The development and pilot testing of a shared decision-making encounter aid for weight management decisions

Obesity management involves multiple treatment options with differing benefits, risks, costs, and burdens, making these decisions highly preference sensitive. Shared decision-making (SDM) is recommended in obesity care, and yet practical tools to support real-time SDM during clinical encounters remain limited. We developed and pilot-tested a point-of-care decision aid, Weight Management Choice, to support structured discussions about weight management options.

This was a two-phase study combining a human-centered design process with a subsequent single-arm observational pilot study conducted in outpatient clinics at two Mayo Clinic sites. The design phase involved evidence review, observation of clinical encounters, iterative prototyping, and stakeholder-informed field testing. The pilot phase then evaluated the resulting tool in routine encounters between adults considering weight management options and participating clinicians. Post-encounter assessments included the SURE test, the 9-item Shared Decision Making Questionnaire (SDM-Q-9), and technology acceptance instrument assessing perceived usefulness (PU) and perceived ease of use (PEOU).

Five clinicians were enrolled, four completed at least one assessment. Of 40 patients enrolled, 29 completed at least one patient-reported assessment (median age, 43 years; 75.9% female). Among patients completing the SURE test (n = 27), the mean score was 3.81 (SD 0.77) on a 0-4 scale. Among those completing the SDM-Q-9 (n = 29), the mean score was 75.0 (SD 18.2) on a 0-100 scale. Patients completing the technology acceptance instrument (n = 26) reported mean PU and PEOU scores of 27.2 (SD 4.52) and 27.8 (SD 3.93), respectively. Across 33 clinician encounter-level assessments, corresponding mean scores were 27.5 (SD 2.74) and 29.1 (SD 2.74) on 5-35 scales.

The Weight Management Choice aid was perceived as feasible and had favorable immediate post-encounter ratings of shared decision-making, decisional conflict, and perceived usability. Future research should evaluate its impact on longer-term decision quality, treatment adherence, and clinical outcomes across diverse care settings.