Evaluation of an Advance Care Planning Activity: Feasibility Testing for a Randomized Controlled Trial
- Conditions
- Chronic DiseaseCaregivers
- Interventions
- Behavioral: Conversation card gameBehavioral: Active Control
- Registration Number
- NCT02619370
- Lead Sponsor
- Lauren Van Scoy
- Brief Summary
The overarching goal of this project is to facilitate engagement of individuals in effective advance care planning (ACP). Our specific objective is to conduct a randomized, controlled trial to determine whether playing a structured conversation game will increase the likelihood that participants will complete advance directives and perform other ACP behaviors compared to those who are provided with only standard ACP educational materials.
- Detailed Description
Our central hypothesis is that having ACP conversations in a non-threatening and enjoyable game format will stimulate participants to engage in additional ACP behaviors including completion of ADs. We will use the ACP Engagement Survey to measure readiness to perform ACP, which includes measures of the "stage of change" for performing ACP behaviors.
The proposed study has two specific aims:
Aim 1. To determine whether individuals who play a conversation game are more likely to subsequently complete an online AD (called 'Making Your Wishes Known'; MYWK) compared to individuals who receive standard information about ACP. Our hypothesis is that playing a conversation game will result in a higher AD completion rate (compared to control) in the three months following the intervention.
Aim 2. To identify which participant and/or conversation-related factors influence movement along the stages of change continuum with respect to ACP behaviors (discussing end-of-life wishes with families or clinicians and then completing ADs). Our hypotheses are that: H1) the game intervention will lead to higher quality conversations than the control; and H2) participants whose conversations consist of high-quality ACP discussions will be more likely to progress toward enacting ACP behaviors (as measured by the ACP Engagement Survey score) than those participants whose conversations consist of low-quality discussions.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 34
Not provided
- Do not fall into one of the above 3 categories
- Are <18 years of age
- Non-English speaking
- Cognitively impaired by self-report or score less than 21 on the MoCA screening tool
- Do not have a chronic illness (lacking one of the diseases from Iezonni's ICD-9 codes in chronic illness categories, described above)
- Have completed an advance directive within the last 18 months
- Do not provide informed consent or unable to provide informed consent
- Carry a diagnosis of dementia
- Unable to complete a 3 hour study session in one sitting (by self-report)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description Intervention Conversation card game Play 'My Gift of Grace,' a conversation card game for 4-6 players (the game consists of 20 question cards that prompt players to identify and articulate their values and beliefs related to dying and end-of-life issues); all game sessions will be audio recorded and transcribed. Control Active Control Review and discuss a brochure on ACP called "Advance Care Planning: Tips from the National Institute of Aging". Discussion will be prompted by the researcher asking participants to discuss the information they've just read with the group. However, there will not be a formal structure to this discussion.
- Primary Outcome Measures
Name Time Method Completion of an online advance directive 3 months
- Secondary Outcome Measures
Name Time Method Advance Care Planning Engagement Survey 3 months This survey includes information about stage of readiness to perform advance care planning, self-efficacy, and other measures of behavioral change
Advance Care Planning Behaviors 3 months Open-ended interviews will ascertain additional advance care planning behaviors performed