Background: The shared clinical decision-making recommendation for mid-adult HPV vaccination in the United States (i.e., CDC 2019) may be successfully facilitated using patient-facing decision aids. The purpose of this study was to design, develop, and field test the HPV Decide decision tool among the target patient population (unvaccinated adults aged 27 to 45) and healthcare providers who provide care to this patient population in the United States.

Methods: The ‘HPV Decide’ online tool was developed through a 6-step process, involving community and provider advisory boards, usability testing with 10 end users, field testing with another 10, and interviews with 18 healthcare providers. The process incorporated both inductive and deductive qualitative data analyses.

Results: Beginning with a logic model based on the Ottawa Decision Support Framework and a systematic literature review, the development highlighted the importance of objective knowledge and managing decisional conflict. Iterative modifications were informed by engagement with our advisory boards, alpha testing, and usability testing. Field testing results demonstrated the utility of the tool to end users, highlighting the straightforward design and lack of medical jargon. Many expressed a desire to access the tool before doctor appointments for preparation, emphasizing its value in a healthcare context and in partnership with informed providers. Lastly, insights were gleaned from healthcare providers focusing on the tool’s information quality, structure, acceptability, and future implementation.

Conclusion: The HPV Decide decision tool demonstrates promise in supporting informed decisions about HPV vaccination among mid-adults. While users recognized its information quality and user-centric design, full evaluation focused on changes in informed decision making and clinic-based implementation are needed.