Evaluation of the “3 Good Questions” program for shared decision-making in pediatric medicine: a feasibility study

The “3 Good Questions” program was developed to increase shared decision making. The current pilot-study determined the feasibility of these questions to increase shared decision-making in Dutch pediatric medicine. Pre-/postintervention surveys were used to include children (10–18 years) at pediatric outpatient clinics of four hospitals in the Netherlands. After their appointment, two different groups of children completed the questionnaires. Group 1 filled in the survey before the intervention; group 2 completed the survey after active implementation of the “3 Good Questions” program. The primary outcome was to determine the feasibility (reach, applicability). Secondary outcomes were related to patient involvement in healthcare and treatment decisions and decision-making process between child and healthcare professional. In total, 168 and 114 children in groups 1 and 2 (61 vs 63% female, P = 0.68; age 13.3 ± 2.4 vs 13.8 ± 2.4 years, P = 0.72), respectively, completed the questionnaire. In group 2, 44% of children were aware of the “3 Good Questions”, of whom 18% posed ≥ 1 of the “3 Good Questions” during their appointment (feasibility). The “3 Good Questions” program led to more shared decision-making (SDM-Q-9: P = < 0.001;95%CI: − 2.43 to − 1.17). The majority of children who have read or heard of the “3 Good Questions” would recommend this program to other children. Conclusion: Implementation of the “3 Good Questions” program seemed feasible, although it is necessary to further explore the implementation of this program at national level as a simple way for children and healthcare professionals to share decisions in practice.What is known• Children have the right to be included in decision-making, and inclusion can improve patient satisfaction and quality of care, and reduce costs.• The “3 Good Questions” program was successfully implemented in adult healthcare to increase shared decision making, and therefore these “3 Good Questions” have been adapted to a child version.What is new• In this pilot study, we found that the implementation of the “3 Good Questions” program to increase shared decision-making in pediatric medicine seemed feasible. Although it is necessary to further explore the implementation of the “3 Good Questions” program at national level as a simple way for children and healthcare professionals to share decisions in practice.