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. Author manuscript; available in PMC: 2020 Jul 1.
Published in final edited form as: Acad Med. 2019 Jul;94(7):1010–1018. doi: 10.1097/ACM.0000000000002715

Table 3.

Estimates of Mean RPAD Scores and Intervention Effects According to 3 Methods of Analysisa

Analysis method Overall RPAD score Period effect,
P value		 RPAD score Service-by-period,
P value
Med-1 Peds-1 Med-2 Peds-2
Descriptive statistics
 Preintervention 3.91 4.72 4.37 3.01 4.15
 Postintervention 5.77 5.62 5.67 5.69 6.13
 Difference, mean 1.86 0.90 1.30 2.68 1.98
Model adjusted for service, period, and their interaction
 Preintervention 4.07 4.72 4.34 3.06 4.14
 Postintervention 5.76 5.62 5.68 5.59 6.13
 Difference, mean
 (95% CI)		 1.69
(1.42–1.96)		 < .001 0.90
(0.35–1.45)		 1.34
(0.81–1.87)		 2.53
(1.92–3.13)		 1.95
(1.55–2.44)		 < .001
 Cohen d 1.08 0.73 0.83 1.27 1.55
Model as above, also adjusted for patient and team covariatesb
 Preintervention 4.13 4.53 4.31 3.50 4.19
 Postintervention 5.81 5.24 5.65 6.02 6.34
 Difference, mean
 (95% CI)		 1.68
(1.33–2.03)		 < .001 0.71
(-0.32–1.75)		 1.35
(0.62–2.07)		 2.52
(1.59–3.45)		 2.15
(1.56–2.74)		 .03
 Cohen d 0.82 0.30 0.61 0.83 1.25

Abbreviation: RPAD indicates Rochester Participatory Decision-Making Scale.23

a

The 8-week Patient Engagement Project Study intervention was delivered at four 4 services (Med-1, Med-2, Peds-1, and Peds-2) at teaching hospitals at Stanford University and the University of California, San Francisco between November 2014 and January 2015. Rounds were observed during 12-week pre- and postintervention periods (August to November 2014 and December 2014 to April 2015) to evaluate rounding teams’ SDM behaviors with patients. SDM encounters were restricted to patients who were present during observed rounds (including guardian for pediatrics), did not have altered mental status, and were deemed medically stable by the hospitalist. Services are ordered by increasing standardized intervention effects using Cohen d statistic.

b

Adjusted for 4 team-level continuous covariates (round census, round duration, team size, and 5-level trainee percentage of team) and 4 patient-level covariates (log-scale duration of patient encounter with linear and quadratic terms, gender {Male/Female}, SDM topic {Diagnosis/Not; Treatment/Not}, and status of lead discussant {Trainee/Trainer}). Random variation among rounds per hospitalist at {Med-1, Peds-1, Peds-2, Med-2} accounted for {0.0, 4.3, 2.8, 6.3} percent of overall variation, respectively.