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

Community-Engaged Pilot Testing of Talking About Cancer (TAC) to Improve Engagement in Advance Care Planning

This clinical trial studies whether telephone-based coaching sessions, Talking About Cancer (TAC), work to improve engagement in advance care planning (ACP) in patients with cancer that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced) and their support person. Participation in ACP, which includes having end of life (EOL) care conversations and completing advance directives (e.g., living will, health care proxy, do not resuscitate order), improves quality EOL care. Despite this, less than half of patients with advanced cancer have EOL care conversations or complete advance directives. TAC coaching sessions are delivered by a social worker over the phone. They are designed to help patients and their support person communicate about ACP, manage the distress these conversations can cause, and participate in the process of ACP with a clear action plan of having goals-of-care conversations and completing advance directives. This may be an effective way to improve ACP participation in advanced cancer patients and their support person.

OUTLINE: Participants are randomized to 1 of 2 arms.

ARM I: Participants attend Talking About Cancer (TAC) telephone-based coaching sessions (2 sessions) designed to support participants in communicating about advance care planning (ACP), managing distress around ACP conversations, engaging in the process of ACP, and completing advance directives over 45-60 minutes each once a week (QW) for 2 weeks.

ARM II: Participants receive an ACP brochure/handout on study.

After completion of study intervention, participants are followed up at 6- and 12-weeks post-randomization.

Inclusion Criteria:

• PATIENT: Current diagnosis of stage III or IV cancer
• PATIENT: Able to provide informed consent
• PATIENT: Fluent in English or Spanish
• PATIENT: Have access to a telephone, computer, or mobile device
• CAREGIVER (SUPPORT PERSON): Person patient indicates provides support
• CAREGIVER (SUPPORT PERSON): English or Spanish speaking
• CAREGIVER (SUPPORT PERSON): 18 years of age or older
• CAREGIVER (SUPPORT PERSON): Able to provide informed consent

Exclusion Criteria:

• PATIENT: Too ill or weak to complete the interviews (as judged by the interviewer)
• PATIENT: Receiving hospice at the time of enrollment
• PATIENT: Younger than age 18