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. 2023 Jul 28;23(1):140.
doi: 10.1186/s12911-023-02236-x.

Using the sociotechnical model to conduct a focused usability assessment of a breast reconstruction decision tool

Randi Foraker  1 , Crystal Phommasathit  2 , Kaleigh Clevenger  2 , Clara Lee  3 , Jessica Boateng  4 , Napiera Shareef  5 , Mary C Politi  4
Affiliations

Using the sociotechnical model to conduct a focused usability assessment of a breast reconstruction decision tool

Randi Foraker et al. BMC Med Inform Decis Mak. .

Abstract

Introduction: BREASTChoice is a web-based breast reconstruction decision aid. The previous clinical trial-prior to the adaptation of this refined tool in which we explored usability-measured decision quality, quality of life, patient activation, shared decision making, and treatment choice. The current usability study was designed to elicit patients' and clinicians' perspectives on barriers and facilitators for implementing BREASTChoice into the clinical workflow.

Methods: We conducted qualitative interviews with patients and clinicians from two Midwestern medical specialty centers from August 2020 to April 2021. Interviews were first double coded until coders achieved a kappa > 0.8 and percent agreement > 95%, then were coded independently. We used a sociotechnical framework to evaluate BREASTChoice's implementation and sustainability potential according to end-users, human-computer interaction, and contextual factors.

Results: Twelve clinicians and ten patients completed interviews. Using the sociotechnical framework we determined the following. People Using the Tool: Patients and clinicians agreed that BREASTChoice could help patients make more informed decisions about their reconstruction and prepare better for their first plastic surgery appointment. Workflow and Communications: They felt that BREASTChoice could improve communication and process if the patient could view the tool at home and/or in the waiting room. Clinicians suggested the information from BREASTChoice about patients' risks and preferences be included in the patient's chart or the clinician electronic health record (EHR) inbox for accessibility during the consultation. Human Computer Interface: Patients and clinicians stated that the tool contains helpful information, does not require much time for the patient to use, and efficiently fills gaps in knowledge. Although patients found the risk profile information helpful, they reported needing time to read and digest.

Conclusion: BREASTChoice was perceived as highly usable by patients and clinicians and has the potential for sustainability. Future research will implement and test the tool after integrating the stakeholder-suggested changes to its delivery process and content. It is critical to conduct usability assessments such as these prior to decision aid implementation to ensure success of the tool to improve risk communication.

Keywords: Breast cancer; Breast reconstruction; Clinical decision aid; Sociotechnical framework.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Adapted sociotechnical framework
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References

    1. Chrimes D, Kitos NR, Kushniruk A, Mann DM. Usability testing of avoiding diabetes thru Action Plan Targeting (ADAPT) decision support for integrating care-based counseling of pre-diabetes in an electronic health record. Int J Med Informatics. 2014;83(9):636–47. doi: 10.1016/j.ijmedinf.2014.05.002. - DOI - PMC - PubMed
    1. Mann DM, Palmisano J, Lin JJ. A pilot randomized trial of technology-assisted goal setting to improve physical activity among primary care patients with prediabetes. Prev Med Rep Dec. 2016;4:107–12. doi: 10.1016/j.pmedr.2016.05.012. - DOI - PMC - PubMed
    1. Foraker RE, Shoben AB, Kelley MM, et al. Electronic health record-based assessment of cardiovascular health: the stroke prevention in healthcare delivery environments (SPHERE) study. Prev Med Rep. 2016;4:303–8. doi: 10.1016/j.pmedr.2016.07.006. - DOI - PMC - PubMed
    1. Boateng J, Lee CN, Foraker RE, et al. Implementing an electronic clinical decision support Tool Into Routine Care: a qualitative study of Stakeholders’ perceptions of a Post-Mastectomy breast Reconstruction Tool. MDM Policy Pract Jul-Dec. 2021;6(2):23814683211042010. doi: 10.1177/23814683211042010. - DOI - PMC - PubMed
    1. Politi MC, Lee CN, Philpott-Streiff SE, et al. A Randomized Controlled Trial evaluating the BREASTChoice Tool for personalized decision support about breast Reconstruction after Mastectomy. Ann Surg Feb. 2020;271(2):230–7. doi: 10.1097/sla.0000000000003444. - DOI - PubMed

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