{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:42:03Z","timestamp":1787496123254,"version":"build-2736575974"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,7,16]]},"abstract":"<jats:sec id=\"jah39896-sec-0001\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Shared decision\u2010making (SDM) has the potential to improve hypertension care quality and equity. However, research lacks diverse representation and evidence about how race and ethnicity affect SDM. Therefore, this study aims to explore SDM in the context of hypertension management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah39896-sec-0002\" xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Explanatory sequential mixed\u2010methods design was used. Quantitative data were sourced at baseline and 12\u2010month follow up from RICH LIFE (Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone) participants (n=1212) with hypertension. Qualitative data were collected from semistructured individual interviews, at 12\u2010month follow\u2010up, with participants (n=36) selected based on their SDM scores and blood pressure outcome. Patients were cross\u2010 categorized based on high or low SDM scores and systolic blood pressure reduction of \u226510 or &lt;10\u2009mm\u2009Hg. Multinomial logistic regression analysis showed that predictors of SDM scores and blood pressure outcome were race and ethnicity (relative risk ratio [RRR], 1.64;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.029), age (RRR, 1.03;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.002), educational level (RRR, 1.87;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.016), patient activation (RRR, 0.98;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001; RRR, 0.99;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.039), and hypertension knowledge (RRR, 2.2;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001; and RRR, 1.57;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.045). Qualitative and mixed\u2010methods findings highlight that provider\u2013patient communication and relationship influenced SDM, being emphasized both as facilitators and barriers. Other facilitators were patients' understanding of hypertension; clinicians' interest in the patient, and clinicians' personality and attitudes; and barriers included perceived lack of compassion, relationship hierarchy, and time constraints.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah39896-sec-0003\" xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Participants with different SDM scores and blood pressure outcomes varied in determinants of decision and descriptions of contextual factors influencing SDM. Results provide actionable information, are novel, and expand our understanding of factors influencing SDM in hypertension.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.032568","type":"journal-article","created":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T07:28:03Z","timestamp":1720682883000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Multiethnic Perspectives of Shared Decision\u2010Making in Hypertension: A Mixed\u2010Methods Study"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2874-1770","authenticated-orcid":false,"given":"Sabrina","family":"Elias","sequence":"first","affiliation":[{"name":"Johns Hopkins School of Nursing","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Wenzel","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Nursing","place":["Baltimore, 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