PLAN Intervention to Enhance Engagement of Latino Cancer Patients in Advanced Care Planning

Primary outcomes

1. Feasibility (Number/Proportion of Participants Who Completed the Intervention)

   Time frame: Five weeks post-randomization (for intervention arm only)

   Will be measured by intervention completion (Benchmark: >= 70% complete the intervention sessions).

2. Acceptability (Helpfulness of the Intervention)

   Time frame: Five weeks post-randomization (for intervention arm only)

   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.

3. Change in Knowledge of Advance Care Planning

   Time frame: Baseline, five weeks post-randomization (after randomizing and completing the 3-week intervention if assigned)

   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.

4. Change in Readiness/Motivation to Engage in Advance Care Planning

   Time frame: Baseline, five weeks post-randomization (after randomizing and completing the 3-week intervention if assigned)

   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.

5. Change in Self-efficacy to Engage in Advance Care Planning

   Time frame: Baseline, five weeks post-randomization (after randomizing and completing the 3-week intervention if assigned)

   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.

6. Change in Engagement in Advance Care Planning (End-of-life Care Discussions)

   Time frame: Baseline, five weeks post-randomization (after randomizing and completing the 3-week intervention if assigned)

   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,

7. Change in Completion of Advance Directives

   Time frame: Baseline, five weeks post-randomization (after randomizing and completing the 3-week intervention if assigned)

   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.