JMIR Publications

ABSTRACT

Background:

Due to gonadotoxic cancer treatments, young adult female (YA-F) survivors often report uncertainty about their fertility, reproductive potential, and family-building options post-treatment. The Roadmap to Parenthood is a web-based decision aid and planning tool for family building after cancer.

Objective:

As part of a patient-centered development process, this study evaluated the user experience with the decision aid website to identify usability problems and inform design modifications.

Methods:

Two rounds of usability testing were conducted with the target population of YA-F cancer survivors. During testing sessions, participants viewed the website twice; first, as a “think aloud” exercise, and second, while a researcher interrupted at key points to obtain user feedback. Quantitative and qualitative data were collected to assess website usability. Quantitative measures included the System Usability Scale (SUS), the WebQual, and the eHealth Impact Questionnaire (eHIQ) Parts 1 and 2. An exit interview with open-ended questions gathered feedback on likes/dislikes and suggestions for improvement.

Results:

Participants (N=10) were YA-Fs averaging 30.9 years old (SD=4.51) and 4.44 years (SD=3.56) post-treatment. Website usability scores improved on the SUS from “acceptable” in round 1 to “excellent” in round 2 after making design changes based on user feedback (scores of 68 and 89.2, respectively). WebQual scores showed similar improvement from round 1 to round 2 testing (M=5.6 to 6.25; range 1-7). On the eHIQ, the information and presentation of the website was perceived as being comprehensive, easy to understand, and trustworthy. Participants also reported improved confidence to discuss and manage fertility/family building issues and felt encouraged to play a more active role in managing their fertility. Three usability themes were identified from qualitative feedback: ease of use, visibility/ navigation, and informational content and usefulness. Overall feedback was positive, and participants reported intentions to use the decision aid website in the future. One participant reported negative emotions when learning of infertility risks and potential family-building challenges.

Conclusions:

Website usability improved after design changes were made in response to user feedback. YA-F survivors reported positive views about the website and indicated that the decision aid would be useful in decision making about family building after cancer. Future work will include further design modifications to consider the emotional experiences of users and to consider any additional navigational features or content to optimize user ease of use and support provided by the tool.