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We sought to address interpersonal and knowledge\u2010related barriers to OAT implementation by facilitating shared decision\u2010making in the context of ED care. The objective of this study was to refine and evaluate an OUD treatment conversation aid in partnership with people with lived experience (PWLE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We combined community\u2010based participatory research principles, decision aid development guidelines, and qualitative methods. Via the longitudinal involvement of a multi\u2010stakeholder Steering Committee (SC), interviews, and focus groups, we iteratively refined and evaluated a conversation aid,\n                      <jats:italic>Talk About It (TAI)<\/jats:italic>\n                      . We performed beta\u2010testing with ED patients with untreated OUD and clinicians and evaluated the aid via validated implementation measures of acceptability, appropriateness, and feasibility (3 scales, 4 questions each, range 1\u20135). Finally,\n                      <jats:italic>TAI<\/jats:italic>\n                      was translated into Spanish and Spanish\u2010speaking patients and clinicians gave feedback.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over 100 people engaged in the refinement and evaluation of\n                      <jats:italic>TAI<\/jats:italic>\n                      . Of the 75 patient and community member participants, about half (34) reported using opioids within the past week. Refinements to\n                      <jats:italic>TAI<\/jats:italic>\n                      included changing content, simplifying language, and adding quotes, faces, and local resources. Validated acceptability, appropriateness, and feasibility measures demonstrated increasing scores. ED patients with untreated OUD gave the final version mean scores of 4.72, 4.70, and 4.67, respectively (range 1\u20135), indicating high agreement with implementation potential.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TAI's content and style were designed, refined, and approved by PWLE, ED clinicians, and addiction experts. Further testing will be needed to measure effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70256","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T13:46:43Z","timestamp":1773236803000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["\u201cTalk About It!\u201d Shared Decision\u2010Making for Methadone and Buprenorphine Initiation: Development and Preliminary Evaluation of a Conversation Aid via\n                    <scp>Community\u2010Based Participatory Research<\/scp>"],"prefix":"10.1111","volume":"33","author":[{"given":"Elizabeth M.","family":"Schoenfeld","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine UMass Chan Medical School\u2014Baystate  Springfield Massachusetts USA"},{"name":"Department of Healthcare Delivery and Population Science UMass Chan Medical School\u2014Baystate  Springfield Massachusetts 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