Trial reportImplementation science : IS2021
Implementation and sustainability factors of two early-stage breast cancer conversation aids in diverse practices.
Trial report in Implementation science : IS, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03136367 (Comparative Effectiveness of Encounter Decision Aids for Early-Stage Breast Cancer Across Socioeconomic Strata), which is not on this map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparative Effectiveness of Encounter Decision Aids for Early-Stage Breast Cancer Across Socioeconomic Strata
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Impact of Decision Aids for Shared Decision-Making for Patients with Early Stage Breast Cancer: A Systematic Review.Current oncology (Toronto, Ont.) · 2026Pooled it
- Supporting translation of research evidence into practice-the use of Normalisation Process Theory to assess and inform implementation within randomised controlled trials: a systematic review.Implementation science : IS · 2023Pooled it
- Trial
- From Clinical Reality to Blueprint Designing: A Qualitative Study Exploring Communication Challenges and Unmet Needs for Patient Decision Aid Development in Early-Stage Breast Cancer.Psycho-oncology · 2026Observational
- Article
- Translational framework for implementation evaluation and research: implementation strategies derived from normalization process theory.Implementation science : IS · 2025Article
- The Implementation of Shared Decision-Making Using Patient Decision Aid Tools to Select Breast Cancer Treatment Options: A Systematic Review in the Time of Minimum Quality Standards.Healthcare (Basel, Switzerland) · 2025Review
- Shared Decision-Making Tools Implemented in the Electronic Health Record: Scoping Review.Journal of medical Internet research · 2025Article
- Digital Age Transformation in Patient-Physician Communication: 25-Year Narrative Review (1999-2023).Journal of medical Internet research · 2025Review
- Living Flat: Stories from Women of Color After Mastectomy.Annals of surgical oncology · 2025Article
- Centering intersectional breast cancer screening experiences among black, Latina, and white women: a qualitative analysis.Frontiers in public health · 2024Article
- The decision aid is the easy part: workflow challenges of shared decision making in cancer care.Journal of the National Cancer Institute · 2023Article
- Implementing shared decision-making interventions in breast cancer clinical practice: a scoping review.BMC medical informatics and decision making · 2023Article
- Implementing shared decision making for early-stage breast cancer treatment using a coproduction learning collaborative: the SHAIR Collaborative protocol.Implementation science communications · 2023Article
- Improving shared decision making in virtual breast cancer surgery consultations.American journal of surgery · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 8 institutions in 4 countries.
Funding
Abstract
backgroundConversation aids can facilitate shared decision-making and improve patient-centered outcomes. However, few examples exist of sustained use of conversation aids in routine care due to numerous barriers at clinical and organizational levels. We explored factors that will promote the sustained use of two early-stage breast cancer conversation aids. We examined differences in opinions between the two conversation aids and across socioeconomic strata.
methodsWe nested this study within a randomized controlled trial that demonstrated the effectiveness of two early-stage breast cancer surgery conversation aids, one text-based and one picture-based. These conversation aids facilitated more shared decision-making and improved the decision process, among other outcomes, across four health systems with socioeconomically diverse patient populations. We conducted semi-structured interviews with a purposive sample of patient participants across conversation aid assignment and socioeconomic status (SES) and collected observations and field notes. We interviewed trial surgeons and other stakeholders. Two independent coders conducted framework analysis using the NOrmalization MeAsure Development through Normalization Process Theory. We also conducted an inductive analysis. We conducted additional sub-analyses based on conversation aid assignment and patient SES.
resultsWe conducted 73 semi-structured interviews with 43 patients, 16 surgeons, and 14 stakeholders like nurses, cancer center directors, and electronic health record (EHR) experts. Patients and surgeons felt the conversation aids should be used in breast cancer care in the future and were open to various methods of giving and receiving the conversation aid (EHR, email, patient portal, before consultation). Patients of higher SES were more likely to note the conversation aids influenced their treatment discussion, while patients of lower SES noted more influence on their decision-making. Intervention surgeons reported using the conversation aids did not lengthen their typical consultation time. Most intervention surgeons felt using the conversation aids enhanced their usual care after using it a few times, and most patients felt it appeared part of their normal routine.
conclusionsKey factors that will guide the future sustained implementation of the conversation aids include adapting to existing clinical workflows, flexibility of use, patient characteristics, and communication preferences.
trial registrationClinicalTrials.gov Identifier: NCT03136367 , registered on May 2, 2017.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.