Table 2.

Themes identified and addressed during the usability studies.

Theme	Location	Description	Changes Made
Content	Light Narrative	Comics are “talking down” and too simplistic; alternatively comics are highly relatable	Users can navigate through light and/or dense narratives based upon preferences for cognitive load
	Dense Narrative	Cancer development and DNA/genetic information is confusing and too technical	Language and pictures were simplified
	Games	Preference elicitation game does not have non-clinical factors, is confusing, not sensitive enough to patient preferences	Scales redesigned to include more preference factors, which were also summarized in the action plan
	Action Plan	Confusion over who the action plan is meant for and what the subject should do with it	Action plan redesigned and given additional instructions
Ease of Use	Dense Narrative	Too much text to read, would prefer audio	Audio feature made more prominent/visible
	Games	Risk assessment clicking game not giving enough feedback, took too long to complete	Clicking feedback improved, number of clicks needed were shortened
	Games	Preference elicitation game had many bugs, drag and drop functionality was difficult for many participants	Scales redesigned to use sliding scales for preset preference options
	Games	Family tree difficult to understand without a legend or key	Legend added to family tree
Navigation	Dashboard	Difficult for users to determine which module they had just completed and how far along they were in RealRisks	Checkbox functionality improved
	Dashboard	Users asked for some sort of aid to guide them through the application	Tutorial videos in development to assist users with low computer literacy