Impact of Active Choice on Advance Directive Completion Rates

Not Applicable

Completed

• Conditions: Advance Directive Completion
• Interventions: Behavioral: Mandatory active choice

• Registration Number: NCT02289105
• Lead Sponsor: University of Pennsylvania

Brief Summary

The overall objective of this project is to assess if an active choice intervention can increase advance directive completion rates.

Detailed Description

Nearly 70% of Americans express the desire to die at home, and most individuals want to avoid aggressive or futile care. Despite this, more than half of Americans die in a hospital. Advance directives provide the opportunity to provide, in advance, one's wishes for end of life care, however their completion rates are low. The overall objective of this project is to assess if an active choice intervention can increase AD completion rates. Eligible participants for this study will be all new employees of the University of Pennsylvania Health System (UPHS) who need to complete their online employment paperwork via the On Boarding portal. Participants will have an advanced health care planning task programmed as part of their On Boarding online employment paperwork. Upon selection of the task, each participant will be directed a designated Advance Healthcare Planning (AHCP) website. Participants will be randomized into either the active choice or control arm of the study and proceed through steps to complete or not complete an AD according to the decision making process of the given study arm. All participants in both groups will have access to additional online and telephone resources thought the entire study for any questions. Participants in the active choice group will be given directions stating they are required to complete either the advanced directive or the declination form in order to complete their On Boarding process. Participants in the control group will be given directions stating that completion of the AD is optional.

Study Timeline

• Study Start: 2014-11
• Study First Submitted: 2014-11-05
• Study First Submitted QC: 2014-11-07
• Study First Posted: 2014-11-13
• Primary Completion: 2015-08
• Study Completion: 2015-10
• Results First Submitted: 2016-06-28
• Status Verified: 2016-12
• Results First Submitted QC: 2016-12-01
• Last Update Submitted: 2016-12-01
• Results First Posted: 2017-01-27
• Last Update Posted: 2017-01-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1279

Inclusion Criteria

• New participants of the University of Pennsylvania Health System who have not yet completed their On Boarding process.
• 18 years of age or older
• Have proficiency in reading, writing, and speaking English

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Exclusion Criteria

• All new UPHS employees will be enrolled

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Mandatory active choice	Mandatory active choice	The mandatory active choice group will be presented two forms at the same time. The first form will be a legally valid AD. The second form will be a declination form. Participants in the intervention arm will be required to complete, and submit either of the two forms the task.

Primary Outcome Measures

Name	Time	Method
Proportion of Participants That Select to Complete an Advance Directive	Baseline - up to 1 year	We will analyze the effects of the active choice intervention on rates of completion.

Secondary Outcome Measures

Name	Time	Method
Proportion of Participants Who Already Have ADs	Baseline - up to 1 year
Proportion of Participants Who Return a Signed AD	Baseline - up to 1 year	This measures the proportion of participants who return a signed and printed copy of their AD of those who completed an AD online.

Trial Locations

Locations (1)

University of Pennsylvania; 🇺🇸 Philadelphia, Pennsylvania, United States