Planning Advance Care Together (PACT) to Improve Engagement in Advance Care Planning
Planning Advance Care Together (PACT) to Improve Engagement in Advance Care Planning
The purpose of this study is to refine and field-test a mobile application intervention
 (PACT) aimed at improving engagement in Advance Care Planning.
The goals of this study are to: (1) refine and field-test a mobile application intervention
 (PACT) using an iterative design approach, "Think Aloud" exercises, and usability protocols;
 (2) evaluate the feasibility, acceptability, usability, satisfaction, and user engagement of
 the intervention among advanced cancer patients and their caregivers; (3) test the
 preliminary efficacy of the intervention on patients' and caregivers' level of engagement in
 ACP, documented ACP conversations, and patients' completion of ADs (primary outcomes); and
 patients' and caregivers' perceived social support and family functioning as well as
 patients' receipt of goal-concordant care (secondary outcomes); and (4) evaluate process
 measures in a post-intervention interview.
Inclusion Criteria:

 -  Patient eligibility criteria: (1) diagnosis of poor prognosis advanced cancer defined
 as locally advanced or metastatic cancer (e.g., pancreaticobiliary, esophagogastric,
 hepatocellular carcinoma, lung, or gynecological cancer) and/or disease progression
 following at least first line chemotherapy; (2) access to a mobile device; (3) the
 ability to provide informed consent; and (4) identification of a loved one/informal
 caregiver.

 -  Caregiver eligibility criteria: (1) the person (family member or friend) whom the
 patient indicates being an informal caregiver; (2) English speaking; (3) 18 years of
 age or older; and (4) able to provide informed consent.

 -  Provider eligibility criteria: (1) current clinical practice and/or research with
 advanced cancer patients, (2) a history of 3+ years working with advanced cancer
 patients; (3) 18 years of age or older. Providers across disciplines (e.g., social
 work, oncology) will be enrolled.

 Exclusion Criteria:

 -  Patient exclusion criteria: (1) not fluent in English; (2) severely cognitively
 impaired (as measured by Short Portable Mental Status Questionnaire scores of < 6);23
 (3) too ill or weak to complete the interviews (as judged by the interviewer); (4)
 currently receiving hospice at the time of enrollment; and (5) children and young
 adults under age 18.

 -  Caregivers and Providers exclusion criteria: None