The Ottawa Decision Support Framework (ODSF)informs the study. The ODSF is an evidence-based,practical, midrange theoretical framework developed to guide people through health and social decisions and incorporates three key elements: decisional needs,decision support, and decision quality. According to the framework, unresolved decisional needs will negatively influence decision quality. While it has not been used specifically with Aboriginal populations, the ODSF has been successfully used to structure the assessment of decisional needs within a range of populations in Canada and internationally and specifically with women. The ODSF provided the theoretical foundation for the patient decision aid adapted in this study and was used with postcolonial theory to guide the creation of key questions and prompts for focus groups and usability interviews. The ODSF provides a theoretical framework for structuring SDM tools and approaches (i.e., patient decision aids, decision coaching) and was used with a postcolonial theoretical lens through which SDM was viewed for this study.