How does a German audience appraise an American decision aid on early stage breast cancer

Abstract Objective To investigate how a German audience appraises an American video-based decision aid on early stage breast cancer for potential use in Germany. Methods A German synchronized voice-over version was produced and subject to different focus groups with patients ( n  = 9), health care providers ( n  = 7) and German health care experts ( n  = 15) using an individual questionnaire-based evaluation and a moderated group discussion. Research questions included a general appraisal of the decision aid and the exploration of adaptation needs for use in Germany. Descriptive statistics were calculated and the qualitative data were analyzed applying an inductive approach to categorize the statements. Results The general appraisal of the decision aid revealed positive results in all groups, especially with regard to comprehensible presentation of information and integration of patients’ testimonials. However, cultural differences between the American decision aid and Germany were debated in all groups. Conclusion Despite a high general interest and positive appraisal of the decision aid, the results of this study suggest that it cannot just be translated and used in another country. Practice implications The decision aid needs further cultural adaptation and testing in an implementation study before it can be transferred to Germany.