Aim: To describe the development and RCT evaluation of Navigate: an online treatment decision aid (DA) for men newly diagnosed with low risk prostate cancer (LRPC) and their partners deciding between active surveillance and curative treatment options.
Methods: Navigate presents evidence-based, unbiased information on active surveillance and curative treatment options, as well as lifestyle and wellness information. It contains sections specific to partners and gay men. Experiential content is provided via video messages from consumers and clinicians. An interactive values clarification exercise (VCE) assists men/partners to integrate their values into their treatment seletion. In the RCT stage, 340 men with LRPC and their designated partners are randomised to usual care (PCFA website) versus Navigate DA. Participants complete self-report questionnairs at baseline, post-treatment decision, and at 3 and 6 months follow-up. Assessed outcomes are: decisional conflict, knowledge, distress, satisfaction, patient-partner communication, decisional regret, and health care costs.
Results: A 'cutting-edge' online DA was created, with 45 video clips embedded in the Navigate website to provide health information, lived experiences, and recommendations from men, partners, clinicians and urology nurses. Evidence-based DA content, developed in line with International Patient Decision Aid Standards (IPDAS) criteria, was iteratively reviewed by clinicians and consumers to ensure accuracy, relevance and completeness, with final content copy-edited to meet low health literacy standards. Three co-design workshiops with cancer consumers, web designers and researchers informed the Navigate online platform development, including VCE.
Conclusions: Navigate is a novel and comprehensive resource designed to meet the needs of a growing number of Australian men diagnosed with LRPC who report need for help with treatment decision-making. A national RCT of Navigate is underway with the aim of improving informed treatment choice and reducing confusion, distress and decisional regret in this cohort. Health care costs of treatment decision-making will also be addressed.