Abstract
BackgroundIn 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.MethodsTargeted 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.ResultsOf 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.ConclusionsThere 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.
Highlights
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
Despite the provincial rollout of the policy and the healthcare system’s efforts to socialize it, to date public participation and awareness of ACP and Goals of Care Designations (GCD) remains limited [6]
Thematic analysis by World Café question Prior learnings about ACP Thematic analysis of Question 1 (Calgary) indicated that prior to attending the World Café activity, participants had learned about ACP through personal experiences such as planning for their own care or care of a loved one, through presentations to their community groups, through their employment, or during funeral and/or estate planning
Summary
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. Canada is a Western Canadian province with a population of 4 million residents, and our provincial healthcare system broke new ground in having the first province-wide policy and procedure for ACP [5], initiated in 2014. This includes a medical order framework, called Goals of Care Designations (GCD), for communicating a person’s goals and guiding the associated approach to his/her medical care. To catalyze new community engagement in ACP activities and awareness, the Advance Care Planning Collaborative Research and Innovation Opportunities research program (ACP CRIO) hosted two World Café events to learn from community members “How can we help Albertans learn about and participate in Advance Care Planning?”
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