Development of an adjective-selection measure evaluating clinicians’ attitudes towards using patient decision aids: The ADOPT measure

Background: The implementation of shared decision-making and patient decision aids (PDAs) is impeded by clinicians’ attitudes. Objective: To develop a measure of clinician attitude towards PDAs. Methods: To develop the ADOPT measure, we used four stages, culminating in measure responses by medically qualified clinicians, 25 from each of the following specialties: emergency medicine, family medicine, oncology, obstetrics and gynaecology, orthopaedics, and psychiatry. To assess validity, we also posed three questions to assess the participants’ attitudinal and behavioural endorsement of PDAs. Allocating a point per adjective, we calculated the sum as well as positive and negative scores. We used univariate logistic regression to determine associations between the scores and attitudinal or behavioural endorsements. Results: 152 clinicians completed the measure. ‘Time-saving’ (39%) and ‘easy’ (34%) were the most frequently selected adjectives. ‘Time-consuming’ and ‘unfamiliar’ were the most frequently selected negative adjectives (both 19%). The sum scores were significantly associated with behavioural endorsement of PDAs. Discussion: Clinicians were able to respond to adjective-selection methods and the ADOPT measure could help assess clinician attitudes to PDAs. Validation will require further research. Practice implications: The ADOPT measure could help identify the extent and source of attitudinal resistance.