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Development and Pilot Testing of a Patient-Centered Web-Based Reproductive Decision Support Tool for Primary Care.

Lisa S Callegari1,2,3, Karin M Nelson4,5,6, David E Arterburn7

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|February 4, 2021
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Summary

The MyPath tool successfully increased discussions about reproductive needs during primary care visits for women Veterans. This web-based decision support tool was highly acceptable and improved decision quality without increasing provider workload.

Keywords:
MyPathcontraceptiondecision aidsfamily planningpatient-centered carepreconception careprepregnancy counselingreproductive healthshared decision-makingwomen Veterans

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Area of Science:

  • Reproductive Health
  • Primary Care Innovation
  • Health Informatics

Background:

  • Patient-centered counseling for reproductive goals is often missing in primary care.
  • Women Veterans require accessible tools to manage their reproductive health.
  • Integrating reproductive health discussions into routine primary care is crucial.

Purpose of the Study:

  • To develop and pilot MyPath, a web-based decision support tool for women Veterans.
  • To assess the tool's integration into primary care visits within the Veterans Administration (VA).
  • To evaluate the impact of MyPath on reproductive health discussions and decision quality.

Main Methods:

  • A non-randomized pilot study in two VA Women's Health clinics.
  • Development of MyPath using user-centered design and theoretical frameworks.
  • Intervention group used MyPath prior to primary care visits; control group did not.

Main Results:

  • Nearly all users (97%) learned new information; 93% would recommend MyPath.
  • A significantly greater proportion of intervention participants discussed reproductive needs (93% vs. 68%, p=0.02).
  • Intervention group showed improved knowledge, self-efficacy, and a trend toward reduced decision conflict.

Conclusions:

  • MyPath is highly acceptable to women Veterans and enhances discussions on reproductive health.
  • The tool improves decision quality without increasing provider workload.
  • Further randomized trials are recommended to confirm MyPath's effectiveness.