 Methods: For Aim 1, implement a randomized controlled trial comparing DECIDE-PAPC with usual care on Shard Decision Making SDM and perceived quality of care. Identify treatment effects using multi-level models that account for nesting of observations, patients, providers, and clinics. For Aim 2, identify underlying mechanisms of the effect of the DECIDE-PAPC intervention on SDM. Mediation analysis techniques are used that allow for rigorous testing of causal pathways and statistical adjustment for spurious correlation is used in instances where mediators and SDM measurement are contemporaneous. For Aim 3, expand Aim 1 models to test whether DECIDE-PAPC impacts SDM and perceived quality differentially by ethnicracial concordantdiscordant dyads. 