Abstract 4362666: Co-Design and Development of a Web-Based Decision Aid to Support Team-Based Shared Decision-Making to Advance Cardiovascular Health: A Mixed Method Study

Abstract

Introduction: Team-based care and shared decision-making (SDM) have been recommended to improve the management of cardiovascular disease (CVD) risk factors. However, decision aids to support team-based SDM for health behavior change and medication management in adults with multiple CVD risk factors are lacking. Objectives: To design and develop a web-based decision aid in health behavior change and medication management to improve multiple CVD risk factor management. Methods: A mixed method study was conducted to develop a web-based decision aid in health behavior change and medication management to improve CVD risk factor management using human-centered design principles and the International Patient Decision Aid Standards. The development process included three phases: (1) SDM workflow and needs assessment: we conducted a modified two-round Delphi study with 18 expert panelists including cardiologist, nurse, community health worker, pharmacist, physician assistant to develop the SDM workflow in multiple CVD risk factor management, (2) Needs assessment: we interviewed 6 clinicians and conducted 3 focus groups with 13 adult patients living with multiple CVD risk factors to understand clinician and patient perceived barriers and facilitators to SDM for CVD risk factor management; and (3) Prototype design and development: we conducted a co-design workshop to design and develop the Preferred-Heart prototype with 15 key stakeholders including software developer, patients with CVD risk factors, primary care providers, pharmacists, and community health workers. Results: The Delphi process resulted in a SDM workflow to improve health behavior change and medication management with 75 items and 8 SDM steps (Figure 1). The qualitative study identified multi-level barriers and facilitators to SDM in CVD risk factor management (Figure 2). Figure 3 shows the developed prototype of the web-based decision aid for multiple CVD risk factor management (“Preferred-Heart”). Conclusion: Key stakeholder input informed development of a web-based decision aid prototype to support health behavior change and medication management to improve multiple CVD risk factor management. Future studies are needed to test the usability, acceptability, and effectiveness of the developed decision aid in improving SDM and health outcomes.