Table 2 Stakeholder engagement meeting final recommendations for the BEFORE (Begin Exploring Fertility Options, Risks, and Expectations) decision aid
Break-out Group Session | Final Recommendations |
|---|---|
 1. Presentation of statistics | − Use pictographs for the visual presentation of statistics on the pregnancy success rates for each fertility option − Reduce the denominator from 100 to 10 − Use a gender-neutral image for the pictograph images to ensure inclusivity |
 2. Inclusion and formatting of an explicit values clarification method | − All participants felt that an explicit values clarification method should be included as an optional tool for those patients who want to use it − Most participants preferred the Likert-scale format with pre-listed values and blank spaces for patients to add in their own values − Suggested modifying the scale headings to ‘important to me’ and ‘not as important to me’ for the values |
 3a. Inclusion and formatting of personal stories | − Personal stories through videos, quotes, and forums were viewed as beneficial for inclusion − Caution was expressed on ‘recreating the wheel’ as many stories exist online currently − Diverse patients and modern stories were requested to ensure representation and a sense of personalization for the patient viewing the story − Recommendations to include ‘quotes of wisdom’ from breast cancer survivors throughout the decision aid |
 3b. Dissemination strategies | National/Broad Strategies − Determining a host location to reach as many young breast cancer patients as possible (e.g., national cancer organizations or advocacy groups) − National dissemination (e.g., providing links to the decision aid through national cancer organizations or advocacy groups) − Add to the curriculum for medical students as well as continuing medical education for health care providers already in practice − Advertise the decision aid in medical journals − Search engine optimization for the online decision aid Local Strategies − Flag use of the decision aid in electronic medical records − Include use of decision aid in physician checklists − Provide information and dissemination in general surgery updates, tumour boards, or multidisciplinary cancer conferences − Directed patient advertising (e.g., have posters on the walls of physician office) − Survivor and health care provider champions |