Preparing Spanish-speaking Older Adults for Advance Care Planning and Medical Decision Making (PREPARE)
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 55 - Any |
| Updated: | 4/21/2016 |
| Start Date: | September 2014 |
| End Date: | March 2017 |
| Contact: | Rebecca Sudore, MD |
| Email: | rebecca.sudore@ucsf.edu |
| Phone: | 415-221-4810 |
Preparing Spanish-speaking Older Adults for Advance Care Planning and Medical Decision Making
In partnership with patients, caregivers, advocacy groups and clinicians, the investigators
plan to:
Aim 1: Adapt and refine PREPARE in Spanish through cognitive interviews with
Spanish-speaking Latinos and stakeholders.
Aim 2: Conduct an RCT to compare the efficacy of PREPARE plus a previously-tested,
easy-to-read- AD (intervention) versus the AD alone (control) to:
2a. Engage older Spanish-speaking Latinos in multiple ACP behaviors (i.e., identify and
discuss wishes with surrogates and clinicians and complete ADs) measured by self-report,
chart review, surrogate reports, and
2b. Direct observation.
2c. Improve self-efficacy and satisfaction with medical decision making.
2d. Determine whether PREPARE efficacy varies by literacy, decision control preferences, and
clinician-patient language concordance.
Aim 3: Disseminate PREPARE with input from patients, surrogates, and stakeholders.
plan to:
Aim 1: Adapt and refine PREPARE in Spanish through cognitive interviews with
Spanish-speaking Latinos and stakeholders.
Aim 2: Conduct an RCT to compare the efficacy of PREPARE plus a previously-tested,
easy-to-read- AD (intervention) versus the AD alone (control) to:
2a. Engage older Spanish-speaking Latinos in multiple ACP behaviors (i.e., identify and
discuss wishes with surrogates and clinicians and complete ADs) measured by self-report,
chart review, surrogate reports, and
2b. Direct observation.
2c. Improve self-efficacy and satisfaction with medical decision making.
2d. Determine whether PREPARE efficacy varies by literacy, decision control preferences, and
clinician-patient language concordance.
Aim 3: Disseminate PREPARE with input from patients, surrogates, and stakeholders.
PREPARE is a website (www.prepareforyourcare.org) that teaches patients how to identify what
is most important in life, how to communicate their preferences to clinicians and loved
ones, and how to make informed decisions. It is written at a 5th grade level and includes
voice-overs of text and closed captioning of videos that model advance care planning
behaviors. The goal of this proposal is to test the efficacy of PREPARE plus an easy-to-read
advance directive, versus an advance directive alone, to improve patient engagement in
multiple advance care planning behaviors including discussions with surrogate decision
makers and clinicians in addition to advance directive completion. The investigators will
also determine whether PREPARE can empower and activate patients within clinical encounters
with their clinicians and help to decrease health disparities in advance care planning.
is most important in life, how to communicate their preferences to clinicians and loved
ones, and how to make informed decisions. It is written at a 5th grade level and includes
voice-overs of text and closed captioning of videos that model advance care planning
behaviors. The goal of this proposal is to test the efficacy of PREPARE plus an easy-to-read
advance directive, versus an advance directive alone, to improve patient engagement in
multiple advance care planning behaviors including discussions with surrogate decision
makers and clinicians in addition to advance directive completion. The investigators will
also determine whether PREPARE can empower and activate patients within clinical encounters
with their clinicians and help to decrease health disparities in advance care planning.
Inclusion Criteria:
- Spanish-speaking adults ≥ 55 years of age
- ≥ 2 chronic illnesses determined by ICD-9 codes
- ≥ 2 visits with an outpatient primary care clinician at San Francisco General
hospital in the past year
- ≥ 2 additional outpatient/inpatient visits to San Francisco General Hospital in the
past year
Exclusion Criteria:
- Deaf, blind, demented or psychotic as determined by ICD-9 codes
- Too mentally or physically ill to participate as determined by their clinicians
- Moderate or severe cognitive impairment as determined by the Short Portable Mental
Status Questionnaire (SPMSQ), and mild cognitive impairment by the SPMSQ plus an
abnormal Mini-Cog (scores minimally affected by education/ethnicity)
- Self-reported poor vision and inability to see the words on a newspaper
- Lack of a telephone (for follow-up)
- Traveling or moving out of the area for ≥3 months during the study follow-up period.
We found this trial at
1
site
San Francisco, California 94110
Principal Investigator: Rebecca Sudore, MD
Phone: 415-221-4810
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