Research Highlight: A New Approach to Advance Care Planning

Traditionally, advance care planning (ACP) involves filling out a form that specifies one’s wishes in the event of catastrophic illness or injury; however Terri Fried, M.D., professor of medicine (geriatrics), has a different idea. Her goal is to develop an intervention that improves communication with loved ones and can be widely disseminated. 

During the course of her research to develop such materials to engage older people in ACP, Fried learned that religious convictions are an issue, particularly in the African American community. Knowing she would have to tackle this concern, she met with the Cultural Ambassadors to ask for their help in how to approach the subject. 

At their first meeting, the group advised Fried on appropriate language that could be helpful to people while at the same time acknowledging their religious beliefs. During the earliest stages of developing a brochure, she again consulted the group, who suggested changes in wording that could be used to draw in people, since there are cultural/ethnic determinants that affect getting people’s attention when it comes to ACP. Fried ended up changing the title of the brochure based on feedback from the Cultural Ambassadors. The group also convinced her that the brochure should be more concise. “That’s when we went back to the drawing board and came up with a bulleted format,” she said. 

Fried is currently pilot-testing the brochure in a series of senior centers. The next step is to use that data to preform a randomized controlled trial with the ultimate goal of getting larger numbers of people to participate in ACP. 

“The reason we’re taking this approach is because it would be inexpensive to disseminate widely,” she said. Right now the readiness assessment and materials are given in person but the next step would be to make these available online. 

“We went to the Cultural Ambassadors for their thoughts and expertise on this subject and that was incredibly valuable,” she said. “It really was a unique opportunity that melded unbelievably well with what I was trying to do with my research.”