Development of a User-Informed Decision Aid for Contraceptive Decision-Making Among Adolescents and Young Adults: Qualitative Study

BACKGROUND Adolescents and young adults seeking contraceptive care face many considerations due to differences in contraceptive indications, knowledge levels, and non-contraceptive benefits, which are often overlooked and can lead to contraceptive non-adherence or non-use and adverse health outcomes. OBJECTIVE Develop a digital decision-aid tool that meets the contraceptive decisional needs of adolescents and young adults from diverse backgrounds. METHODS We developed a web-based decision aid using a user-centered design framework by Elwyn et al. and the International Patient Decision Aid Standards. The design and development process were informed by a literature review, consultations with scientific experts, health informatics specialists, clinicians experienced in adolescent reproductive health, and a diverse group of adolescent and young adult advisors. We gathered feedback on the decision aid's content and functionality from clinicians, adolescents, and young adult stakeholders during focus group interviews conducted across two user testing cycles. Their feedback was recorded, transcribed, and analyzed to refine the content and improve the decision aid's functionality. RESULTS Twenty-four clinicians, adolescents, and young adult participants from diverse backgrounds shared their perspectives on the decision aid's content, relevance, design, and usability over two user testing cycles from February 2023 to June 2024. The decision aid features a survey with a decision algorithm that provides contraceptive method recommendations based on user preferences and health history, as well as infographics and a provider summary view. CONCLUSIONS This approach resulted in a functional decision aid prototype, MyPlanMyChoice©, which is now ready for pilot and feasibility evaluation in a clinical setting.