{
  "abstract": "Background Traditional approaches to designing decision aids have focused on providing completeness of information and quantitative detail. An alternative approach based on psychological research emphasises understanding the essence or ‘gist’ of the decision. Few gist-based decision aids exist. The objective of this study was to develop novel gist-based decision aids for prostate and breast cancer screening and evaluate their acceptability.Methods Men aged 40–60 years and women aged 40–49 years eligible for prostate or breast cancer screening were recruited from ResearchMatch (National Institutes of Health) and a public hospital located in New York City. Three rounds of semistructured interviews were performed to determine self-reported comprehensibility and acceptability, with iterative modifications after each phase, including: Phase 1: initial feedback; Phase 2, Round 1: evaluating our modifications; and Phase 2, Round 2: confirming final content.Results A total of 80 participants were involved in the two-phase qualitative interview process; Phase 1 and Phase 2 included 32 and 48 participants, respectively. Racial distribution was 50% white, 30% black and 10% Asian; 9% of participants were Hispanic or Latino. Most participants were highly educated. Interview themes established content validity of the final decision aids. In a quantitative analysis of the final decision aids using a questionnaire with fixed response options, acceptability was high, with two-thirds finding the length and amount of information of the decision aid to be optimal. The majority found the decision aid visually appealing, easy to read and easy to get through, and indicated that it held their interest and did not require much mental effort to read. One-quarter said the tool made them feel somewhat nervous, and three-quarters not at all. Most participants could understand and relate to the images, graphs and patient stories in the decision aid. After Phase 2, 45 of the 48 participants (94%) said they would find the decision aid helpful when making a decision.Conclusion This study describes the iterative development and pilot testing of a novel gist-based decision aid for cancer screening, demonstrating high acceptability. Our findings provide a foundation for randomised trials comparing gist-based and traditional tools.",
  "authors": [
    {
      "affiliations": [
        "Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, New York, USA",
        "Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Sunny Nalavenkata"
    },
    {
      "affiliations": [
        "Department of Surgical Sciences, Uppsala University, Uppsala, Uppsala County, Sweden"
      ],
      "name": "Oskar Bergengren"
    },
    {
      "affiliations": [
        "Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA",
        "Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, New York, USA"
      ],
      "name": "Kathleen Lynch"
    },
    {
      "affiliations": [
        "Department of Medical Anthropology and Cross-Cultural Practice, Boston University School of Medicine, Boston, Massachusetts, USA"
      ],
      "name": "Nicholas Emard"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA"
      ],
      "name": "Mia Austria"
    },
    {
      "affiliations": [
        "Division of Cardiovascular Research, Montefiore Einstein Center for Heart and Vascular Care, New York, New York, USA"
      ],
      "name": "Sené Martin"
    },
    {
      "affiliations": [
        "Department of Obstetrics and Gynecology, Montefiore Hospital and Albert Einstein College of Medicine, New York, New York, USA"
      ],
      "name": "Gabriel Ogbennaya"
    },
    {
      "affiliations": [
        "Columbia University School of Nursing, New York, New York, USA"
      ],
      "name": "Khadra Dualeh"
    },
    {
      "affiliations": [
        "Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA"
      ],
      "name": "Kristina Stevanovic"
    },
    {
      "affiliations": [
        "Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Manish I Patel"
    },
    {
      "affiliations": [
        "NYC Health + Hospitals/Kings County, New York, New York, USA"
      ],
      "name": "Jason Gonsky"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA"
      ],
      "name": "Andrew Vickers"
    },
    {
      "affiliations": [
        "University of Utah Health, Salt Lake City, Utah, USA"
      ],
      "name": "A Fagerlin"
    },
    {
      "affiliations": [
        "Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA"
      ],
      "name": "Jada G Hamilton"
    },
    {
      "affiliations": [
        "Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA"
      ],
      "name": "Jennifer L Hay"
    },
    {
      "affiliations": [
        "Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, New York, USA",
        "Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA",
        "Department of Translational Medicine, Division of Urological Cancers, Medical Faculty, Lund University, Lund, Skåne County, Sweden",
        "German Cancer Research Center (DKFZ), Foundation under Public Law, Im Neuenheimer Feld, Heidelberg, Germany"
      ],
      "name": "Sigrid Carlsson"
    }
  ],
  "title": "Development and acceptability of gist-based decision aids for prostate and breast cancer screening: a two-phase qualitative interview study in an online setting",
  "uid": "d93bfecc-eef1-5d8a-bb7f-14e82208ab13"
}