A web-based, user-centered decision aid to support parental choices in myopia control: A development and usability study

Background Childhood myopia, intensified by rapid technological advancements, is an escalating public health issue. Shared decision-making (SDM) facilitates collaborative treatment engagement and adherence, contributing to the mitigation of myopia progression. Objective This study developed and evaluated a web-based decision aid aimed at assisting parents in making informed, value-aligned decisions. Methods Following the International Patient Decision Aid Standards framework, we conducted a two-phase process: development (scoping, stakeholder engagement, and content planning) and testing (prototype creation and alpha and beta testing with external users) to develop the Childhood Myopia Shared Decision-Making Aid (CMSDM) to support informed and value-congruent treatment decisions. The study involved 55 parents, 12 ophthalmologists, 3 school nurses, 2 health education teachers, and 20 optometrists. Results CMSDM comprises two decision aids (myopia treatment and optical correction) with six components: (1) Introduction—stating the purpose of the tool; (2) Comparison—outlining treatment options with pros and cons; (3) Consideration—prompting value reflection; (4) Understanding—clarifying key points; (5) Decision—guiding informed choice; and (6) Submission—sharing the decision with the ophthalmologist. A review from five experts provided the aid with a content validity index of 0.85, demonstrating consensus on content relevance. Users reported a mean System Usability Scale score of 85, indicating excellent usability. The use of CMSDM was associated with improved parental knowledge (t = 2.31, p < 0.01; Cohen's d = 0.60) and reduced decisional regret (t = 2.01, p < 0.05; Cohen's d = 0.52) in preliminary testing. Conclusions CMSDM, the first SDM aid for childhood myopia, supports informed parental choice. Its effectiveness should be further examined in randomized controlled trials.