Development of My Decision/Mi Decisión, a web-based decision aid to support permanent contraception decision making

Abstract

ObjectiveTo develop a patient-centered, web-based decision aid to support informed and value-concordant decision making among Medicaid enrollees considering tubal sterilization. MethodsWe used the Ottawa Decision Support Framework and the International Patient Decision Aids Standards (IPDAS) to guide systematic development of our decision aid. We interviewed 15 obstetrician-gynecologists and 40 women, who had considered or were considering tubal sterilization. A Steering Committee—comprising healthcare providers, social scientists, reproductive health and justice advocates, and people with lived experience—provided feedback and direction. We developed English and Spanish prototypes, which were beta tested with 24 women. ResultsThe resulting web-based My Decision/Mi Decisión tool (English/Spanish) includes written and video information about tubal sterilization procedures; an interactive table of contraception options; values clarification exercises; reflection and deliberation; knowledge checks; and a summary report to share with one's provider. Users found the decision aid to be informative, engaging, easy to use, and helpful in informing contraception decision making. ConclusionMy Decision/Mi Decisión is a scalable tool that could be implemented widely to support informed decision making about tubal sterilization. InnovationThis is a novel and timely web-based decision tool for tubal sterilization, when demand for permanent contraception is rapidly increasing post-Dobbs. While designed for Medicaid enrollees, further investigation will explore more generalized use.