Evaluation of the Choosing Wisely Australia® 5 Questions resource and a shared decision-making preparation video: Protocol for an online experiment

This study seeks to compare the relative effectiveness of multiple shared decision making interventions (1: a preparation video alone vs. 2: enablement intervention alone vs. 3: preparation video and enablement intervention vs. 4: no intervention) on consumer outcomes. It will also assess whether the level of health literacy (adequate or inadequate) will impact the two primary outcomes: the intention and the self-efficacy of participants to use shared decision making. Participants will be randomised into one of four intervention groups using randomisation embedded in Qualtrics, stratified by level of health literacy. Each participant will then be randomly assigned to one of the four interventions and asked to complete an online questionnaire based around a hypothetical healthcare scenario to measure primary and secondary outcomes in regard to use of shared decision making. Mixed qualitative and quantitative methods will be used. Using Qualtrics to monitor link usage, we will assess the proportion of participants who click on a link to their intervention at 2-weeks follow-up. PREVENTION INTERVENTION The preparation intervention is a short 3 minute video we developed, which will be given to survey participants via a link. Participants will have access to the video once within the post-intervention survey and only permitted to progress with the intervention once 3 minutes have elapsed to ensure adherence. The preparation video script was developed via an iterative process drawing upon existing shared decision making literature to inform, encourage and clarify the rights of participants to engage in this process. ENABLEMENT INTERVENTION The enablement intervention is a question prompt list developed by Choosing Wisely Australia. It will be included in single page graphic form within the survey given to participants. Participants will only be permitted to progress with the intervention once a minute has elapsed to ensure adherence. The question prompt list consists of five questions which patients can ask their healthcare professionals in order to make informed, shared decisions. The interventions will be displayed to participants within the survey platform. To ensure intervention exposure, a timer has been added to the pages displaying the video (3 minutes) and 5 Questions resource (1 minute), preventing participants from progressing to the next survey page until the specified time has elapsed. In the preparation video and 5 Questions resource arm, the video will be presented before the 5 Questions resource. Participants will not be prevented from exposure to any other care or interventions prior to or during the study.