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Group Advanced Care Planning Pilot for Veterans

NCT ID: NCT06646614Sponsor: VA Palo Alto Health Care SystemLast updated: 2026-01-28

Summary

The proposed research aims to engage participants in group educational sessions to facilitate learning of topics related to advanced care planning and to determine whether this approach is more effective than usual care alone.

Detailed description

The purpose of this study is to compare usual care against a group advanced care planning intervention comprised of two sessions led by trained community health workers or health educators from VA Palo Alto. A total of 60 participants will be randomly assigned to either usual care (n=30) or usual care + group advanced care planning intervention (n=30). Those in usual care will be mailed some educational materials about advanced care planning that they may review independently. Those in the group advanced care planning arm will participate in two 60-90 minute educational sessions led by a community health worker/educator that will either be conducted in person on-site, by VA-approved video conference, or a hybrid model. Topics will include an introduction to advanced care planning, goals of care topics, advance directives, and physicians order of life sustaining treatment. Both usual care and the group advanced care planning arms will also participate in pre/post surveys and/or interviews.

Arms & interventions

  • BehavioralGroup Advance Care Planning Education

    Those assigned to the group ACP arm will receive usual care and the intervention which consists of 2 virtual or in-person sessions for a total of 2 hours by a trained community health worker/health educator. Sessions will introduce advanced care planning, help veterans discuss their goals of care with their care teams and learn how to discuss with their families and oncologist, and filing an advanced directive. Participants will be surveyed and interviewed at baseline and again at 8 months post-enrollment.

Outcome measures

Primary

  • Goals of Care Documentation

    Documentation of goals of care discussions will be analyzed for each patient at 8 weeks after patient enrollment.

    Time frame: Week 8 after patient enrollment

Secondary

  • Feeling Heard and Understood

    Time frame: Baseline and Week 8 after patient enrollment

  • Change in patient activation using the Patient Activation Measure

    Time frame: Baseline and Week 8 after patient enrollment

  • Change in patient satisfaction with decision using the Satisfaction with Decision Measure

    Time frame: Baseline and Week 8 after patient enrollment

  • Palliative Care Use (Self-reported and Chart Review)

    Time frame: At Baseline, 8 weeks and 6 months after patient enrollment

  • Hospice Care Use (Self-reported and Chart Review)

    Time frame: At Baseline, 8 weeks and 6 months after patient enrollment

  • Hospitalization Visits (Self-reported and Chart Review)

    Time frame: At Baseline, 8 weeks and 6 months after patient enrollment

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Inclusion Criteria: 1. All patients \>18 years old with newly diagnosed cancer are eligible. 2. Patients must have the ability to understand and willingness to provide verbal consent 3. Participants must speak English Exclusion Criteria: 1. Inability to consent to the study 2. Plans to move within the area and leave the VA system within 4 months

Study locations (1)

VA Palo Alto

Palo Alto, California, 94305

Recruiting
Madhuri Agrawal, MS · Contact
650-304-7744madhuri.agrawal@va.gov