{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T10:08:24Z","timestamp":1766138904950,"version":"3.37.3"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006390","name":"University of Lausanne","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006390","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Fibroids are non-cancerous uterine growths that can cause symptoms impacting quality of life. The breadth of treatment options allows for patient-centered preference. While conversation aids are known to facilitate shared decision making, the implementation of these aids for uterine fibroids treatments is limited. We aimed to develop two end-user-acceptable uterine fibroids conversation aids for an implementation project. Our second aim was to outline the adaptations that were made to the conversation aids as implementation occurred.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We used a multi-phase user-centered participatory approach to develop a text-based and picture-enhanced conversation aid for uterine fibroids. We conducted a focus group with project stakeholders and user-testing interviews with eligible individuals with symptomatic uterine fibroids. We analyzed the results of the user-testing interviews using Morville\u2019s Honeycomb framework. Spanish translations of the conversation aids occurred in parallel with the English iterations. We documented the continuous adaptations of the conversation aids that occurred during the project using an expanded framework for reporting adaptations and modifications to evidence-based interventions (FRAME).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The first iteration of the conversation aids was developed in December 2018. Focus group participants (<jats:italic>n<\/jats:italic>\u2009=\u20096) appreciated the brevity of the tools and suggested changes to the bar graphs and illustrations used in the picture-enhanced version. User-testing with interview participants (<jats:italic>n<\/jats:italic>\u2009=\u20099) found that both conversation aids were satisfactory, with minor changes suggested. However, during implementation, significant changes were suggested by patients, other stakeholders, and participating clinicians when they reviewed the content. The most significant changes required the addition or deletion of information about treatment options as newer research was published or as novel interventions were introduced into clinical practice.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This multi-year project revealed the necessity of continuously adapting the uterine fibroids conversation aids so they remain acceptable in an implementation and sustainability context. Therefore, it is important to seek regular user feedback and plan for the need to undertake updates and revisions to conversation aids if they are going to be acceptable for clinical use.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12911-024-02637-6","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T10:01:56Z","timestamp":1727690516000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Continuous adaptation of conversation aids for uterine fibroids treatment options in a four-year multi-center implementation project"],"prefix":"10.1186","volume":"24","author":[{"given":"Danielle","family":"Schubbe","sequence":"first","affiliation":[]},{"given":"Marie-Anne","family":"Durand","sequence":"additional","affiliation":[]},{"given":"Rachel C.","family":"Forcino","sequence":"additional","affiliation":[]},{"given":"Jaclyn","family":"Engel","sequence":"additional","affiliation":[]},{"given":"Marisa","family":"Tomaino","sequence":"additional","affiliation":[]},{"given":"Monica","family":"Adams-Foster","sequence":"additional","affiliation":[]},{"given":"Carla","family":"Bacon","sequence":"additional","affiliation":[]},{"given":"Carrie Cahill","family":"Mulligan","sequence":"additional","affiliation":[]},{"given":"Sateria","family":"Venable","sequence":"additional","affiliation":[]},{"given":"Tina","family":"Foster","sequence":"additional","affiliation":[]},{"given":"Paul J.","family":"Barr","sequence":"additional","affiliation":[]},{"given":"Raymond M.","family":"Anchan","sequence":"additional","affiliation":[]},{"given":"Shannon","family":"Laughlin-Tommaso","sequence":"additional","affiliation":[]},{"given":"Anne","family":"Lindholm","sequence":"additional","affiliation":[]},{"given":"Maya","family":"Seshan","sequence":"additional","affiliation":[]},{"given":"Rossella M.","family":"Gargiulo","sequence":"additional","affiliation":[]},{"given":"Patricia","family":"Stephenson","sequence":"additional","affiliation":[]},{"given":"Karen","family":"George","sequence":"additional","affiliation":[]},{"given":"Mobolaji","family":"Ajao","sequence":"additional","affiliation":[]},{"given":"Tessa","family":"Madden","sequence":"additional","affiliation":[]},{"given":"Erika","family":"Banks","sequence":"additional","affiliation":[]},{"given":"Antonio R.","family":"Gargiulo","sequence":"additional","affiliation":[]},{"given":"James","family":"O\u2019Malley","sequence":"additional","affiliation":[]},{"given":"Maria","family":"van den Muijsenbergh","sequence":"additional","affiliation":[]},{"given":"Johanna W. 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Brigham and Women\u2019s Hospital and Montefiore Medical Center provided their authorization agreement to rely on Dartmouth\u2019s approval on May 2, 2019. Ethics approval was provided by Barnes-Jewish Hospital Institutional Review Board on May 10, 2019. The Mayo Clinic provided ethics approval on May 7, 2019. Informed consent was obtained from all human participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Glyn Elwyn has edited and published books that provide royalties on sales by the publishers: the books include Shared Decision Making (Oxford University Press) and Groups (Radcliffe Press). Glyn Elwyn\u2019s academic interests are focused on shared decision making and coproduction. He owns copyright in measures of shared decision making and care integration, namely collaboRATE, integRATE (measure of care integration), consideRATE (patient experience of care in serious illness), coopeRATE (measure of goal setting), toleRATE (clinician attitude to shared decision making), Observer OPTION-5, and Observer OPTION-12 (observer measures of shared decision making). He has in the past provided consultancy for organizations, including: 1) Emmi Solutions, LLC who developed patient decision support tools; 2) National Quality Forum on the certification of decision support tools; 3) Washington State Health Department on the certification of decision support tools; 4) SciMentum LLC, Amsterdam (workshops for shared decision making). He is the Founder and Director of & think LLC, which owns the registered trademark for Option GridsTM patient decision aids; Founder and Director of SHARPNETWORK LLC, a provider of training for shared decision making. He provides advice in the domain of shared decision making and patient decision aids to: 1) Access Community Health Network, Chicago (Adviser to Federally Qualified Medical Centers); 2) EBSCO Health for Option GridsTM patient decision aids (consultant); 3) Bind on Demand Health Insurance (consultant); 4) PatientWisdom Inc (adviser); 5) abridge AI Inc (Chief Clinical Research Scientist). Glyn Elwyn and Marie-Anne Durand have developed the Option Grid conversation aids, which are licensed to EBSCO Health. They receive consulting income from EBSCO Health, and may receive royalties in the future. Marie-Anne Durand was a consultant for ACCESS Community Health Network until 2019. For all other co-authors, no other competing interests are declared.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"277"}}