Table 1.

Feedback from client and clinician participants on each section of the decision aid.

	“Information, factsheets, and resources” page	“What matters to me” page	“Am I at risk?” page	“Treatment options” page
Client Feedback
Usefulness	• 1 neutral response • 1 negative response (not useful) • 7 positive responses, including ease of navigation, amount and type of information, practical application e.g., “It is a useful starting point for a conversation” e.g., “It lets the people know how I want to be treated”	• 1 did not use • 2 didn't find it useful e.g., “made me feel like getting over these things was really easy, when in reality it's the hardest thing I've ever done” • 6 found it useful e.g., “You can express what you like and don't like”	• 1 negative • 8 positive e.g., “was quite detailed in what an at risk mental state is” e.g., “because it's a question I ask myself”	• 2 didn't find it useful e.g., “left with doubts” • 1 appreciated finding out about treatment options they weren't aware of (e.g., Omega-3 fatty acids)
Relevance	• All positive responses, including noting that the diagrams and facts were useful, as were the personal stories e.g., “It was good hearing people's personal experiences and seeing stats”	• 1 negative: “I didn't agree with some things and I found that most of it was already what I thought” • 8 positive, including that the content related to their personal circumstances e.g., “I liked being able to find out what is important to me”	• All positive responses, including that it was reassuring, told them “what I need to know about what could potentially happen,” and they found it useful to read about “people with my condition”	• All clients found it relevant e.g., “I will be going through these treatments at some point and it explains what they are,” e.g., “it really helped me understand there's more help than just counseling.” • One client found it reassuring to be provided with information, saying “I have been terrified of institutions since opening up about my condition. It's nice to know what's actually going on.”
Suggestions	• More interviews • Larger font size • Additional links to resources • Additional interactive components	• Boring • Clearly displayed • Easy to navigate • More options and categories	• Additional information • More interactive features	• Additional information e.g., “personal experiences of success stories for each treatment” • More information about side effects of medication • More interactive components • More color: “a tad bland”
Clinician Feedback
Usefulness	• All positive, including that it looked good, was engaging, easy to navigate e.g., “range of topics and different mediums useful” e.g., “lots of info in one place, easy access, videos were good option”	• All positive apart from one who replied “somewhat” but did not elaborate; two could not remember section e.g., “very engaging” e.g., “Like videos and consumer testimony”	• All positive but one clinician noted they were unsure the client understood the risk concept e.g., “Useful to have visual ways of presenting this concept” e.g., “Diagram was good [at] showing increased risk without being scary”	• 2 positive e.g., “Yes, able to talk about different options” • 6 conditional responses (e.g., “somewhat,” “didn't find it as useful”) and related caveats about mismatch between options presented in the decision aid and what the service can offer e.g., “need to be careful that it doesn't set expectations in [service] there is a standard package of care eg don't offer omega”
Relevance	• All positive apart from one participant who said “mostly” but didn't elaborate e.g., “helpful when providing psychoed to young person” e.g., “yes emphasized drop in functioning yet hopeful about recovery”	• All positive except one negative “didn't seem as relevant as first section” and one who could not remember the section e.g., “[very] helpful to explain stress-vulnerability model in a fun way” e.g., “animations and visual interactions are most useful”	• All positive, including “ARMS focus good” and “relevant to PACE cohort, visuals helpful to explain concepts” • Three caveats, including that “less text is more engaging,” that it was a “difficult concept to convey and needed more explanation,” and that “young people still find the ‘longitudinal' paradigm less of ‘relevance' than the here and now”	• 2 positive e.g., “Yes, given I had discussed some of these options already with the young person” • 6 noted caveats around including Omega-3 fatty acids as a treatment option when it wasn't available at the service • 1 noted that more recent evidence (not incorporated into the clinical practice guidelines) was not reflected in the decision aid • 1 noted the limitations of the decision aid for young people with other mental health challenges e.g., “Mostly, I'm unsure how to talk about use of fish oil and unclear what current recommendations should be. Also one client had BPD too so also talked about CAT” e.g., “We don't usually present fish oil as an option and the diagram presents it as very effective whereas neurapro didn't show this so it feels very prominent in the choices given, and at the point that the decision aid was used it's a little hard to describe therapy as a choice between supportive and CBT and to differentiate that from treating mental health in general as often these are combined”
Suggestions	• 4 said no changes required • Additional information required for some clients • Too much information to cover in one session • Balance provision of information with engagement • Include fact sheet on role of general practitioner • Preference for videos over “boring” fact sheets	• Make it less simplistic for some clients • Being able to print out section • Interactive version for client to use at home or handout to accompany online decision aid used in session	• Try and emphasize how here and now affects the “at risk” concept • Include audio to explain each graph • Risk communication graphs were too big—suggestion to reduce them to be out of 10 people instead of 100	• Additional details about different therapies • Have a function so that clinicians can tailor it to the young person and/or what is available at the service • Additional details about options beyond the clinical practice guidelines (e.g., psychosocial recovery groups, vocational support, medication, family work)