Chatbot-Assisted Advance Care Planning Education for Family Members

Official title

Messaging-and-chatbot-assisted Nursing Consultation to Empower Family Members of Residents Living in Nursing Homes on Advance Care Planning (ChatACP)

Overview

The goal of this clinical trial is to learn if a messaging and chatbot program, called ChatACP, helps family members of people living in nursing homes take part in advance care planning. The main questions this study aims to answer are: * Does ChatACP help family members feel more ready to talk about future medical and personal care with their loved one? * Does ChatACP help family members take part in advance care planning activities, such as having care discussions or completing planning documents? * Is ChatACP easy to use and acceptable for family members? Researchers will compare ChatACP to standard self-learning materials about advance care planning to see which approach works better. Participants will: * Receive short daily messages with pictures or videos about advance care planning and access to a chatbot specialized in ACP for 10 days * Complete surveys at the start of the study, after the program ends, and again 3 months later * Take part in an interview to share their experience with the program

Interventions

• Behavioral ChatACP - Messaging- and-Chatbot Assisted Nursing Consultation
  The ChatACP for family members encompassed a digital education component and a care provider engagement component. The digital education component includes 10-day messages of ACP infographics, video clips, and a chatbot with specific content for ACP. The care provider engagement component includes one nurse-led telephone consultation.
• Behavioral ACP self- learning handout (Hong Kong Hospital Authority ACP education material)
  Participants in the control group will be provided with self-learning ACP education material created by the Hong Kong Hospital Authority for public education.

Primary outcome measures

• Recruitment feasibility [Time frame: From enrollment to 3-month follow-ups]
• Retention rate [Time frame: From enrollment to 3-month follow-ups]
• Percentage of Intervention Components Delivered in Compliance with the Intervention Protocol [Time frame: From enrollment to 3-month follow-ups]
• Participant Engagement Measured by Messaging Platform Interaction Logs and Self-Reported Message Reading Percentage [Time frame: assessed at post-intervention (T1, immediately after completion of the intervention), based on usage data collected during the intervention period]
• Mean Score of the Perceived Infographic Usability Scale (0-100% per Item) [Time frame: post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)]
• Proportion of Participants Reporting High Satisfaction (Score 4-5) on all three items of the Investigator-Developed Acceptability Survey (5-Point Likert Scale) [Time frame: post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)]
• Intervention safety [Time frame: From enrollment to 3-month follow-ups]
• Background questionnaire [Time frame: at baseline (T0, prior to intervention)]
• Qualitative Findings on Feasibility and Acceptability of the Intervention Based on Semi-Structured Interviews [Time frame: at 3-month post-intervention follow-up (T2)]

Secondary outcome measures (3)

• Chinese Version of the 10-item Family Members' ACP Readiness Questionnaire (Total Score, 10-50) [Time frame: at baseline (T0, prior to intervention), post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)]
• Chinese Version of the 17-item Advance Care Planning Engagement Survey for Surrogate Decision Makers (Total Score, 17-85) [Time frame: at baseline (T0, prior to intervention), post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)]
• Number of Participants Reporting Completion of Each of Six Advance Care Planning Activities [Time frame: at baseline (T0, prior to intervention), post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)]

Eligibility criteria

Inclusion criteria

• aged 18 years or older
• providing care for an older adult (age 65 or above) living in a care home as a family member (including the family members in the traditional sense and the guardian and persons close to or significant to the older adult)
• able to read, write and communicate in Cantonese or Mandarin
• the resident, care recipient, having a prefrail or frail status as defined by a score of 3 or above on the Clinical Frailty Scale (CFS)
• having a mobile device to receive instant messages and access to cellular network
• engaged in minimal or no prior EOL care discussions with the care home resident as defined by a self-reported status of pre contemplation/contemplation stage on ACP discussions with the resident using the ACP staging algorithm

Exclusion criteria

• suffering from moderate to severe cognitive impairment defined by an Abbreviated Mental Test score of 5 or less and unable to give consent
• suffering from communication problems (e.g., deafness or aphasia)

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Supportive care

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT07448649 · UW25-567

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗