Rebecca L. Sudore|Sara J. Knight|Ryan Mcmahan|Mariko Feuz|David Farrell|Yinghui Miao|Deborah E. Barnes
A Novel Website to Prepare Diverse Older Adults for Decision Making and Advance Care Planning: A Pilot Study
University of California, San Francisco|San Francisco VA Medical Center|Health Services Research & Development|University of California, San Francisco|University of California, San Francisco|San Francisco VA Medical Center|University of California, San Francisco|San Francisco VA Medical Center|People Designs (United States)|University of California, San Francisco|San Francisco VA Medical Center|San Francisco VA Medical Center|University of California, San Francisco
reconceptualized advance care planning acp multistep process focused preparing patients skills needed communication inthemoment decision makingto operationalize paradigm created easytouse acp website prepareforyourcareorg based theoretical framework behavior change pilottested efficacy engage older adults acpat baseline 1 week viewing prepare website assessed behavior change acp using validated survey includes process measures knowledge contemplation selfefficacy readiness 5point likert scales action measures yesno whether acp behavior completed also assigned participants behavior change stages ie precontemplation contemplation preparation action maintenance determined percentage participants moved precontemplation baseline higher stages 1 week also assessed prepare easeofuse 10point scale 10 easiest changes assessed wilcoxon signed rank sum tests mcnemars testsmean age participants 684 years sd 66 65 nonwhite behavior change process measures average likert scores increased 31 09 37 07 p 0001 action measures change significantly however precontemplation significantly decreased actions eg talking doctor desired medical care 61 35 p 0003 mean decrease 21 range 1633 prepare rated nine ten 19 easeofusea new patientcentered acp website focuses preparing patients communication decision making significantly improves engagement process acp behavior change clinical trial prepare currently underway