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Iterative Development of an Interactive Website to Support Shared Decision-Making in Metastatic Breast Cancer

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Abstract

Recent treatment advances have resulted in significantly increased survival times following metastatic breast cancer (MBC) diagnosis. Novel treatment approaches–and their related side effects–have changed the landscape of MBC treatment decision-making. We developed a prototype of an online educational tool to prepare patients with MBC for shared decision-making with their oncologists. We describe the five phases of tool development: (1) in-depth, semi-structured qualitative interviews and (2) feedback on storyboards of initial content with patients with MBC and oncology providers. This was followed by three phases of iterative feedback with patients in which they responded to (3) initial, non-navigable website content and (4) a beta version of the full website. In the final phase (5), patients newly diagnosed with MBC (N = 6) used the website prototype for 1 week and completed surveys assessing acceptability, feasibility, treatment knowledge, preparation for decision-making, and self-efficacy for decision-making. Participants in Phase 1 characterized a cyclical process of MBC treatment decision-making and identified key information needs. Website content and structure was iteratively developed in Phases 2–4. Most participants in Phase 5 (n = 4) accessed the website 2–5 times. All participants who accessed the website at least once (n = 5) felt they learned new information from the website prototype and would recommend it to others newly-diagnosed with MBC. After using the website prototype, participants reported high preparation and self-efficacy for decision-making. This multiphase, iterative process resulted in a prototype intervention designed to support decision-making for MBC patients.

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Data availability

The qualitative datasets analyzed during the current study will not be made available, given the conditions under which participants provided informed consent and the fact that qualitative interview data cannot be completely anonymized, even when aliases are used to replace names. Quantitative datasets will be made available upon on reasonable request to the corresponding author.

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Funding

This work was supported by a Pfizer Independent Education Grant (MPIs: O’Neill & Conley) and the National Cancer Institute (K08CA270402, PI: Conley; T32CA261787: O’Neill, Abduljawad). This research was also supported by the Georgetown Lombardi Comprehensive Cancer Center’s Survey, Recruitment, and Biospecimen Collection Shared Resource (SRBSR), which is partially supported by the National Cancer Institute (P30CA051008, PI: Weiner).

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Authors and Affiliations

  1. Department of Oncology, Georgetown University, Washington, DC, USA

    Claire C. Conley, Sophia Cumbo, Jacqueline Chavez Ochoa, Afton Boles, Jennifer D. Rodriguez, Nicole Schwab, Suzan Abduljawad, Claudine Isaacs & Suzanne C. O’Neill

  2. People Designs, Durham, NC, USA

    David Farrell

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  1. Claire C. Conley
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  2. Sophia Cumbo
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  3. Jacqueline Chavez Ochoa
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  4. Afton Boles
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  5. Jennifer D. Rodriguez
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  6. Nicole Schwab
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  7. David Farrell
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  8. Suzan Abduljawad
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  9. Claudine Isaacs
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  10. Suzanne C. O’Neill
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Corresponding author

Correspondence to Claire C. Conley.

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Ethics approval

All procedures were approved by the Georgetown University Institutional Review Board (IRB #00003415). This study confirms to the standards outlined in the Declaration of Helsinki and US Federal Policy for the Protection of Human Subjects.

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All persons gave their informed consent prior to study participation.

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Conley, C.C., Cumbo, S., Chavez Ochoa, J. et al. Iterative Development of an Interactive Website to Support Shared Decision-Making in Metastatic Breast Cancer. J Canc Educ (2024). https://doi.org/10.1007/s13187-024-02451-8

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  • DOI: https://doi.org/10.1007/s13187-024-02451-8

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