title: Development and field testing of a decision support tool to facilitate shared decision making in contraceptive counseling.
abstract: OBJECTIVE
  We developed and formatively evaluated a tablet-based decision support tool for use by women prior to a contraceptive counseling visit to help them engage in shared decision making regarding method selection.
  
  
  METHODS
  Drawing upon formative work around women's preferences for contraceptive counseling and conceptual understanding of health care decision making, we iteratively developed a storyboard and then digital prototypes, based on best practices for decision support tool development. Pilot testing using both quantitative and qualitative data and cognitive testing was conducted. We obtained feedback from patient and provider advisory groups throughout the development process.
  
  
  RESULTS
  Ninety-six percent of women who used the tool in pilot testing reported that it helped them choose a method, and qualitative interviews indicated acceptability of the tool's content and presentation. Compared to the control group, women who used the tool demonstrated trends toward increased likelihood of complete satisfaction with their method. Participant responses to cognitive testing were used in tool refinement.
  
  
  CONCLUSIONS
  Our decision support tool appears acceptable to women in the family planning setting.
  
  
  CONCLUSIONS
  Formative evaluation of the tool supports its utility among patients making contraceptive decisions, which can be further evaluated in a randomized controlled trial.
authors.affiliation: Department of Family & Community Medicine, University of California, San Francisco,1001 Potrero Avenue, San Francisco, CA, USA; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco,1001 Potrero Avenue, San Francisco, CA, USA; Department of Epidemiology & Biostatistics, University of California, 1001 Potrero Avenue, San Francisco, CA, USA. Electronic address: christine.dehlendorf@ucsf.edu.
authors.forename: Christine
authors.initials: C
authors.lastname: Dehlendorf
authors.affiliation: Department of Family & Community Medicine, University of California, San Francisco,1001 Potrero Avenue, San Francisco, CA, USA. Electronic address: judith.fitzpatrick@ucsf.edu.
authors.forename: Judith
authors.initials: J
authors.lastname: Fitzpatrick
authors.affiliation: Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco,1001 Potrero Avenue, San Francisco, CA, USA. Electronic address: jody.steinauer@ucsf.edu.
authors.forename: Jody
authors.initials: J
authors.lastname: Steinauer
authors.affiliation: The National Campaign to Prevent Teen and Unplanned Pregnancy, 1776 Massachusetts Ave NW, Washington, DC 20036, USA. Electronic address: lswiader@thenc.org.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Swiader
authors.affiliation: Department of Family & Community Medicine, University of California, San Francisco,1001 Potrero Avenue, San Francisco, CA, USA. Electronic address: kevin.grumbach@ucsf.edu.
authors.forename: Kevin
authors.initials: K
authors.lastname: Grumbach
authors.affiliation: University of Rochester School of Medicine and Dentistry (URSMD), 601 Elmwood Ave, Rochester, NY 14642, USA. Electronic address: cara_Hall@urmc.rochester.edu.
authors.forename: Cara
authors.initials: C
authors.lastname: Hall
authors.affiliation: Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco,1001 Potrero Avenue, San Francisco, CA, USA; Department of Epidemiology & Biostatistics, University of California, 1001 Potrero Avenue, San Francisco, CA, USA. Electronic address: miriam.kuppermann@ucsf.edu.
authors.forename: Miriam
authors.initials: M
authors.lastname: Kuppermann
mesh_terms: D000293:Adolescent; D000328:Adult; D002755:Choice Behavior; D003071:Cognition; D003267:Contraception / Q000379:methods* / Q000523:psychology; D003268:Contraception Behavior / Q000523:psychology*; D003270:Contraceptive Agents; D003273:Contraceptive Devices; D003376:Counseling; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D057240:Patient Preference; D036301:Qualitative Research; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult
chemical_list: D003270:Contraceptive Agents
keywords: Contraception; Contraceptive counseling; Decision making; Decision support tool; Shared decision making