How to increase public participation in advance care planning: findings from a World Café to elicit community group perspectives

Abstract

Background In 2014, Alberta, Canada broke new ground in having the first provincial healthcare policy and procedure for advance care planning (ACP), the process of communicating and documenting a person’s future healthcare preferences. However, to date public participation and awareness of ACP remains limited. The aim of this initiative was to elicit community group perspectives on how to help people learn about and participate in ACP. Methods Targeted invitations were sent to over 300 community groups in Alberta (e.g. health/disease, seniors/retirement, social/service, legal, faith-based, funeral planning, financial, and others). Sixty-seven participants from 47 community groups attended a “World Café”. Participants moved between tables at fixed time intervals, and in small groups discussed three separate ACP-related questions. Written comments were captured by participants and facilitators. Each comment was coded according to Michie et al.’s Theoretical Domains Framework, and mapped to the Capability, Opportunity and Motivation behavior change system (COM-B) in order to identify candidate intervention strategies. Results Of 800 written comments, 76% mapped to the Opportunity: Physical COM-B component of behavior, reflecting a need for access to ACP resources. The most common intervention functions identified pertained to Education, Environmental Restructuring, Training, and Enablement. We synthesized the intervention functions and qualitative comments into eight recommendations for engaging people in ACP. These pertain to access to informational resources, group education and facilitation, health system processes, use of stories, marketing, integration into life events, inclusion of business partners, and harmonization of terminology. Conclusions There was broad support for the role of community groups in promoting ACP. Eight recommendations for engaging the public in ACP were generated and have been shared with stakeholders.

Awareness and Attitudes Toward Advance Care Planning Among Community-Dwelling Older Adults in China: A Mixed-Methods Study

“…Canada, Australia, and Japanese studies have shown that the legislative and nongovernmental organizations (NGOs) are important drivers of ACP development. [19][20][21] The success of ACP development in Hongkong and Taiwan, 22,23 many of which experience is worth learning. From public awareness to gradually practice to legislative support, in mainland China, it is in this regard that LWPA as NGOs can push forward the process, the promotion will be intended to conduct using a method of combining online services and offline services.…”

A Multimodal Intervention for Prevention of Overweight and Obesity in Schoolchildren. A Protocol Study “PREVIENE-CÁDIZ”

“…These aspects will be studied using two different activities. First, a qualitative technique called “World Cafe” [ 52 ] which will consist of gathering a sample of the participating agents (teachers, management teams, parents and schoolchildren) and dividing them into three different groups: (1) teachers and management team, (2) parents, and (3) schoolchildren. Each of the groups will be accompanied by someone from the research team, who will act as a moderator of the table, guiding the conversation through a script of semi-structured questions.…”

‘It’s almost superstition: If I don’t think about it, it won’t happen’. Public knowledge and attitudes towards advance care planning: A sequential mixed methods study

“…26,27 For example, more than 90% of Americans believed it was important to talk about their wishes with a loved one however less than 30% had initiated this conversation, believing it was not the right time and not something they felt they needed to worry about at that stage. 23 In an attempt to normalise the conversation and increase public engagement, several social media forums 5 and community promotion initiatives have been launched. 28,29 Yet evidence 18 suggests comfort levels around these discussions depend on one's personal experience with death and dying as well as their knowledge of advance care planning.…”