Form #3 Form #3 Pre-Focus Group Questionnaire - Group1

Form Approved
OMB No. 0935-0179
Exp. Date 7/31/2014

ATTACHMENT C1

Pre-Focus Group Questionnaire (Group 1)

1. How often would you say you engage patients in educational discussions regarding their health care options in each of the following situations?

	Every time	Almost every time	Occasionally	Almost never	Never
Changing their lifestyle behaviors
Better understanding their medicines (e.g., blood pressure, cholesterol, depression)
Better understanding the risks and benefits of various cancer screening tests (e.g., colon, breast, prostate)
Better understanding the risks and benefits of having surgery (e.g., back surgery, knee or hip replacements)
Better understanding the risks and benefits of various cardiac procedures
How to manage chronic conditions
Better understanding the risks and benefits of having various imaging procedures (e.g., MRI or CT Scan)

2. When the subject of medical treatments, procedures, or medicine regime comes up, how much time per visit are you able to spend with individual patients discussing options or in decisionmaking processes?

• 3 minutes or less

• 4 to 5 minutes

• 6 to 10 minutes

• 11 to 15 minutes

• More than 15 minutes

Public reporting burden for this collection of information is estimated to average 2 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

3. To what extent have you found that the following situations prohibit you from fully engaging patients as much as you would like in the decisionmaking process or educating about the patient’s health care options?

	To a great extent	Somewhat	Not at all
Not having enough time with patients
Not having access to trusted sources of information that can be used in this process
Not being able to stay up-to-date on current clinical research
Patients/caregivers having difficulty understanding the information
Patients not being interested in participating in this process
Patients not being confident in participating in this process
Coming from a different culture
Not speaking the same language
Other reasons (Please specify other reasons) ________________________________________

4. When you engage in shared decisionmaking with patients, how do you do it (please select all that apply)?

• Through one-on-one conversations with the patient

• In the clinic during their regular visits, with family or other caregivers present

• In a group setting

• In a community setting

• In the patients home

• By phone before an office visit

• By phone after an office visit

• Directing patients to a Web site that provides patient decision aids online prior to their visit

• Directing patients to a Web site that provides patient decision aids online after their visit

• Some other way (please specify)______________________________________________

5. How valuable would you find each of the following topics in a training course on educating patients about their health care options:

	Very valuable	Somewhat valuable	Not very valuable	Not valuable at all
How to communicate technical information about health care options with patients
How to discuss harms and benefits of various health care options
How to address different cultural sensitivities of my patients
How to convey information to patients with who speak little English
How to convey information about likely outcomes of different health care options
How to engage patients to better understand their preferences and values
Where I can find and access information that would be useful to me in my practice
Other topics that would be valuable (Please specify)_____________________

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