Decision Support Tool to Improve Decision-Making for HIV Pre-Exposure Prophylaxis (PrEP): Development Process and Alpha Testing.

Background: Black communities in Canada are disproportionately affected by the HIV epidemic. There is currently no patient decision support intervention for Black patients being asked to consider PrEP for HIV prevention, especially in the context of previous studies indicating that most of these patients do have decisional conflict regarding PrEP. Objective: The aim of this project was to develop a decision support tool to improve decision-making for PrEP-eligible Black clients. Methods: Using the Ottawa Decision Aids Development and Evaluation Guideline, a multidisciplinary team steered the development and evaluation of the DST in a seven steps process: Assess needs; Assess feasibility; Define the objectives of the aids; Identify the framework of decision support; Select the methods of decision support to be used in the aid; Select the designs and measures to evaluate the aid; and Plan dissemination. Both potential PrEP clients and providers reviewed the DST for usability and provided feedback. Results: The development process resulted in a web-based DST with 6 sections: Introductory section; Clarify your decision section, Information about the benefits and drawbacks of various prevention methods section; Value clarification exercise section; Identifying support system section; Next steps section. Both potential PrEP clients and PrEP providers expressed satisfaction with the use of the DST. Conclusions: A decision support tool was developed for PrEP-eligible Black patients to enhance their decision-making process for HIV prevention options. Potential users (Black patients and clinicians) found it usable.