An Iterative Process for Developing and Evaluating a Computer-Based Prostate Cancer Decision Aid for African American Men

Background. The disproportionate burden of prostate cancer (PrCA) among African American (AA) men amplifies the need for informed decisions about PrCA screening. To create a computer-based decision aid (CBDA) for increasing prostate knowledge, decision self-efficacy, and intention to make an informed decision, the study implemented an iterative approach to develop a culturally appropriate CBDA. Method. A short CBDA prototype containing PrCA information and interactive activities was developed. A sample of 21 AA men aged 37 to 66 years in South Carolina participated in one of seven 90-minute focus groups and completed a 36-item survey. Updates were made to the CBDA based on participant feedback. The CBDA and heuristic evaluation surveys were then distributed to six expert reviewers. Ten men were also randomly selected from our sample population to participate in interviews regarding usability of the CBDA. Results. Participants and expert reviewers expressed consensus on many features of the CBDA, but some suggested changes to the format and graphics in order to enhance the CBDA’s effectiveness. Development and evaluation processes and implications are discussed. Conclusions. Using CBDAs for informed decision making may be appropriate for AA men. It is important to engage the community and experts in an iterative development process to ensure that a CBDA is relevant for priority populations.