Clinical Trials Logo

Clinical Trial Summary

Compared to the general population, individuals from underserved communities are more likely to receive low quality end-of-life care and unwanted, costly and burdensome treatments due in part to a lack of advance care planning (ACP; the process of discussing wishes for end-of-life care with loved ones/clinicians and documenting them in advance directives). This study will use existing, trusted, and respected social networks to evaluate two conversation-based tools intended to engage underserved individuals in discussions about end-of-life issue and motivate them to carry out ACP behaviors. Through this study, investigators will learn how best to engage underserved populations in ACP so as to: 1) increase the likelihood that patients from underserved communities will receive high-quality end-of-life care; 2) address health disparities related to end-of-life treatments; and 3) reduce unnecessary suffering for patients and their families.


Clinical Trial Description

The overall project goal of this 3-armed cluster, randomized control trial in underserved, diverse communities is to determine whether playing a serious conversation game called Hello is more effective than other advance care planning (ACP) approaches, or usual care (i.e., simply distributing an advance directive [AD]). The investigators will randomize 75 underserved communities across the US. The primary outcome is completion of a visually verified AD; secondary outcomes include performance of other ACP behaviors. Many Black/African Americans and Latina/Latino patients are more likely to receive low quality end-of- life medical care than White individuals- in fact, they are 3 times more likely than white Americans to die after a lengthy intensive care unit stay. Advance care planning (ACP)- the process of discussing one's wishes with loved ones and clinicians, and then documenting them in an advance directive (AD)- can help reduce these health inequities by preventing costly/burdensome treatments that are unlikely to reduce suffering or improve quality of life. Though ~60% of Americans engage in ACP, <25% of underserved populations have done so- in large part due to distrust of the healthcare system/clinicians, and reluctance to discuss death and dying. This study leverages underserved communities' existing, trusted social networks to deploy two community-based ACP interventions and study their mechanisms of action. By identifying which interventions increase engagement in ACP in underserved communities (and why), this project will help improve quality of end-of-life care, reduce unnecessary suffering, and end-of-life healthcare costs which conserves public health resources. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT04612738
Study type Interventional
Source Milton S. Hershey Medical Center
Contact Heather J Costigan
Phone 717-531-6499
Email hcostigan@pennstatehealth.psu.edu
Status Recruiting
Phase N/A
Start date March 19, 2022
Completion date January 31, 2026

See also
  Status Clinical Trial Phase
Completed NCT05203146 - PIMPmyHospital: a Mobile App to Improve Emergency Care Efficiency and Communication N/A
Completed NCT04105751 - Testing a Novel Manual Communication System for Mechanically Ventilated ICU Patients N/A
Completed NCT04595695 - The Effect of Clear Masks in Improving Patient Relationships N/A
Completed NCT05540444 - RadConnect Communication Application
Recruiting NCT04317664 - Intervention to Improve Driving Practices Among High-Risk Teen Drivers Phase 3
Completed NCT05812599 - Understanding COVID-19 Testing Knowledge and Practices Among 2-1-1 Helpline Callers N/A
Completed NCT03221985 - ESM Pilot: Mobile Phones and Psychology N/A
Completed NCT02267265 - Pilot Study of Novel Postpartum Educational Video Intervention N/A
Completed NCT02695316 - Barrier-free Communication in Maternity Care of Allophone Migrants N/A
Completed NCT03203018 - Health Literacy and Cardiovascular Knowledge Workshop in Women From Disadvantaged Communities N/A
Completed NCT02619474 - The Effect of Whiteboards on Patient Satisfaction N/A
Completed NCT01933789 - Improving Communication About Serious Illness N/A
Completed NCT01697137 - Patient and Physician Intervention to Increase Organ Donation N/A
Completed NCT01459744 - An Intervention to Improve Implantable Cardioverter-Defibrillator Deactivation Conversations N/A
Recruiting NCT01170000 - Timely End-of-Life Communication to Parents of Children With Brain Tumors N/A
Completed NCT01040975 - Teen CHAT: Improving Physician Communication With Adolescents About Healthy Weight N/A
Completed NCT03044145 - The Cultural Formulation Interview-Engagement Aid N/A
Recruiting NCT04533126 - Channels of Communication & Brain Functioning: Pilot fMRI Study
Withdrawn NCT03901547 - Emotion Regulation and Burnout Impact on Communication Documentation N/A
Completed NCT06081660 - Advance Care Planning for Older Latinos With Chronic Illness N/A