ACP education consisting of

• a brief social work screening,
• an educational pamphlet,
• advance directive forms (in English and Spanish), and
• community resource materials (i.e., handout)

ACP education plus counseling consisting of

• a brief social work screening,
• an educational pamphlet,
• advance directive forms (in English and Spanish), and
• community resource materials (i.e., handout);
• motivational interviewing
• decisional support, and
• patient navigation to address barriers

ACP-I Plan consisting of education, counseling, decisional support, and patient navigation

Feasibility

We use benchmarks for feasibility.

1. Number of Participants Recruited, and screening no more than 100 participants,
2. tracking numbers of participants consented into the study,
3. percent refused to participate and dropout, amount of time to screen participants and complete a baseline survey once consented into the study,
4. ACP-I Plan intervention delivered for the first session <2 weeks from their recruitment and randomization date and second session <4 weeks from recruitment,
5. identify missing data.
6. Track the number of participants who indicate they returned a completed AD to their provider and/or talked with a family member regarding ACP.

Acceptability of the intervention

Satisfaction survey questions includes 14 questions using "I" statements and a 5-point Likert scale: Strongly Disagree to Strongly Agree). Improved scores at follow up indicate satisfaction of information delivery.

Reference

Lyon ME, Garvie PA, Briggs L, He J, McCarter R, D'Angelo LJJJopm. Development, feasibility, and acceptability of the Family/Adolescent-Centered (FACE) Advance Care Planning intervention for adolescents with HIV. 2009;12(4):363-372.

Feasibility of recruitment and retention

Self report yes/no completed an advance directive document.

We use the method that Douglas & Brown (2002) used ask about completion of advance directives at 2 points, baseline and 1-month follow-up. Questions have yes/no [Y/N], responses.

Reference Douglas R, Brown HN. Patients' attitudes toward advance directives. Journal of Nursing Scholarship.

2002;34(1):61-65.

We also use the Advance Directive Attitude Survey (ADAS) by Nolan has 16 items and asks questions (uses a 4-point Likert scale, Strongly Agree to Strongly Disagree with AD decision making). Sixteen questions are subscales and ask about: (a) opportunity for treatment choices, (b) effect of advance directives on the family, (c) effect of an AD on treatment, and (d) perception of illness.

Nolan MT, Bruder M. Patients' attitudes toward advance directives and end-of-life treatment decisions. Nursing outlook. 1997;45(5):204-208.