of SDM trainings and decision-support tools (DSTs) specifically designed for this population.

Objective:

We aim to co-develop an SDM resource platform, including locally relevant DSTs and instructional materials, to support SDM with women and girls in Brazil, Cameroon, Rwanda and Senegal.

Methods:

We will conduct a four-phase participatory research project. We will use the Gender-based Analysis Plus (GBA Plus) tool to support inclusive participatory research throughout the study. First, we will follow the Integrated Knowledge Mobilization framework to form a local steering committee in each country, including patients and community representatives, health and social service professionals, and decision makers. Second, we will follow the Ottawa Decision Support Framework to conduct individual interviews or focus groups to identify the decision-making needs of women and girls. We will include 20 women and girls, along with their family members, 15 health and social service professionals, and 15 representatives of community-based organizations in each country (n = 150). The Double Diamond human-centered design framework will be used to co-develop the SDM resource platform. Finally, we will assess the scalability of the resource platform using the Innovation Scalability Self-Administrated Questionnaire (ISSaQ 4.0). We will report our study using the Standards for Reporting Qualitative Research (SRQR) guideline and the Guidance for Reporting Involvement of Patients and the Public (GRIPP-2).

Results:

The local steering committees will ensure equitable partnerships and a co-construction approach. The SDM resource platform, adapted to the contexts of Brazil, Cameroon, Rwanda and Senegal, should promote more inclusive approaches to SDM worldwide. The scalability assessment will help us reflect on expanding the impact of the platform to other regions.

Conclusions:

Ultimately, more women and girls from low- and middle-income countries will be involved in healthcare decisions and more clinical teams will be able to integrate SDM into their care practices.