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119 Making the BEST decision-the BESTa project -Description of the design phase as part of the development of a digital decision aid to be used in Swedish cancer screening programmes
  1. Anna Jervaeus,
  2. Kaisa Fritzell
  1. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Sweden


Introduction The European Code Against Cancer includes actions to take to reduce cancer risk, such as organized cancer screening. A digital Decision Aid (DA) for cancer screening will gather balanced information in one place and give individuals the opportunity to elucidate their knowledge, values, and engage in a Shared Decision-Making (SDM) process. The present project aims at describing the design phase of the development of a digital DA for cancer screening in Sweden.

Methods The project is based on the IPDAS framework and the suggested model for development of DAs. The DA, in paper format, was evaluated in interviews (online or in real life) with lay people and experts. Pictures and questionnaires were scrutinized with the think- aloud method. Interviews were analysed with content analysis.

Results In total 18 individuals participated. A positive outlook on the DA were a common perception. Still certain words (decision aid, screening, polyp) were considered difficult, and suggestions were given to improve understanding. Worry or anxiety were expressed e.g., that the information can lead to thoughts of having cancer and challenges regarding the decision- making process, such as ´it is difficult to know what one wants´. Responses to the pictures varied depending on if the picture was abstract or more tangible by nature. The questionnaires were also perceived differently, some found items clear while others had difficulties to understand, found items unnecessary or lacked response options.

Discussion The variation in findings illustrate the challenges with DA development. However, the continued work including alpha- and beta testing will elucidate how the final version will be designed and perceived by end-users.

Conclusion Developing a digital DA for use in connection to cancer screening is a complex process. Different expertise, stake holders and end-users are necessary and using a framework like IPDAS is a prerequisite during the whole process.

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