title: Development and evaluation of a patient decision aid for young people and parents considering fixed orthodontic appliances.
abstract: OBJECTIVE
  To develop and evaluate a child-centred patient decision aid for young people, and their parents, supporting shared decision making about fixed orthodontic appliance treatment with dental health professionals, namely the Fixed Appliance Decision Aid (FADA).
  
  
  METHODS
  The studies were undertaken in a UK teaching dental hospital orthodontic department in 2013-2014. The development phase involved an interview study with: (a) 10 patients (12-16 years old), and their parents, receiving orthodontic care to investigate treatment decision making and inform the content of the FADA and (b) 23 stakeholders critiquing the draft decision aid's content, structure and utility. The evaluation phase employed a pre-/post-test study design, with 30 patients (12-16 years old) and 30 parents. Outcomes included the Decisional Conflict Scale; measures of orthodontic treatment expectations and knowledge.
  
  
  RESULTS
  Qualitative analysis identified two informational needs: effectiveness of treatment on orthodontic outcomes and treatment consequences for patients' lives. Quantitative analysis found decisional conflict reduced in both patients (mean difference -12.3, SD 15.3, 95% CI 6.6-17.9; p < 0.001) and parents (mean difference - 8.6, SD 16.6, 95% CI 2.5-14.8; p = 0.002); knowledge about duration and frequency of orthodontic treatment increased; expectations about care were unchanged.
  
  
  CONCLUSIONS
  Using the FADA may enable dental professionals to support patients and their parents, decisions about fixed appliance treatments more effectively, ensuring young people's preferences are integrated into care planning.
authors.affiliation: c Leeds Institute of Health Sciences , Charles Thackrah Building, University of Leeds, Leeds , UK.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Marshman
authors.affiliation: a Academic Unit of Dental Public Health, School of Clinical Dentistry , University of Sheffield , Claremont Crescent, Sheffield , S10 2TA , UK.
authors.forename: Abdussalam
authors.initials: A
authors.lastname: Eddaiki
authors.affiliation: a Academic Unit of Dental Public Health, School of Clinical Dentistry , University of Sheffield , Claremont Crescent, Sheffield , S10 2TA , UK.
authors.forename: Hilary L
authors.initials: HL
authors.lastname: Bekker
authors.affiliation: b Academic Unit of Oral Health and Development, School of Clinical Dentistry , University of Sheffield , Claremont Crescent, Sheffield , S10 2TA , UK.
authors.forename: Philip E
authors.initials: PE
authors.lastname: Benson
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D009967:Orthodontic Appliances; D010290:Parents
keywords: Patient decision aid; child; fixed-appliance; orthodontics; shared decision making