Related Experiment Video
Updated: Apr 25, 2026
Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility
Published on: May 30, 2025
Development and Pilot Evaluation of REFLECT: A Digital Health Application Supporting Fertility and Genetic
Sarita Pathak Desai1, Lindsay Fuzzell2, Paige W Lake2
1Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Purpose:
Adolescent and young adult (AYA) patients with cancer face complex decisions about family building, often compounded by misconceptions about hereditary cancer risk. Although guidelines recommend early discussion of fertility- and genetics-related risks, these topics are inconsistently integrated into routine care. To address this gap, we developed Reproductive Education and Fertility Links for Cancer Treatment (REFLECT), a digital health application designed to provide education and decision support related to fertility, genetic risk, and future family building for AYAs with cancer. This study developed and pilot-tested REFLECT to support informed decision-making.
Methods:
REFLECT was developed using evidence-based content and implemented on a web-based platform integrating multimedia education and decision support. Two iterative rounds of user testing were conducted with AYA survivors (ages 18-39) using a Learner Verification framework to assess comprehension, usability, relevance, and acceptability. Participant feedback informed iterative refinements.
Results:
Participants (N = 16) reported that REFLECT was engaging, easy to navigate, and relevant to fertility, genetics, and future family-building concerns. Iterative testing identified opportunities to improve navigation, accessibility, and content organization, which were addressed through refinement. Participants reported increased confidence in discussing fertility preservation and genetic risk with providers and emphasized the value of an integrated patient-centered tool, particularly at the time of diagnosis.
Conclusion:
This pilot demonstrates that REFLECT is feasible, acceptable, and usable among AYAs. By integrating fertility and genetic risk education with decision support in an accessible digital format, REFLECT addresses a critical gap in AYA oncology care. These findings support further evaluation in clinical settings.
