Summary of disparities in the use of SDM and potential solutions
| Target group | Disparities in the use of SDM | Potential solutions |
| Patients | Patient barriers to engagement in SDM with providers (eg, low literacy skills, low numeracy skills and low communication efficacy) | Educational interventions that enhance SDM competencies, for example, a narrative that provides information in an easily digestible format and with conversational scripts for patients to initiate or engage providers in SDM discussions |
| Researchers/developers of decision tools | Lack of understanding of SDM needs and preferences of cultural minorities | More research examining attitudes towards and perspectives of SDM among cultural minorities, and their needs and preferences |
| Lack of culturally appropriate patient decision aids | Go beyond cultural adaptation of existing tools or language translation of a tool, and engage in the design of culturally appropriate patient decision aids with community involvement in the design process | |
| Providers | Provider barriers to engagement in SDM with patients who are cultural minorities (eg, limited cultural knowledge or cultural competence skills) | Building provider’s skills in cultural competence and development of culturally appropriate patient decision aids that can be used by providers during the SDM consultation |
| System level | System-level barriers to supporting patients who are socially advantaged and/or are cultural minorities during the SDM process | Increasing support for patients who are socially advantaged and/or are cultural minorities by including translators or patient navigators in the SDM process |
SDM, shared decision making.