Table 3 Factors for intervention success using the APEASE criteria
From: Co-designing a theory-informed intervention to increase shared decision-making in maternity care
APEASE criteria | Factors for interventions to increase success |
|---|---|
Acceptability | Cultural factors – specifically alignment with strategic direction, support of leaders across disciplines, and adopting clinical champions to act as role models – were felt to be critical enablers of success. Participants also felt it was crucial to consider both clinicians and patients when highlighting and measuring the benefits to both in terms of patient safety and other outcomes. A further key success factor identified was on-going co-design and co-ownership of interventions by stakeholders across the service |
Practicability | For interventions to be practical, participants felt they should work within the current systems of care. Participants spoke about the importance of using the EMR and Patient Portal to provide information to patients, become a communication channel between patients and clinicians and, importantly, have a shared record of SDM Participants felt it most practical to make changes to established ways of working, for example adding prompts to the EMR or adding additional information to informational videos. Any intervention would also need to align with information provided across the health service |
Affordability | Participants were sure that interventions would be most affordable to the Women’s if they were able to draw upon existing resources from a mix of different departments. This would allow budget restraints to be shared |
Effectiveness | Participants felt that departments having co-ownership of interventions would reduce the burden on any one department’s resources. They felt this would also reduce the siloed nature of implementation projects, which can contribute to failure of implementation Participants also highlighted that the interventions must be strengths based (i.e. highlight what clinicians are doing well, rather than what they are doing wrong or poorly) and aim to increase self-efficacy of clinicians in order to be successful. Messaging should also be consistent across all platforms |
Equity and side effects | Participants felt it was important to strike a balance between active (conversational) and passive (information provision) dimensions of SDM. Participants also emphasized the need for equitable access to interventions. For example, any information must be provided in languages other than English, and all intervention items should be provided across different formats (i.e. paper, online, SMS) to ensure equitable access |