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JMIR Hum Factors
. 2026 Apr 16:13:e86283.
doi: 10.2196/86283.
Interactive, Personalized Patient Decision Aid for COVID-19 Vaccination in Canada: User-Centered Design Approach
Doriane Etienne 1 2 3 , Patrick M Archambault 1 2 4 , Isaac I Bogoch 5 , Christine T Chambers 6 7 , Andrea D Chittle 8 , Juliette Demers 9 , S Michelle Driedger 10 , Ève Dubé 3 , Marie-Pierre Gagnon 2 11 , Teresa Gavaruzzi 12 , Anik Giguère 1 2 , Nathalie Grandvaux 13 14 , Kelly Grindrod 15 , Hina Hakim 1 2 3 , Samira Jeimy 16 , Jason Kindrachuk 17 , Annie LeBlanc 1 2 , Shannon E MacDonald 18 , Ruth Ndjaboue 19 20 , Magniol Noubi 1 2 3 , Rita Orji 21 , Jean-Sébastien Paquette 1 2 , Elizabeth Parent 1 , Jean-Sébastien Renaud 1 2 , Beate Sander 22 , Monica Taljaard 23 , Dana Tannenbaum Greenberg 24 , Marie-Claude Tremblay 1 , Sabina Vohra-Miller 25 , Vivian A Welch 26 , Holly O Witteman 1 2 3
Affiliations
Background: The COVID-19 pandemic highlighted the need for practical digital health tools to support informed decision-making amid rapidly evolving evidence and widespread misinformation.
Objective: We iteratively developed and refined VaxDA-C19, a bilingual (English and French) web-based patient decision aid designed to support informed decision-making in Canada about COVID-19 vaccination. VaxDA-C19 integrates interactive and personalized features aimed to enhance vaccine confidence, reduce cognitive overload, and respond to diverse informational needs.
Methods: VaxDA-C19 was developed using an iterative, user-centered design approach. Throughout the development process, we involved a citizen panel, health care professionals, user experience designers, and scientific experts to guide refinements. We also conducted usability testing sessions with adults in Canada, using semistructured interviews, comparative testing, and think-aloud protocols with thematic analysis. We ultimately conducted 4 design cycles in total with adults in Canada (users) and expert reviewers (experts). Cycle 1 involved 9 people (9 users), cycle 2 involved 22 people (22 users), cycle 3 involved 9 people (3 users and 6 experts), and cycle 4 involved 9 people (9 experts).
Results: In cycle 1, user feedback guided design decisions about how to present quantitative information and technical vaccine descriptions more simply. In cycle 2, while most users (9/11, 82%) favored in-depth explanations of vaccine development, a few raised concerns about content that could be perceived as politically charged. Cycle 3 identified usability improvements, including more explicit navigation controls, simplified medical terminology, and optimized interactive components (avatars and sliders). Expert reviews in cycle 4 refined linguistic consistency, mobile responsiveness, content transparency, and scientific accuracy, emphasizing explicit instructional guidance and bilingual accessibility.
Conclusions: Our iterative process produced a personalized, bilingual digital decision aid to support evidence-informed, values-congruent decisions about COVID-19 vaccination. A randomized controlled trial will further evaluate VaxDA-C19's impact on vaccination intentions, knowledge retention, emotional responses, decisional conflict, and decisional regret. If it proves effective, the patient decision aid may also be used as a platform to support other vaccine decisions, namely, influenza, measles, shingles, pertussis, and potentially other emerging infectious diseases.
Keywords: COVID-19 vaccination; data visualization; digital health; health literacy; iterative human-centered design; patient decision aid; personalized avatar; public health communication; user engagement; web-based tool.
. 2026 Apr 16:13:e86283.
doi: 10.2196/86283.
Interactive, Personalized Patient Decision Aid for COVID-19 Vaccination in Canada: User-Centered Design Approach
Doriane Etienne 1 2 3 , Patrick M Archambault 1 2 4 , Isaac I Bogoch 5 , Christine T Chambers 6 7 , Andrea D Chittle 8 , Juliette Demers 9 , S Michelle Driedger 10 , Ève Dubé 3 , Marie-Pierre Gagnon 2 11 , Teresa Gavaruzzi 12 , Anik Giguère 1 2 , Nathalie Grandvaux 13 14 , Kelly Grindrod 15 , Hina Hakim 1 2 3 , Samira Jeimy 16 , Jason Kindrachuk 17 , Annie LeBlanc 1 2 , Shannon E MacDonald 18 , Ruth Ndjaboue 19 20 , Magniol Noubi 1 2 3 , Rita Orji 21 , Jean-Sébastien Paquette 1 2 , Elizabeth Parent 1 , Jean-Sébastien Renaud 1 2 , Beate Sander 22 , Monica Taljaard 23 , Dana Tannenbaum Greenberg 24 , Marie-Claude Tremblay 1 , Sabina Vohra-Miller 25 , Vivian A Welch 26 , Holly O Witteman 1 2 3
Affiliations
- PMID: 41989979
- PMCID: PMC13086185
- DOI: 10.2196/86283
Background: The COVID-19 pandemic highlighted the need for practical digital health tools to support informed decision-making amid rapidly evolving evidence and widespread misinformation.
Objective: We iteratively developed and refined VaxDA-C19, a bilingual (English and French) web-based patient decision aid designed to support informed decision-making in Canada about COVID-19 vaccination. VaxDA-C19 integrates interactive and personalized features aimed to enhance vaccine confidence, reduce cognitive overload, and respond to diverse informational needs.
Methods: VaxDA-C19 was developed using an iterative, user-centered design approach. Throughout the development process, we involved a citizen panel, health care professionals, user experience designers, and scientific experts to guide refinements. We also conducted usability testing sessions with adults in Canada, using semistructured interviews, comparative testing, and think-aloud protocols with thematic analysis. We ultimately conducted 4 design cycles in total with adults in Canada (users) and expert reviewers (experts). Cycle 1 involved 9 people (9 users), cycle 2 involved 22 people (22 users), cycle 3 involved 9 people (3 users and 6 experts), and cycle 4 involved 9 people (9 experts).
Results: In cycle 1, user feedback guided design decisions about how to present quantitative information and technical vaccine descriptions more simply. In cycle 2, while most users (9/11, 82%) favored in-depth explanations of vaccine development, a few raised concerns about content that could be perceived as politically charged. Cycle 3 identified usability improvements, including more explicit navigation controls, simplified medical terminology, and optimized interactive components (avatars and sliders). Expert reviews in cycle 4 refined linguistic consistency, mobile responsiveness, content transparency, and scientific accuracy, emphasizing explicit instructional guidance and bilingual accessibility.
Conclusions: Our iterative process produced a personalized, bilingual digital decision aid to support evidence-informed, values-congruent decisions about COVID-19 vaccination. A randomized controlled trial will further evaluate VaxDA-C19's impact on vaccination intentions, knowledge retention, emotional responses, decisional conflict, and decisional regret. If it proves effective, the patient decision aid may also be used as a platform to support other vaccine decisions, namely, influenza, measles, shingles, pertussis, and potentially other emerging infectious diseases.
Keywords: COVID-19 vaccination; data visualization; digital health; health literacy; iterative human-centered design; patient decision aid; personalized avatar; public health communication; user engagement; web-based tool.