Tradeoffs between pace and reach of patient decision aids: a case study adapting a breast reconstruction decision aid from clinical implementation to social media dissemination.
8 affiliations
- 1Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
- 2Division of Plastic and Reconstructive Surgery, University of North Carolina, Chapel Hill, NC, USA.
- 3Bursky School of Public Health, Washington University in St. Louis, St. Louis, MO, 63130, USA.
- 4Hackensack Meridian Health Center for Discovery & Innovation, Nutley, NJ, USA.
- 5Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.
- 6UNC Lineberger Comprehensive Cancer Center, Community Advisory Board, BREASTChoice Study, Chapel Hill, NC, USA.
- 7UNC Lineberger Comprehensive Cancer Center, Patient and Community Engagement to Educate Researchers (PEER) Advisory Committee, Chapel Hill, NC, USA.
- 8Bursky School of Public Health, Washington University in St. Louis, St. Louis, MO, 63130, USA. [email protected].
Abstract
Background
Patient decision aids (PtDAs) support shared decision making and can improve patient outcomes. Nevertheless, PtDAs have not been widely adopted in healthcare settings because of numerous patient-, clinician-, and organizational-level factors. To address the slow pace of implementation and limited reach of PtDAs, we adapted a PtDA from implementation through the electronic health record in clinical settings for dissemination on social media and online communities.Methods
We describe the adaptation of BREASTChoice, a PtDA about breast reconstruction after mastectomy, originally used in clinical settings and the electronic health record (EHR), for dissemination through social media and online communities. We conducted focus groups and interviews with patients and topical experts to guide the adaptation process, using Rogers' Diffusion of Innovations and ADAPT-ITT, and tracked adaptations using FRAME.Findings
Based on our findings, we propose a model that identifies differences in accelerators and inhibitors of BREASTChoice and its implementation and dissemination strategies, with the goal of outlining how speed of implementation and dissemination can differ between contexts.Implications for dissemination and implementation research
This study provides a model that explicitly outlines the potential determinants of implementation and dissemination of PtDAs both within and outside of health settings. Evaluating these determinants will help researchers and PtDA developers to increase speed and reach of PtDAs while maintaining scientific rigor.
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BibTeX
@article{baumann2026tradeoffs,
title = {{Tradeoffs between pace and reach of patient decision aids: a case study adapting a breast reconstruction decision aid from clinical implementation to social media dissemination.}},
author = {Ana A Baumann and Clara N Lee and Krista Cooksey and Viktoria Vonder Haar and Kathryn Chetwynd and Victor Catalan Gallegos and Victoria Triana and Lisa Carter-Bawa and Eva A May and Vivian Muzyk and Mary C Politi},
journal = {Implementation science communications},
year = {2026},
month = jul,
doi = {10.1186/s43058-026-01062-2},
url = {https://europepmc.org/article/MED/42919428},
note = {CC BY},
}
RIS
TY - JOUR
TI - Tradeoffs between pace and reach of patient decision aids: a case study adapting a breast reconstruction decision aid from clinical implementation to social media dissemination.
AU - Ana A Baumann
AU - Clara N Lee
AU - Krista Cooksey
AU - Viktoria Vonder Haar
AU - Kathryn Chetwynd
AU - Victor Catalan Gallegos
AU - Victoria Triana
AU - Lisa Carter-Bawa
AU - Eva A May
AU - Vivian Muzyk
AU - Mary C Politi
PY - 2026
DA - 2026/07/01
JO - Implementation science communications
DO - 10.1186/s43058-026-01062-2
UR - https://europepmc.org/article/MED/42919428
AB - Background Patient decision aids (PtDAs) support shared decision making and can improve patient outcomes. Nevertheless, PtDAs have not been widely adopted in healthcare settings because of numerous patient-, clinician-, and organizational-level factors. To address the slow pace of implementation and limited reach of PtDAs, we adapted a PtDA from implementation through the electronic health record in clinical settings for dissemination on social media and online communities.Methods We describe the adaptation of BREASTChoice, a PtDA about breast reconstruction after mastectomy, originally used in clinical settings and the electronic health record (EHR), for dissemination through social media and online communities. We conducted focus groups and interviews with patients and topical experts to guide the adaptation process, using Rogers' Diffusion of Innovations and ADAPT-ITT, and tracked adaptations using FRAME.Findings Based on our findings, we propose a model that identifies differences in accelerators and inhibitors of BREASTChoice and its implementation and dissemination strategies, with the goal of outlining how speed of implementation and dissemination can differ between contexts.Implications for dissemination and implementation research This study provides a model that explicitly outlines the potential determinants of implementation and dissemination of PtDAs both within and outside of health settings. Evaluating these determinants will help researchers and PtDA developers to increase speed and reach of PtDAs while maintaining scientific rigor.
SN - 2662-2211
ER -