{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:51:30Z","timestamp":1790034690620,"version":"4.0.1"},"reference-count":106,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Deciding whether and how to disclose one\u2019s autism at work is complex, especially for autistic youth and young adults who are newly entering the labor market and still learning important decision-making and self-determination skills. Autistic youth and young adults may benefit from tools to support disclosure processes at work; however, to our knowledge, no evidence-based, theoretically grounded tool exists specifically for this population. There is also limited guidance on how to pursue the development of such a tool in collaboration with knowledge users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to co-design a prototype of a disclosure decision aid tool with and for Canadian autistic youth and young adults, explore the perceived usability of the prototype (usefulness, satisfaction, and ease of use) and make necessary revisions, and outline the process used to achieve the aforementioned objectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Taking a patient-oriented research approach, we engaged 4 autistic youths and young adults as collaborators on this project. Prototype development was guided by co-design principles and strategies, and tool content was informed by a previous needs assessment led by our team, the autistic collaborators\u2019 lived experiences, considering intersectionality, research on knowledge translation (KT) tool development, and recommendations from the International Patient Decision Aid Standards. We co-designed a web-based PDF prototype. To assess perceived usability and experiences with the prototype, we conducted 4 participatory design and focus group Zoom (Zoom Video Communications) sessions with 19 Canadian autistic youths and young adults aged 16 to 29 (mean 22.8, SD 4.1) years. We analyzed the data using a combined conventional (inductive) and modified framework method (deductive) analysis to map the data onto usability indicators (usefulness, satisfaction, and ease of use). Grounded in participants\u2019 feedback, considering factors of feasibility and availability of resources, and ensuring tool fidelity, we revised the prototype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We developed 4 categories pertaining to the perceived usability of and participant experiences with the prototype: past disclosure experiences, prototype information and activities, prototype design and structure, and overall usability. Participant feedback was favorable and indicative of the tool\u2019s potential impact and usability. The usability indicator requiring the most attention was ease of use, which was prioritized when revising the prototype. Our findings highlight the importance of engaging knowledge users throughout the entire prototype co-design and testing processes; incorporating co-design strategies and principles; and having content informed by relevant theories, evidence, and knowledge users\u2019 experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We outline an innovative co-design process that other researchers, clinicians, and KT practitioners may consider when developing KT tools. We also developed a novel, evidence-based, and theoretically informed web-based disclosure decision aid tool that may help autistic youth and young adults navigate disclosure processes and improve their transitional outcomes as they enter the workforce.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/44354","type":"journal-article","created":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T09:01:29Z","timestamp":1682586089000},"page":"e44354","source":"Crossref","is-referenced-by-count":10,"title":["Development and Usability Testing of a Web-Based Workplace Disability Disclosure Decision Aid Tool for Autistic Youth and Young Adults: Qualitative Co-design Study"],"prefix":"10.2196","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1127-6577","authenticated-orcid":false,"given":"Vanessa","family":"Tomas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1231-984X","authenticated-orcid":false,"given":"Shaelynn","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2051-7221","authenticated-orcid":false,"given":"Shauna","family":"Kingsnorth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3455-9887","authenticated-orcid":false,"given":"Evdokia","family":"Anagnostou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3266-6742","authenticated-orcid":false,"given":"Bonnie","family":"Kirsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5903-290X","authenticated-orcid":false,"given":"Sally","family":"Lindsay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2023,4,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2017.1363824"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-020-04513-4"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2017.1323018"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1089\/aut.2020.0014"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-022-05766-x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1177\/0034355213493930"},{"key":"ref7","year":"2013","journal-title":"Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3233\/jvr-191018"},{"key":"ref9","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-29049-8","author":"Hurley-Hanson, A","year":"2020","journal-title":"Autism in the Workplace. Palgrave Explorations in Workplace Stigma"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1002\/aur.2288"},{"key":"ref11","first-page":"191","author":"MacDonald-Wilson, KL","year":"2010","journal-title":"Work Accommodation and Retention in Mental Health"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1089\/aut.2020.0063"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1177\/23969415211022955"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2019.1635658"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1111\/iops.12149"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-018-03878-x"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-022-05884-6"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-021-05384-z"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.rasd.2020.101598"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1037\/apl0000058"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1089\/aut.2019.29003.djn"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1177\/13623613221080813"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s10926-022-10023-0"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.rasd.2022.101936"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1037\/dhe0000108"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2018.1451926"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.3233\/jvr-170922"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1525\/9780520933019-011"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-019-03923-3"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-020-04662-6"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1177\/1362361319877329"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1080\/13854046.2021.1971767"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1111\/iops.12134"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1080\/1359432x.2017.1387536"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1352\/2326-6988-8.4.320"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1177\/1362361313516548"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1177\/1362361316661855"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1177\/1362361317702507"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13252"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2019-105726"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.113.128470"},{"key":"ref42","unstructured":"Employment Tool KitAutism Speaks20188272022-08-15https:\/\/www.autismspeaks.org\/tool-kit-excerpt\/disclose-or-not-disclose"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1177\/10442073030140030601"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-019-03940-2"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2923.2009.03611.x"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1002\/chp.47"},{"key":"ref47","unstructured":"Canada's strategy for patient-oriented research improving health outcomes through evidence-informed careCanadian Institutes of Health Research201182022-08-15https:\/\/cihr-irsc.gc.ca\/e\/44000.html"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-038339"},{"key":"ref49","unstructured":"O'Connor, AMWorkbook on Developing and Evaluating Patient Decision AidsPatient Decision Aids20032022-08-15https:\/\/decisionaid.ohri.ca\/resources.html"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1007\/s10926-014-9550-5"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000001324"},{"key":"ref52","unstructured":"Strategy for patient-oriented research patient engagement frameworkCanadian Institutes of Health Research2022-08-15https:\/\/cihr-irsc.gc.ca\/e\/48413.html"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12873"},{"key":"ref54","unstructured":"CHILD-BRIGHT National Youth Advisory PanelLearning from youth and young adults: engagement strategies for patient-oriented research projects, committees, and councilsCHILD-BRIGHT Network202010192022-08-15https:\/\/www.child-bright.ca\/events\/2020\/9\/9\/youth-engagement-strategies"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1177\/1362361319830523"},{"key":"ref56","unstructured":"Cross, AHanesJMcCauleyDGorterJWTeam member introductionCanChild McMaster University20172023-01-30Hamiltonhttps:\/\/canchild.ca\/system\/tenon\/assets\/attachments\/000\/003\/455\/original\/KBHN_Team_member_introduction_fillable_\u200bFINAL_2021.pdf"},{"key":"ref57","unstructured":"Security Guide - Zoom Video Communications IncZoom Video Communications Inc2022-08-15https:\/\/explore.zoom.us\/docs\/doc\/Zoom-Security-White-Paper.pdf"},{"key":"ref58","unstructured":"Doorley, SHolcombSKlebahnPSegoviaKUtleyJDesign Thinking BootlegHasso Plattner Institute of Design at Stanford University2022-08-15https:\/\/dschool.stanford.edu\/resources\/design-thinking-bootleg"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.13140\/2.1.2570.3361"},{"key":"ref60","author":"Stappers, PJ","year":"2013","journal-title":"Convivial Toolbox: generative research for the front end of design"},{"key":"ref61","unstructured":"Guide to co-design: learn how to create a participatory design processSunlight Foundation2022-08-15https:\/\/communities.sunlightfoundation.com\/action\/codesign\/#how-to-apply-co-design-principles"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6947-13-S2-S2"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38926.629329.ae"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-020-00031-7"},{"key":"ref65","unstructured":"Knowledge Translation ProgramIntersectionality and knowledge translation: intersectionality guideIntersectionality Guide2022-08-15https:\/\/knowledgetranslation.net\/wp-content\/uploads\/2020\/08\/Intersectionality_KT_Guide_20200317_FD.pdf"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.55.1.68"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-7-37"},{"key":"ref69","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2008.12.004"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-0952"},{"key":"ref71","unstructured":"BinnsADilayLFaragHFamily engagement in research check-in documentMcMaster University2023-01-30https:\/\/canchild.ca\/system\/tenon\/assets\/attachments\/000\/003\/428\/original\/FER-Check_In_Doc_(fillable).pdf"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.1177\/1937586715614171"},{"issue":"2","key":"ref73","first-page":"163","volume":"52","author":"Spinuzzi, C","year":"2005","journal-title":"Tech Commun"},{"key":"ref74","author":"Krueger, RA","year":"1988","journal-title":"Focus Groups A Practical Guide for Applied Research"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.3109\/0142159x.2014.917165"},{"key":"ref76","doi-asserted-by":"publisher","DOI":"10.2196\/23337"},{"key":"ref77","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-021-04918-9"},{"key":"ref78","doi-asserted-by":"publisher","DOI":"10.1177\/1362361318803935"},{"key":"ref79","author":"Patton, M","year":"2014","journal-title":"Qualitative Research & Evaluation Methods Integrating Theory and Practice"},{"key":"ref80","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-8606.2007.00016.x"},{"key":"ref81","unstructured":"A portrait of Canadian Youth: March 2019 UpdatesStatistics Canada201932022-08-15https:\/\/www150.statcan.gc.ca\/n1\/pub\/11-631-x\/11-631-x2019003-eng.htm"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.1177\/001872089203400407"},{"key":"ref83","doi-asserted-by":"publisher","DOI":"10.29019\/enfoqueute.v8n1.126"},{"key":"ref84","doi-asserted-by":"publisher","DOI":"10.46743\/2160-3715\/2020.4212"},{"key":"ref85","doi-asserted-by":"crossref","DOI":"10.4135\/9781483328126","author":"Krueger, R","year":"1998","journal-title":"Developing Questions for Focus Groups"},{"key":"ref86","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"ref87","unstructured":"Cisco SystemsSlido PlatformSlido20122022-08-15https:\/\/www.slido.com\/"},{"key":"ref88","unstructured":"Sync File SharingSync20112023-01-30https:\/\/www.sync.com\/"},{"key":"ref89","doi-asserted-by":"publisher","DOI":"10.2196\/mental.8999"},{"key":"ref90","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"ref91","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-117"},{"key":"ref92","unstructured":"NVivo (Version 12)QSR International20182022-08-15https:\/\/www.qsrinternational.com\/nvivo-qualitative-data-analysis-\u200bsoftware\/home"},{"key":"ref93","author":"Ritchie, J","year":"1994","journal-title":"Analyzing Qualitative Data"},{"key":"ref94","author":"Jackson, K","year":"2019","journal-title":"Qualitative Data Analysis with NVivo"},{"key":"ref95","doi-asserted-by":"publisher","DOI":"10.1177\/1609406919899220"},{"key":"ref96","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0b013e31828abf7f"},{"key":"ref97","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2006.03727.x"},{"key":"ref98","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-016-3763-6"},{"key":"ref99","doi-asserted-by":"publisher","DOI":"10.1177\/0272989x20984134"},{"key":"ref100","doi-asserted-by":"publisher","DOI":"10.1177\/0272989x211014163"},{"key":"ref101","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369-7625.2012.00795.x"},{"key":"ref102","doi-asserted-by":"publisher","DOI":"10.1177\/1362361318786721"},{"key":"ref103","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2021.04.007"},{"key":"ref104","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2007.12.004"},{"key":"ref105","doi-asserted-by":"publisher","DOI":"10.1089\/aut.2018.0020"},{"key":"ref106","doi-asserted-by":"publisher","DOI":"10.1177\/1609406918821574"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2023\/1\/e44354","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:48:23Z","timestamp":1782841703000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2023\/1\/e44354"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,27]]},"references-count":106,"URL":"https:\/\/doi.org\/10.2196\/44354","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.44354","asserted-by":"object"}]},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,27]]}}}