# Testing the usability of a web-based hypospadias decision aid for parents using a user-centered design approach

> **NIH NIH R03** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $132,750

## Abstract

Reconstructive surgery is advocated for most children with hypospadias to prevent potentially serious cosmetic
and functional problems. Parents faced with a decision about hypospadias repair encounter an irreversible
choice with potentially lifelong consequences. Recent studies have identified decisional conflict (DC) and
decisional regret (DR) as a significant problem for parents. Shared decision-making (SDM) addresses the
issues of DC and DR by clarifying modifiable factors in decision-making and enabling families and physicians
to utilize a bi-directional flow of information. Decision aids (DA) facilitate SDM between families and physicians
by providing decision support thereby improving decision quality. Through my career development award
(K23DK111987), I have completed a qualitative assessment to explore parents’ informational needs for
decision-making regarding hypospadias surgery. This qualitative work has resulted in the creation of the
‘Hypospadias Homepage,’ a DA for use by parents/caregivers of children with hypospadias. Our next step, as
proposed in the K23 award, is to perform acceptability testing of the ‘Hypospadias Homepage’ outlined by the
International Patient Decision Aids Standard Collaboration. This will be done utilizing an “acceptability
questionnaire,” which will evaluate the amount, length, clarity, helpfulness and balanced manner of the
information presented in the DA. However, the Hypospadias Homepage is not a traditional paper-based DA.
Instead our DA is designed to be used by parents/caregivers via the Internet. At the time of the initial K23
proposal we did not anticipate this mode of delivery, but the parents and providers proposed a DA that would
be available online for convenience and “24/7” availability. When designing a DA for online delivery, it is
necessary to assess the DA’s “usability” (i.e., ease of learning, efficiency of use, memorability, error frequency
and severity and subjective satisfaction). Therefore, we need to assess usability of the ‘Hypospadias
Homepage’ in addition to conducting acceptability testing. To accomplish this, I have partnered with experts in
the evaluation of health information technology and human computer interaction. By incorporating cutting-edge
techniques for usability testing of the ‘Hypospadias Homepage’, we will be able to identify a number of areas
for improvement/revision. We can then implement these changes prior to pilot field-testing of the DA in the
clinical setting as proposed in Aim 4 of the K23 award. The specific aim of this proposal is to conduct two
rounds of usability testing in a naturalistic setting (i.e. an initial “field test”) where parents/caregivers will be
instructed to use the Hypospadias Homepage over a one-week period outside of the controlled research
setting while we capture their interactions with the website using server-side data collection techniques. Upon
completion of the work proposed in this R03 application, as well as the work proposed in...

## Key facts

- **NIH application ID:** 10104749
- **Project number:** 1R03DK126843-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Katherine Hubert Chan
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $132,750
- **Award type:** 1
- **Project period:** 2021-04-15 → 2023-04-14

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10104749

## Citation

> US National Institutes of Health, RePORTER application 10104749, Testing the usability of a web-based hypospadias decision aid for parents using a user-centered design approach (1R03DK126843-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10104749. Licensed CC0.

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