The Association between the Social determinants of health and Shared decision making: An Investigation of the National Survey of Children's Health

Objective: Shared decision-making (SDM) is defined as a clinical approach that allows both physicians and patients to communicate on the best treatment options that will improve the patient's overall health outcomes. Shared decision-making plays a vital role in how parents engage with their physicians regarding the healthcare needs of their children. This dissertation assessed the association between the social determinants of health and shared decision-making regarding children’s health-related issues. Methods: The data for the current research were the National Survey of Children’s Health (NSCH), combined 2017-2020. The dependent variable was shared decision-making and included discussing treatment options, raising concerns regarding recommendations for care, and working together on choices for treatment. The main independent variable was social determinants of health and included economic stability, neighborhood built and environment, educational access and quality, health care access and quality. The researcher analyzed sample characteristics, and estimated logistic regression to make valid conclusions in answering the research question, how are various social determinants of health associated with different types of shared decision-making regarding children’s health related issue? Results: Approximately 70% of respondents engaged in at least one type of shared decision making. Several social determinants of health such as family resilience, safe neighborhoods, English language, higher education, private health insurance, health care visits, and alternative health care visit were associated with more shared decision making, compared to economic instability, adverse childhood experience, trouble paying medical bills, health insurance type, and special education associated with less shared decision making