Communication Clinical Trial
Official title:
Project Talk Trial: Engaging Underserved Communities in End-of-life Conversations: a Cluster, Randomized Controlled Trial
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.
Status | Recruiting |
Enrollment | 1500 |
Est. completion date | January 31, 2026 |
Est. primary completion date | January 31, 2026 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria Community Hosts 1. Ability to recruit 20 individuals from underserved populations to attend a community event 2. Experience hosting a community event 3. Experience working with underserved populations 4. Participation in a series of mandatory live study-related web-based trainings 5. Completes a research site agreement Research Participants 1. Adults over the age of 18 years old in underserved populations 2. Able to speak and read English and/or Spanish 3. Have not completed an AD within the previous 5 years 4. All participants regardless of health status 5. Individuals from the same household can enroll Exclusion Criteria Community Hosts 1. Inability to recruit 20 individuals from underserved populations 2. Inexperience for hosting a community event 3. Inexperience working with underserved populations 4. Unable to attend a series of mandatory live study-related web-based trainings 5. Do not provide informed consent 6. Do not complete a research site agreement 7. Previously hosted a Hello project event Research Participants 1. Anyone <18 years of age 2. Anyone not able to speak and read English and/or Spanish 3. Have significant difficulties with hearing or speaking difficulties by self-report 4. Completed an AD in the past 5 years 5. Do not provide informed consent |
Country | Name | City | State |
---|---|---|---|
United States | Cleveland Clinic | Akron | Ohio |
United States | Phoebe Putney Memorial Hospital | Albany | Georgia |
United States | Pincham-Lincoln Community Center | Athens | Alabama |
United States | University of Colorado Hospital | Aurora | Colorado |
United States | Northeast Mississippi Coalition Against COVID-19 | Belden | Mississippi |
United States | St. Mark Missionary Baptist Church | Bennettsville | South Carolina |
United States | Harney County Home Health & Hospice | Burns | Oregon |
United States | Turner Alumni Association | Carthage | Texas |
United States | Welcome Home of Chattanooga | Chattanooga | Tennessee |
United States | Trinity Lutheran Church | Cherokee | Iowa |
United States | University of Chicago Medical Ctr | Chicago | Illinois |
United States | High Point Neighborhood Family Center | Clearwater | Florida |
United States | Hope Behavioral Health | Cleveland | Ohio |
United States | Hospice of the Western Reserve | Cleveland | Ohio |
United States | Como Community Center | Fort Worth | Texas |
United States | Washoe Tribe Health Center | Gardnerville | Nevada |
United States | Latino Hispanic American Community Center | Harrisburg | Pennsylvania |
United States | People's Community Baptist Church | Harrisburg | Pennsylvania |
United States | Ohio County Senior Centers | Hartford | Kentucky |
United States | Greater Vision United Methodist Church | Huntersville | North Carolina |
United States | Hospice & Home Care of Reno | Hutchinson | Kansas |
United States | Ocean Beach Hospital | Ilwaco | Washington |
United States | Lightways Hospice & Serious Illness Care | Joliet | Illinois |
United States | Acadian Advocacy Network | Lafayette | Louisiana |
United States | Hospice and Community Care | Lancaster | Pennsylvania |
United States | Hospice and Community Care | Lancaster | Pennsylvania |
United States | Center for Practical Bioethics | Lawrence | Kansas |
United States | St. Mary's Health System | Lewiston | Maine |
United States | Bluegrass Care Navigators | Lexington | Kentucky |
United States | Sunshine Terrace Foundation | Logan | Utah |
United States | Hospice Care of Middletown | Middletown | Ohio |
United States | HopeWest Montrose | Montrose | Colorado |
United States | Union County Senior Services | Morganfield | Kentucky |
United States | Christ Temple Church | Muskegon Heights | Michigan |
United States | Corsi Senior Center | New York | New York |
United States | Elder Law Project of North Mississippi Rural Legal Services | Oxford | Mississippi |
United States | Hospice of St. Lawrence Valley | Potsdam | New York |
United States | University of Rochester Medical Center | Rochester | New York |
United States | Patch Center | Saint Louis | Missouri |
United States | Promotores y Promotoras | Santa Paula | California |
United States | Holy Cross Health | Silver Spring | Maryland |
United States | Our Lady of Solitude | Soledad | California |
United States | Hospice of Lake Cumberland | Somerset | Kentucky |
United States | Choice Hospice | Sulphur Springs | Texas |
United States | St. Phillip AME Church | Tallahassee | Florida |
United States | Hospital Council of Northwest Ohio | Toledo | Ohio |
United States | El Rio Neighborhood Center | Tucson | Arizona |
United States | Vitas | Walnut Creek | California |
United States | MedStar Washington Hospital Center | Washington | District of Columbia |
United States | 47Million Reasons Healthcare Movement | West Palm Beach | Florida |
United States | Plaza on Princess | Wilmington | North Carolina |
United States | Atrium Health Wake Forest Baptist | Winston-Salem | North Carolina |
Lead Sponsor | Collaborator |
---|---|
Milton S. Hershey Medical Center | Hospice Foundation of America, University of Kentucky |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Previous Exposure to ACP Interventions and Advance Directives | This baseline assessment of ACP completion and exposure | Baseline (Day 0) | |
Other | Healthcare System Distrust Scale | An assessment of two primary domains of distrust (values and competence) in the healthcare system. This is a 9-item measure, scored 9 - 45 with 9 being the least amount of distrust. | Baseline (Day 0) | |
Other | Experience and Comfort with Games Questionnaire | This is a 4-item questionnaire to control for whether participants with familiarity with games respond differently to the intervention. | Baseline (Day 0 ) | |
Other | Acceptability of Intervention Measure | This 3-item measure to access a participants' perceived acceptability of the intervention | Immediately post-intervention (Day 0) | |
Other | Conversation Satisfaction Questionnaire | This is a 8-item questionnaire that assesses a participant's satisfaction with conversation, with each item scored on a 1 - 7 scale, with 1 being lowest conversation satisfaction. The items are averaged for the final score ranging 1 - 7 with 7 indicating the highest conversation satisfaction. | Immediately post-intervention (Day 0) | |
Other | Communication Quality Analysis (CQA) Measure | This is a validated coding method which measures communication quality using outside observer ratings of audio recordings of an intervention. | post-intervention | |
Other | Qualitative Community Host Interview | A follow-up qualitative telephone interview will explore implementation and process outcomes. | 2 weeks post-intervention | |
Other | Participant Follow-up Qualitative Telephone Interview | A qualitative follow-up interview with a subset of intervention participants to explore experiences and perceptions of the intervention, adverse events and cultural norms related to healthcare and advance care planning. | 2 weeks post-intervention | |
Other | Six-Month Participant Follow-up Telephone Interview | This follow-up phone interview includes questionnaires that access whether participants went on to perform various behaviors related to advance care planning, as well as explore qualitatively how sociocultural environment impacts the advance care planning experience. | 6 months post-intervention | |
Primary | Rates of Completion of a Visually Verified Advance Directive | Study team confirms completion of a signed advance directive | 6 months post-intervention | |
Secondary | Rates of Other Advance Care Planning (ACP) behaviors | Performance of other ACP behaviors such as self-reported ACP completion, discussions with loved ones, financial preparations | 6 months post-intervention | |
Secondary | Advance Care Planning Engagement Survey | This short-version survey measures readiness to perform ACP | Baseline (Day 0); 6 months post-intervention |
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