STEP intervention development and implementation process
| Step | Objective | Framework | Method |
| 1.1 | Convene an expert panel | UKMRC/IPDAS | Expert consensus (face-to-face meetings) |
| 1.2 | Needs assessment (completed) | UKMRC/IPDAS | 12 Patient and 12 clinician interviews |
| 1.3 | Review of existing resources (completed) | UKMRC/IPDAS | Literature review and environmental scan of existing information resources Regional survey of 20 hospitals (26 inpatient/outpatient oncology departments, 12 day units and 12 palliative care teams) |
| 1.4 | Evidence: collate the clinical evidence for treatment options (completed) | IPDAS/UKMRC | Time4PallCare Project; retrospective cohort study of 6080 cancer deaths |
| 1.5 | Map existing patients’ pathways | UKMRC | (1) Interviews with patients’ oncologists, oncology nurse specialists and general practitioners (2) Retrospective population cohort study |
| 2.1 | Develop the prototype intervention and (alpha testing I) | UKMRC/IPDAS | Draft–review–revise iterative process by the research team and design experts |
| 2.2 | Review by expert panel, focus groups (alpha testing II) | UKMRC/IPDAS | (1) Expert panel consensus—meeting and emails (2) Focus groups |
| 2.3 | Develop the STEP training module for clinicians | (1) Ottawa training module and workshop (2) Development of STEP clinician handbook—expert consensus involving research team, decision support experts and medical educator | |
| 3.1 | Implementation study (beta testing) | IPDAS | (1) Pilot STEP with patients and their clinicians (2) Patient and clinician questionnaires (3) Individual interviews with patients and clinicians |
| 3.2 | Implementation toolkit | (1) Develop toolkit (2) Embed toolkit within SystmOne (3) Create STEP website |
IPDAS, International Patient Decision Aids Standards; UKMRC, UK Medical Research Council.