Conclusion
Reducing low-value health services is a complex issue, with significant clinical and health policy implications. This is the first randomized study to demonstrate that the consumer Choosing Wisely questions and a video intervention to promote question asking and engagement in SDM may improve participants’ intention to engage in SDM and support them in identifying questions that align with the Choosing Wisely campaign (with some additional benefits of the video intervention in reducing willingness to accept treatment without asking questions). Although effect sizes are small, and we did not find significant improvements on all outcomes and at all time points, the simple, low-cost nature of the interventions may make them appropriate for implementation within a suite of approaches to address low-value care at a population level.