Abstract
BackgroundThe Personal Patient Profile-Prostate (P3P), a web-based decision aid, was demonstrated to reduce decisional conflict in English-speaking men with localized prostate cancer early after initial diagnosis. The purpose of this study was to explore and enhance usability and cultural appropriateness of a Spanish P3P by Latino men with a diagnosis of prostate cancer.MethodsP3P was translated to Spanish and back-translated by three native Spanish-speaking translators working independently. Spanish-speaking Latino men with a diagnosis of localized prostate cancer, who had made treatment decisions in the past 24 months, were recruited from two urban clinical care sites. Individual cognitive interviews were conducted by two bilingual research assistants as each participant used the Spanish P3P. Notes of user behavior, feedback, and answers to direct questions about comprehension, usability and perceived usefulness were analyzed and categorized.ResultsSeven participants with a range of education levels identified 25 unique usability issues in navigation, content comprehension and completeness, sociocultural appropriateness, and methodology. Revisions were prioritized to refine the usability and cultural and linguistic appropriateness of the decision aid.ConclusionsUsability issues were discovered that are potential barriers to effective decision support. Successful use of decision aids requires adaptation and testing beyond translation. Our findings led to revisions further refining the usability and linguistic and cultural appropriateness of Spanish P3P.
Highlights
The Personal Patient Profile-Prostate (P3P), a web-based decision aid, was demonstrated to reduce decisional conflict in English-speaking men with localized prostate cancer early after initial diagnosis
Like the Healthy Texas study, we found usability issues related to unfamiliarity with Internet use, and higher satisfaction than performance among test users
Despite some limitations, which suggest areas for further research, our usability testing and revision process represents a significant improvement over mere direct translation
Summary
The Personal Patient Profile-Prostate (P3P), a web-based decision aid, was demonstrated to reduce decisional conflict in English-speaking men with localized prostate cancer early after initial diagnosis. The purpose of this study was to explore and enhance usability and cultural appropriateness of a Spanish P3P by Latino men with a diagnosis of prostate cancer. According to the 2009 Healthcare Disparities Report [3], Hispanic adults reported worse provider-patient communication than non-Hispanic White adults, likely creating barriers to informed and shared decision making about health issues. Patient decision aids have been developed to support informed and shared decision making among individuals facing a variety of specific health care decisions [5]. An effective decision aid will enhance patients’ decision making with information, values clarification, self-efficacy and communication skills tailored to the decision they face, resulting in a high quality decision. Most decision aids in the U.S exist only in English, while
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