{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T13:16:11Z","timestamp":1761657371359,"version":"build-2065373602"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"ITMO Cancer AVIESAN"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Human papillomaviruses (HPVs) cause several vaccine-preventable cancers, including cervical cancer. In France, HPV vaccination coverage remains low. Decision aids (DAs) can help individuals make informed health choices. This study assessed the impact of an online DA (SOSHPV) on decisional conflict and vaccination intention, and explored user perceptions in real-life contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A convergent mixed-methods design was used (November 2023\u2013June 2024). The quantitative component included a pre\u2013post questionnaire assessing knowledge, vaccination intention, and decisional conflict. The qualitative component involved semistructured interviews with a subsample of users, analyzed using grounded theory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 943 website visitors, 187 participants (54 males, 12 adolescents) completed the presurvey, and 44 (12 males, 6 adolescents) completed both assessments. Over half (54%) were young parents using the tool to support HPV vaccination decisions for their child. Post-intervention, knowledge improved (P &amp;lt; 0.001), and decisional conflict decreased (P &amp;lt; 0.001). Vaccination intention shifted: 55%\u201375% in favor and 32%\u201318% undecided (P &amp;lt; 0.001). Qualitative analysis (n = 12) revealed three themes: social ambivalence around vaccination, the DA as a support for informed choices, and its role in enhancing communication with healthcare providers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study showed a reduction in decisional conflict and increased vaccination intention. These findings suggest that DAs may play an important role in addressing vaccine hesitancy and supporting value-aligned choices in real-world settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the potential of an online DA to improve vaccine acceptance by reducing decisional conflict and enhancing dialog. Further research is needed to assess its large-scale impact on vaccine uptake.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/fampra\/cmaf077","type":"journal-article","created":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T11:51:09Z","timestamp":1758369069000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of a shared medical decision-making aid on patient decisional conflict regarding human papillomavirus vaccination: a mixed-methods study"],"prefix":"10.1093","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8644-1103","authenticated-orcid":false,"given":"Dragos-Paul","family":"Hagiu","sequence":"first","affiliation":[{"name":"Department of General Practice, Facult\u00e9 de M\u00e9decine Jacques Lisfranc, Universit\u00e9 Jean Monnet, Universit\u00e9 de Lyon , Saint-Etienne 42100 ,","place":["France"]},{"name":"CIC-INSERM 1408, CHU de Saint-Etienne , Saint-Priest-en-Jarez 42270 ,","place":["France"]},{"name":"Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon , Lyon 69007 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"Saquet","sequence":"additional","affiliation":[{"name":"Department of General Practice, Facult\u00e9 de M\u00e9decine Jacques Lisfranc, Universit\u00e9 Jean Monnet, Universit\u00e9 de Lyon , Saint-Etienne 42100 ,","place":["France"]},{"name":"CIC-INSERM 1408, CHU de Saint-Etienne , Saint-Priest-en-Jarez 42270 ,","place":["France"]},{"name":"Health, Systemic, Process, Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon , Lyon 69007 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henri","family":"Partouche","sequence":"additional","affiliation":[{"name":"Department of General Practice, Universit\u00e9 Paris Cit\u00e9 , Paris 75006 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serge","family":"Gilberg","sequence":"additional","affiliation":[{"name":"Department of General Practice, Universit\u00e9 Paris Cit\u00e9 , Paris 75006 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0892-2187","authenticated-orcid":false,"given":"Amandine","family":"Gagneux-Brunon","sequence":"additional","affiliation":[{"name":"CIC-INSERM 1408, CHU de Saint-Etienne , Saint-Priest-en-Jarez 42270 ,","place":["France"]},{"name":"Centre International de Recherche en Infectiologie, Team GIMAP, Univ. de Lyon, Univ. 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Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308 , Lyon 69007 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6090-8211","authenticated-orcid":false,"given":"Morgane","family":"Michel","sequence":"additional","affiliation":[{"name":"ECEVE UMR 1123, Universit\u00e9 Paris Cit\u00e9 , Paris 75006 ,","place":["France"]},{"name":"Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Robert Debr\u00e9, Service de sant\u00e9 publique, \u00e9quipe REPERES , Paris 75019 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Sophie","family":"Le Duc-Banaszuk","sequence":"additional","affiliation":[{"name":"Centre R\u00e9gional de Coordination des D\u00e9pistages des cancers-Pays de la Loire , Angers 49000 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith E","family":"Mueller","sequence":"additional","affiliation":[{"name":"Institut Pasteur, Universit\u00e9 Paris Cit\u00e9, Emerging Disease Epidemiology Unit , Paris 75006 ,","place":["France"]},{"name":"EHESP, CNRS, Inserm, Ar\u00e8nes\u2014UMR 6051, RSMS (Recherche sur les Services et Management en Sant\u00e9)\u2014U1309, University Rennes , Rennes 35000 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aur\u00e9lie","family":"Gauchet","sequence":"additional","affiliation":[{"name":"Univ. 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