Abstract
Background. Developing patient decision aids (PtDAs) requires considerable resources. We aimed to create a digital platform to streamline the process and investigate stakeholder perceptions of factors influencing the adoption of a mock-up of the platform. Methods. Using the Framework for Innovation, a design team developed an alpha version of the platform, with support from an advisory panel. A convenience sample of key stakeholders involved in the development of PtDAs, who were fluent in English, French, or Spanish, reviewed the mock-up in think-aloud sessions and answered open-ended questions structured along Normalization Process Theory constructs: Coherence, Cognitive Participation, Collective Action, and Reflective Monitoring. A thematic qualitative analysis was conducted by 3 researchers, iteratively improving the mock-up until no major issues emerged. Results. We recruited 20 participants, mainly women (n = 11), from 4 continents, including clinician-researchers (n = 15), patients (n = 4), and a health care manager (n = 1). Their experience in developing PtDAs ranged from none (n = 2) to more than 10 PtDAs (n = 1), with most having developed 2 to 5 PtDAs (n = 9). Participants noted that the platform could enhance the shared understanding of processes and roles (Coherence), support input from different stakeholders (Cognitive Participation), and streamline development and revision, recommending features such as version tracking (Collective Action). They also emphasized the need for customizable PtDA templates, training, and PtDA certification (Reflective Monitoring). Limitations. Few participants were from middle- or low-income countries, limiting the findings' transferability to these populations. Conclusions. Next steps include developing and evaluating a minimum viable version of the platform incorporating these findings. Implications. This innovation has the potential to scale the development of PtDAs and ultimately support evidence-based and preference-sensitive clinical decisions. HIGHLIGHTS: This formative research presents an innovative infrastructure designed to scale patient decision aids through capacity-building tools and standardized templates.Stakeholder feedback suggests that the platform could enable more timely and resource-efficient development of decision aids, although its effectiveness has yet to be evaluated.The platform's collaborative features could foster partnerships between developers, clinicians, and patients by promoting a shared understanding of the process and making roles and decisions about content more transparent.To increase confidence in the quality of decision aids, future work should introduce a validation process for decision aids and integrate evidence-synthesis guidance into the platform.