Planning for Your Advance Care Needs (PLAN): A Communication Intervention to Improve Advance Care Planning among Latino Patients with Advanced Cancer

SIMPLE SUMMARY: The goal of this study was to develop an intervention designed to help improve engagement in advance care planning among Latino patients with advanced cancer. Specifically, this study aimed to include feedback from key users of the intervention—Latino patients with advanced cancers, their caregivers, and clinicians and researchers working with this population—to ensure it was optimized to meet the needs of this patient population. Results from this study were used to modify and improve this intervention to be tested in future research for its acceptability, usability, and ability to improve engagement in advance care planning among Latino patients. Future research is needed to demonstrate the intervention effects on reducing clearly documented health disparities in advance care planning completion and end-of-life care received among Latino patients with advanced cancer. ABSTRACT: Background: The goal of this study was to develop and optimize an intervention designed to address barriers to engagement in advance care planning (ACP) among Latino patients with advanced cancer. The resulting intervention, titled Planning Your Advance Care Needs (PLAN), is grounded in theoretical models of communication competence and sociocultural theory. Materials and Methods: An initial version of the PLAN manual was developed based on a prior intervention, Ca-HELP, that was designed to improve communication around pain among cancer patients. PLAN uses this framework to coach patients on how to plan for and communicate their end-of-life care needs through ACP. In the present study, feedback was obtained from key stakeholders (n = 11 patients, n = 11 caregivers, n = 10 experts) on this preliminary version of the PLAN manual. Participants provided ratings of acceptability and feedback around the intervention content, format, design, modality, and delivery through quantitative survey questions and semi-structured qualitative interviews. Results: Results indicated that the PLAN manual was perceived to be helpful and easy to understand. All stakeholder groups liked the inclusion of explicit communication scripts and guidance for having conversations about ACP with loved ones and doctors. Specific feedback was given to modify PLAN to ensure it was optimized and tailored for Latino patients. Some patients noted reviewing the manual motivated engagement in ACP. Conclusions: Feedback from stakeholders resulted in an optimized, user-centered version of PLAN tailored to Latino patients. Future research will examine the acceptability, feasibility, and potential efficacy of this intervention to improve engagement in ACP.