Die-logue Program for Community Dwelling Adults: A Randomized Controlled Trial

Effects of a Die-logue Program in Enhancing Community Dwelling Adults's Death Attitudes, Coping With Death and Readiness for Advance Care Planning: A Two-phase Study

The goal of this clinical trial is to evaluate whether the Die-logue program can improve attitudes toward death, coping with death, and readiness for advance care planning (ACP) among community-dwelling middle-aged adults aged 40-60 years who have not completed any advance directives and not diagnosed with any life limiting diseases.

This study aims to address the following research questions:

• Does the Die-logue program improve community-dwelling middle-aged adults' attitudes towards death, ability to cope with death, readiness and uptake for Advanced Care Planning (ACP).
• What are community-dwelling middle-aged adults' perceptions of advance care planning, death and dying, and their experiences of participation in the Die-logue program.

Researchers will compare participants who receive the Die-logue program (death conversation and online ACP education) with participants who receive only the online ACP education to see if informal death conversations improve attitudes toward death, coping with death, and readiness for ACP.

Participants will:

• Complete online questionnaires measuring attitudes toward death, coping with death, and readiness for advance care planning.
• Participate in a facilitator-led group discussion session about perceptions of death, coping with death, and readiness for ACP (intervention group only).
• Complete an asynchronous online ACP education session consisting of short recorded videos and an online discussion forum (both intervention and control group).
• Complete follow-up surveys, including a 6-month follow-up assessing whether they have undertaken advance care planning.

Inclusion Criteria:

• Between the ages of 40 to 60 years
• Able to comprehend the English language
• Have not completed any form of advance directives
• Able and willing to participate in the Die-logue programme and surveys

Exclusion Criteria:

• Individuals diagnosed with any life limiting diseases
• Individuals with self-reported history of mental health disorders or neurological disorders