Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 7, 2022
Date Accepted: Oct 11, 2022
The Web-based Advance Care Planning Program ‘Explore Your Preferences for Treatment and Care’: Development, Pilot Study, and Before-and-After Evaluation
ABSTRACT
Background:
Web-based advance care planning (ACP) programs may support patients in thinking about and discussing their preferences for future treatment and care. However, they are not widely available and only a limited number of programs is evidence-based.
Objective:
To develop and evaluate an evidence-based web-based ACP program that guides users through the process of thinking about, discussing and recording of preferences for treatment and care.
Methods:
The program ‘Explore your preferences for treatment and care’ was developed, pilot-tested (usability and feasibility), and subsequently evaluated; engagement in ACP was assessed before and two months after program completion using the Advance Care Planning Engagement Survey (score 1-5) among 147 persons with chronic disease. Usability (score 0-100) and user satisfaction (score 1-5) were also assessed.
Results:
ACP engagement increased from 2.8 before to 3.0 two months after program completion (P<.001); contemplation about ACP increased from 2.6 to 2.8 and readiness for ACP from 2.2 to 2.5 (P<.01). No changes were found for knowledge about ACP (3.0 to 3.2, P=.07) and self-efficacy for ACP (3.8 to 3.8, P=.25). The program was perceived as usable (70, SD=13), attractive (3.8, SD=0.7) and comprehensible (4.2, SD=0.6).
Conclusions:
We developed an evidence-based web-based ACP program in co-creation with patients, relatives and healthcare professionals. Before-and-after evaluation showed that the program can support people in taking first steps in ACP and in reflecting on preferences for treatment and care, by guiding them through the process of ACP using a stepwise-approach. Participants perceived the program as usable and understandable, and they were satisfied with the program and with the amount of information. Healthcare professionals may use the program as a tool to start ACP discussions with their patients. The program may increase awareness of ACP.
Citation
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