Development and evaluation of a decision aid for HPV vaccination among adults aged 27–45 years old in the United States

Objective: To design, develop, and field test the HPV Decide decision tool to facilitate shared clinical decision-making recommendation for mid-adult HPV vaccination. Methods: The ‘HPV Decide’ online tool was developed through a 6-step process, involving community and provider advisory boards, usability testing with 10 end users (unvaccinated adults aged 27–45), field testing interviews with another 10, and interviews with 18 healthcare providers. The process incorporated both inductive and deductive qualitative data analyses. Results: The logic model, based on the Ottawa Decision Support Framework, highlighted the importance of objective knowledge and managing decisional conflict. Iterative modifications were informed by the advisory boards, alpha testing, and usability testing. Field testing showed utility to end users, highlighting the straightforward design, and lack of medical jargon. Many expressed a desire to access the tool before doctor appointments, emphasizing its value in a healthcare context and in partnership with providers. Lastly, healthcare provider feedback highlighted information quality, structure, acceptability, and future implementation. Discussion: While users recognized the tool's information quality and user-centric design, full evaluation focused on changes in informed decision making and clinic-based implementation are needed. Practical value: The HPV Decide decision tool demonstrates promise in supporting informed decisions about HPV vaccination among mid-adults. © 2024 Elsevier Ltd