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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
27
Weill Cornell Medicine
New York, New York, United States
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
Feasibility (Number/Proportion of Participants Who Completed the Intervention)
Will be measured by intervention completion (Benchmark: \>= 70% complete the intervention sessions).
Time frame: Five weeks post-randomization (for intervention arm only)
Acceptability (Helpfulness of the 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"). Data reported as a count number of those who reported "4=helpful" or "5=very helpful" to this question.
Time frame: Five weeks post-randomization (for intervention arm only)
Change in Knowledge of Advance Care Planning
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. Responses to these 6 items are summed to create total scores, ranging from 6 (low levels of knowledge) to 30 (high levels of knowledge). Higher scores indicate higher levels of knowledge. Mean score differences were calculated between baseline and follow-up for each study arm and tested for significance.
Time frame: Baseline, five weeks post-randomization (after randomizing and completing the 3-week intervention if assigned)
Change in Readiness/Motivation to Engage in Advance Care Planning
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. Scores from these items are summed to created total scores, ranging from 10 (low level of readiness/motivation) to 60 (high level of readiness/motivation). Higher scores indicate higher levels of readiness/motivation. Mean score differences were calculated between baseline and follow-up for each study arm and tested for significance.
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Time frame: Baseline, five weeks post-randomization (after randomizing and completing the 3-week intervention if assigned)
Change in Self-efficacy to Engage in Advance Care Planning
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. These items are summed to create total scores, ranging from 6 (low levels of self-efficacy) to 30 (high levels of self-efficacy). Higher scores indicated higher levels of self-efficacy. Mean score differences were calculated between baseline and follow-up for each study arm and tested for significance. Data reported is the mean change in this outcome from pre-randomization/baseline to post-randomization.
Time frame: Baseline, five weeks post-randomization (after randomizing and completing the 3-week intervention if assigned)
Change in Engagement in Advance Care Planning (End-of-life Care Discussions)
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). Data reported is the mean change in this outcome from pre-randomization/baseline to post-randomization,
Time frame: Baseline, five weeks post-randomization (after randomizing and completing the 3-week intervention if assigned)
Change in Completion of Advance Directives
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). Data reported is the mean change in this outcome from pre-randomization/baseline to post-randomization.
Time frame: Baseline, five weeks post-randomization (after randomizing and completing the 3-week intervention if assigned)