Development and pilot testing of a web-based decision aid for fertility-preservation decisions among women with cancer in South Korea.
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OBJECTIVE: Fertility preservation is an important concern for women of reproductive age with cancer. Many receive insufficient counseling and may experience decisional conflict and psychological distress. This study aimed to develop and pilot test SHARE, a web-based decision aid supporting fertility-preservation decisions among women of reproductive age with cancer in South Korea, using a process informed by the Ottawa Decision Support Framework and the International Patient Decision Aid Standards (IPDAS). METHODS: This development and pilot-testing study included scoping, steering-group formation, a needs assessment with 16 women who had completed cancer treatment and 7 health care professionals, evidence synthesis, iterative prototyping, think-aloud alpha testing (n = 4), and beta testing with post-treatment participants (n = 15) assessing acceptability, user experience, and the importance assigned to decision factors. RESULTS: SHARE comprises seven interactive modules covering fertility risks, fertility-preservation options, values clarification, and preparation for clinical discussions. Alpha testing identified navigation, terminology, personalization, and visual-design issues. In beta testing, mean module information-presentation ratings ranged from 2.73 to 3.40 on a 4-point scale; 11 of 15 participants (73.3%) reported that SHARE was useful for decision-making, and 12 of 15 (80.0%) perceived the information as balanced. User Experience Questionnaire scores were positive for Perspicuity (1.42), Efficiency (0.98), and Dependability (0.97) and neutral for Attractiveness (0.64), Stimulation (0.33), and Novelty (-0.02). The importance of starting cancer treatment as soon as possible was rated 9.67/10, compared with 6.33/10 for having a child in the future. CONCLUSIONS: This small post-treatment pilot provided preliminary evidence of acceptability and stronger pragmatic than hedonic user-experience ratings; it did not establish decisional or clinical effectiveness. Prospective evaluation in newly diagnosed women across cancer types is warranted.