PLAN Intervention to Enhance Engagement of Latino Cancer Patients in Advanced Care Planning
- Conditions
- Metastatic Malignant Solid NeoplasmLocally Advanced Malignant Solid Neoplasm
- Interventions
- Other: Communication InterventionOther: Best PracticeOther: Questionnaire Administration
- Registration Number
- NCT04889144
- Lead Sponsor
- Fred Hutchinson Cancer Center
- Brief Summary
This trial tests whether Planning for Your Advance Care Needs (PLAN) intervention works to enhance Latino patients' understanding of and engagement in advanced care planning. The PLAN intervention may be an effective method to help people with cancer plan for and talk about advance care planning (the care they would want if they were unable to communicate) with their loved ones and doctors.
- Detailed Description
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients participate in PLAN intervention, consisting of 3 coaching sessions over 45-60 minutes each with a health coach.
ARM II: Patients receive usual care.
After completion of study treatment, patients are followed up at 1 week and then at 3 months.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 50
- Identifying ethnically as Latino.
- Locally advanced or metastatic cancer and/or have experienced disease progression on at least first-line chemotherapy.
- Ability to provide informed consent.
- Not fluent in English or Spanish.
- Severely cognitively impaired (as measured by Short Portable Mental Status Questionnaire scores of >= 6 to be delivered by trained study research staff during screening).
- Too ill or weak to complete the interviews (as judged by interviewer).
- Currently receiving palliative care/hospice at the time of enrollment (to allow prediction of [advanced care planning] ACP).
- Children and young adults under age 18.
- Patients deemed inappropriate for the study by their treating oncologist.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm I (PLAN intervention) Communication Intervention Patients participate in PLAN intervention, consisting of 3 coaching sessions over 45-60 minutes each with a health coach. Arm I (PLAN intervention) Questionnaire Administration Patients participate in PLAN intervention, consisting of 3 coaching sessions over 45-60 minutes each with a health coach. Arm II (Best practice) Best Practice Patients receive usual care. Arm II (Best practice) Questionnaire Administration Patients receive usual care.
- Primary Outcome Measures
Name Time Method Acceptability (helpfulness of the intervention) One week post-intervention Will be measured by a single-item question assessing helpfulness of the intervention (1 = not at all helpful, 5 = very helpful) as well an open-ended question about helpfulness of the intervention ("What was helpful about the intervention?") (Benchmark: \>= 70% rate it as "helpful" or "very helpful").
Change in completion of advance directives Baseline, one week post-intervention Completion of advance directives will be assessed by examining the medical chart for completed advance directive documents (DNR order, living will, health care proxy/durable power of attorney). Completion will be measured as a count to the degree to which they completed each of these, with no=0 and yes=1. Scores can range from 0 (low or none completed) to 3 (high or all completed).
Feasibility (intervention completion) One week post-intervention Will be measured by intervention completion (Benchmark: \>= 70% complete the intervention sessions).
Change in knowledge of advance care planning Baseline, one week post-intervention Knowledge subscale of the Advance Care Planning Engagement survey, which is a 49-item scale with high reliability (Cronbach's alpha = .94). Subscale is 6 items with Likert-type answers ranging from 1=not at all to 5=extremely. Total scores range from 6 (low) to 30 (high).
Change in readiness/motivation to engage in advance care planning Baseline, one week post-intervention Readiness/motivation subscale of the Advance Care Planning Engagement survey, which is a 49-item scale with high reliability (Cronbach's alpha = .94). Subscale is 10 items with Likert-type answers ranging from 1=not at all to 5=extremely. Total scores range from 10 (low) to 60 (high).
Change in self-efficacy to engage in advance care planning Baseline, one week post-intervention Self-efficacy subscale of the Advance Care Planning Engagement survey, which is a 49-item scale with high reliability (Cronbach's alpha = .94). Subscale is 6 items with Likert-type answers ranging from 1=not at all to 5=extremely. Total scores range from 6 (low) to 30 (high).
Change in engagement in advance care planning (end-of-life care discussions) Baseline, one week post-intervention End-of-life care discussions will be measured by asking patients to self-report whether they have discussed any of the following: (1) wishes they have about the care they would like to receive if they were dying and/or (2) advance care directives, with an oncology provider or family member: DNR orders, living wills, durable powers of attorney for health care (yes/no format). Engagement will be measured as a count to the degree to which they engaged in each of these, with no=0 and yes=1. Total score can range from 0 (low or none) to 8 (high or discussed all domains with providers and family).
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (4)
UT Southwestern/Simmons Cancer Center-Dallas
🇺🇸Dallas, Texas, United States
Fred Hutch/University of Washington Cancer Consortium
🇺🇸Seattle, Washington, United States
Confluence Health
🇺🇸Wenatchee, Washington, United States
Weill Cornell Medicine
🇺🇸New York, New York, United States