Development and pilot testing of the Population And ContExt adaption of decision aids (PACE) framework.

This study aimed to develop and pilot test a new framework for the adaptation of patient decision aids (PtDAs) using a specific case example of contraceptive method PtDAs for Chinese-speaking migrant women. We developed a novel approach for adaptation - the PACE (Population And ContExt adaption of decision aids) framework - that incorporated both existing models and frameworks and innovative elements. It involves six stages: selection and appraisal; review by content experts; content validity and usability pre-testing; translation; decisional needs assessment; and perceived acceptability, usability and feasibility testing. We then followed the framework to pilot and adapt a suite of PtDAs on contraceptive methods for Chinese-speaking migrant women in Australia. Twenty healthcare providers and 22 Chinese migrant women participated during the stages five and six. The pilot resulted in adapted PtDAs that were acceptable to end users. For future research, we proposed further recommendations and considerations based on lessons learnt, which include flexibility in applying the framework and considering an additional real-world evaluation step. Adaptation of PtDAs required a multi-stage and multidisciplinary team-based and pragmatic approach as exemplified in the application of the PACE framework. The PACE framework developed and piloted in this study fills a crucial gap in knowledge about how to adapt PtDAs for new populations and contexts and provides an innovative and systemic approach to guide the adaptation process.

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© 2024 The Authors. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Deborah Bateson had been supported to attend educational events by Bayer Healthcare and Mayne Pharma, both are manufacturers of contraceptives, and had attended advisory committees Organon, Besins and Mayne Pharma as part of her role at Family Planning New South Wales and The University of Sydney. Rachel Thompson has received research funding from government and non-profit organizations to study shared decision-making and shared decision-making interventions, including contraceptive care; she receives royalties from Oxford University Press from the sale of a book on shared decision-making and owns copyright in several decision aids, including a decision aid on contraception. Carissa Bonner received government and non-profit funding not related to this topic. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.