Telephone-Based Coaching Sessions (TAC) to Improve Advance Care Planning Participation in Advanced Cancer Patients and Their Support Person

Feasibility will be examined using enrollment rates. Feasibility cutoffs will be based on prior research and include the following: ≥ 50% of eligible participants will enroll in the study. Low rates of enrollment, including missing data, will indicate low feasibility.

Feasibility will be examined using enrollment and intervention completion rates as outcomes. Feasibility cutoffs will be based on prior research and include the following: ≥ 75% of Talking About Cancer sessions will be delivered with fidelity.

To analyze intervention acceptability, will examine the median score for the AIM measure, with a median of >= 4 indicating acceptability (on a 5-point Likert scale where 4=Agree and 5=Completely agree and higher scores indicate higher levels of acceptability).

Feasibility of the study collection procedures will be examined using study-related assessment completion rates and includes the following: ≥ 50% of enrolled patients will adhere to and complete assigned intervention components and study-related assessments.

Completion of advance directives will be assessed with questions that ask patients (caregivers) whether the patient has completed a do not resuscitate (DNR) order, living will or identified a health care proxy. This item is scored as having not advance directives (0) to all advance directives completed (3). In addition to the primary outcome of advance directives (0 to 3 score), will also examine each outcome separately (e.g., yes/no to completing a health care proxy) as secondary measures. Descriptive statistics will be run, including means and standard deviations for continuous data and frequencies and proportions for categorical data. Bivariate correlations will be run between demographics and clinical characteristics to determine if any are associated with the primary outcome at baseline.

Completion of advance directives will be assessed with questions that ask patients (caregivers) whether the patient has completed a DNR order. This item is scored as having not advance directives (0) to all advance directives completed (3). In addition to the primary outcome of advance directives (0 to 3 score), will also examine each outcome separately (e.g., yes/no to completing a health care proxy) as secondary measures. Descriptive statistics will be run, including means and standard deviations for continuous data and frequencies and proportions for categorical data.

Completion of advance directives will be assessed with questions that ask patients (caregivers) whether the patient has completed a living will. This item is scored as having not advance directives (0) to all advance directives completed (3). In addition to the primary outcome of advance directives (0 to 3 score), will also examine each outcome separately (e.g., yes/no to completing a health care proxy) as secondary measures. Descriptive statistics will be run, including means and standard deviations for continuous data and frequencies and proportions for categorical data.

Completion of advance directives will be assessed with questions that ask patients (caregivers) whether the patient has identified a health care proxy. This item is scored as having not advance directives (0) to all advance directives completed (3). In addition to the primary outcome of advance directives (0 to 3 score), will also examine each outcome separately (e.g., yes/no to completing a health care proxy) as secondary measures. Descriptive statistics will be run, including means and standard deviations for continuous data and frequencies and proportions for categorical data.

Will be assessed with the previously utilized 8-item measure of discussing end-of-life care (e.g., goals of care conversation), living will, health care proxy and DNR orders with doctor(s) and family members/loved ones. Descriptive statistics will be run, including means and standard deviations for continuous data and frequencies and proportions for categorical data.

Will be measured using the reliable and valid Advance Care Planning Engagement Survey: Action Measures. It is an 18-item measure assessing domains of decision maker, quality of life, flexibility, and asking questions about treatment and ACP (yes/no). Descriptive statistics will be run, including means and standard deviations for continuous data and frequencies and proportions for categorical data.

Will be assessed using the previously developed and validated questionnaire, the Advance Care Planning Readiness Scale. This is an 8-item questionnaire that asks questions about patients' readiness to engage in ACP on a 7-point Likert scale (1=Strongly disagree, 7 = Strongly agree). Descriptive statistics will be run, including means and standard deviations for continuous data and frequencies and proportions for categorical data.

Will be measured by the Decision-Making Participation Self-Efficacy (DEPS) scale. The DEPS scale is a 5-item validated measure that assesses cancer patients' confidence in engaging in different activities related to decision-making. Patients are asked to indicate how confident they are that they would be able to engage in various decision-making activities (e.g., "Tell your doctor about the option you would prefer"); items are rated on a 5-point Likert scale (0 = not at all confident, 4 = completely confident). Descriptive statistics will be run, including means and standard deviations for continuous data and frequencies and proportions for categorical data.

Will be measured using the Hospital Anxiety and Depression Scale, a valid and reliable 14-item, Likert-type self-report measure of mood disturbance commonly used with cancer patients. Descriptive statistics will be run, including means and standard deviations for continuous data and frequencies and proportions for categorical data.

Will be assessed with items used previously in the team's National Institutes of Health-funded cohort studies of advanced cancer patients and their caregivers: terminal nature of the illness (terminal [accurate] versus non-terminal [inaccurate]) and life-expectancy (months [accurate] versus years [inaccurate]). Descriptive statistics will be run, including means and standard deviations for continuous data and frequencies and proportions for categorical data.

Will be measured using the Zarit Burden Interview, a reliable and valid 22-item measure of caregiver burden used in intervention studies of cancer caregivers. Descriptive statistics will be run, including means and standard deviations for continuous data and frequencies and proportions for categorical data.