Knowledge Of Care Planning Research Articles

Home Care Services in the Last Year of Life by Type of Care Management.

Care management of home-based long-term care is vital for community-dwelling older adults. Regarding care planning, which is a part of care management, appropriate care plans according to individual conditions are extremely important for older adults to continue living independently in their familiar environment for as long as possible. We compared the use of care services in the last year of life between advanced and conventional care management. The results showed that among the older adults with a care-need level of 3, 4, or 5, the advanced care management group had a significantly higher rate of use of home-visit nursing services than the conventional care management group. These differences could be attributed to differences in the care planning knowledge, experience, and the training environment of the care managers' offices.

Views on advance care planning of family members of older adults with Turkish and Moroccan backgrounds: An exploratory interview study

Background: Significantly fewer individuals with migration backgrounds than native-born individuals undertake advance care planning. Older adults with Turkish and Moroccan backgrounds represent one of the largest ageing non-Western minority groups in Europe. Their relatives could play important roles in facilitating or hindering advance care planning, but their views remain underexplored. Aim: To explore advance care planning knowledge, experience, views, facilitators and barriers among older Turkish and Moroccan adults’ relatives in Belgium. Design: Qualitative thematic analysis of semi-structured interview data. Setting/participants: Twenty-two relatives of older Turkish and Moroccan adults in Brussels, Mechelen and Antwerp, recruited via general practitioners. Results: Participants had limited advance care planning knowledge and had not discussed it with healthcare professionals. Some found discussing end-of-life preferences with relatives beneficial; others opposed the discussion of specific topics or felt discussions were unnecessary, as they felt responsible for caregiving and trusted by their relatives to make future decisions. Barriers included personal and relational characteristics, emotional difficulty and perceived non-urgency. Facilitators included information in older adults’ native languages, general practitioners’ cautious initiation and the involvement of several family members. Conclusions: Relatives of older people with Turkish and Moroccan backgrounds are unfamiliar with advance care planning and have highly variable views on it. People should be given opportunities to discuss advance care planning in a culturally appropriate manner, and the diversity of perspectives regarding whether and how to engage in such planning should be recognised. ClinicalTrials.gov no. NCT05241301.

"There is No Communication": A Qualitative Examination of Deaf Signers' Experiences With Advance Care Planning.

Objective(s): Deaf American Sign Language (ASL) users are subject to health care disparities resulting from communication and language barriers. Currently, few resources on advance care planning and end-of-life care exist in ASL. This study explores Deaf ASL users' perceptions and experiences with end-of-life care and advance care planning. Methods: Semi-structured 1:1 interviews with Deaf signers were translated, and transcribed into English by a bilingual researcher. Investigators inductively coded transcripts and identified themes of barriers, facilitators, knowledge, and sources of information regarding end-of-life care. Participants' knowledge of advance care planning and completion of advance care planning documents were evaluated using a brief assessment. Results: Eleven Deaf ASL users participated in the study with two deaf interviewers. Participants reported barriers to end-of-life care including poor provider communication, inaccessible sources, and inadequate provision of accommodations, leading to patient distrust. Participants' understanding of advance care planning was facilitated by accessible forms of communication and their social networks, such as family, friends, and Deaf peers. Participants primarily gained information on end-of-life care from first-hand familial experience, peers, and media. Participants' mean advance care planning knowledge was 4.6 out of 15 (SD = 2.6). Conclusions: Deaf ASL users face scarce accessible resources around end-of-life care, lowering their ability to understand and proceed with advance care planning. Implementation of ASL accessible advance care planning educational tools in health care settings is needed.

Effects of advance care planning training on advanced practice nurse students’ knowledge, confidence, and perception of end-of-life care: A mixed-method study

AimsThis study aimed to assess how an advance care planning training program affected advanced practice nursing students’ knowledge, confidence and perception of end-of-life care in South Korea. BackgroundEffective communication between healthcare providers, patients and their families is one of the most important components of quality end-of-life care. However, nurses in South Korea may feel uncomfortable helping patients and families with advance care planning because of the cultural taboo against talking about dying. DesignA mixed-method design was used with data obtained from self-administered questionnaires at the onset and end of the advance care planning training program and qualitative data from participant feedback after the program. MethodsData collected from 65 advanced practice nursing students who participated in advance care planning training programs in June-July 2020 and 2021, conducted as part of a graduate clinical practice course, were analyzed. Data were originally collected to examine students’ course outcomes. A training program was provided to advanced practice nursing students to improve their knowledge, confidence and perception in advance care planning conversations with their patients. The program comprised three sessions: online lectures, face-to-face simulations and discussions on advance care planning and ethical issues. Changes in advance care planning knowledge, confidence in supporting patients’ advance directives, perceived nursing roles in end-of-life treatment decisions and perception of a good death were examined before and after the training. ResultsThere were statistically significant increases in participants’ advance care planning knowledge, confidence in supporting patients’ advance directives and perception of the active role of nurses in patients’ end-of-life treatment decisions after the training. ConclusionsThe results indicate the effects of training programs on advanced practice nursing students’ knowledge, confidence and perception of advance care planning communication. They also provide evidence about what contents and methods can be helpful in developing end-of-life care training for advanced practice nursing students.

Basic Advance Care Planning Knowledge for Dental Hygienists

Basic Advance Care Planning Knowledge for Dental Hygienists

Community workshops increase advance care planning knowledge, appointment of legal proxies and completion of end-of life written plans

Advance Care Planning involves having conversations, completing documents detailing individuals’ end-of life treatment and care preferences, and appointing legal proxies who make health, lifestyle, or financial decisions. Although beneficial outcomes have been demonstrated, community rates of Advance Care Planning remain low. We developed a theoretically based workshop to increase knowledge and change behaviors in relation to Advance Care Planning; 347 participants completed the workshop. Advance Care Planning knowledge and action significantly improved three months post workshop. The intervention increased Advance Care Planning knowledge and changed behaviors.

Knowledge, attitudes, and behavioral intentions of elderly individuals regarding advance care planning: Questionnaire development and testing.

BackgroundStudies have indicated that the advance care planning knowledge and attitudes of elderly individuals strongly affect their implementation of advance care planning. A measurement with a theoretical base for evaluating elderly individuals’ knowledge, attitudes, and behavioral intentions regarding advance care planning is lacking.ObjectivesTo develop a questionnaire and understand elderly individuals’ knowledge, attitudes, and behavioral intentions regarding implementing advance care planning.MethodsA cross-sectional questionnaire survey was conducted. The content validity index, and statistical methods, including discrimination, factor, and reliability analysis, were adopted for psychometric testing. Descriptive statistics mainly presented data analysis.Results401 elderly individuals were recruited from a medical center and one senior activity center. The content validity index was approximately 0.71–0.92 for the developed questionnaires, the Kuder–Richardson formula 20 was 0.84 for advance care planning knowledge, and the Cronbach’s alpha was 0.86, 0.94, 0.76, and 0.92 for attitudes, behavioral intentions, influencing factors, and subjective norms, respectively. The average score for advance care planning knowledge for elderly individuals was 4.42, with a correct answer rate of 49.1%. They lacked knowledge of advance care planning-related legislation. The mean score for attitudes and behavioral intentions was 14.32 and 3.48, respectively. Elderly individuals agreed that advance care planning has benefits but were worried about the emotional distress caused by advance care planning discussions. Elderly individuals with positive behavioral intentions tend to implement advance care planning. Spouses, children, doctors, and nurses are significant reference people for elderly individuals.ConclusionsThe developed questionnaire exhibits good validity and reliability for understanding elderly individuals’ knowledge, attitudes, and behavioral intentions concerning advance care planning. Advance care planning materials or decision aids suitable for elderly individuals must be developed to increase their understanding of advance care planning. Additionally, the role of nurses is indispensable in promoting advance care planning among elderly individuals.

Older patients' and their caregivers' understanding of advanced care planning.

The aim of this study was to review the recent literature (2019-2021) on older patients' and their caregivers' understanding of advance care planning. Recent studies highlight the continued gaps in knowledge about advance care planning for older adults with cancer and their caregivers both domestically and abroad. The recent literature also revealed that there is a lack of research methodology to assess knowledge of advance care planning reliably and validly in older adults with cancer and their caregivers given the lack of uniform scales to measure knowledge of advance care planning. Older adults with cancer are at an elevated risk of death from their illness, and it is essential they understand how advance care planning can improve their quality of life, facilitate goal congruent care and ultimately decrease medical expenditures at end of life. In order to engage in a process such as advance care planning, patients must know what it is and how it can be helpful to them. The lack of understanding about advance care planning presents a significant barrier to patients engaging in the process. Public health campaigns to increase advance care planning knowledge are needed to ensure that older adults with cancer and their caregivers understand how this service can be helpful to them as they approach end of life.

Pengembangan Pelaksanaan Discharge Planning dengan Penyusunan Panduan Berbasis Knowledge Management SECI Model

This study aims to identify the development of discharge planning implementation, which is attempted by compiling a discharge planning guide based on the knowledge management SECI Model. The method used is a pilot project that starts from the problem, analyzes problems, prioritizes, prepares action plans, implements and evaluates structures and discussions based on literature review. The results showed that nurses' knowledge of care planning needed further improvement, while perceptions of care planning wanted a revision of standard operating procedures. In conclusion, the implementation of discharge planning can be done by optimizing the control function either at the head of the room or at the service level, and the SECI model knowledge management method guide is an effort that can assist the discharge planning implementation process.
 Keywords: Discharge Planning, Knowledge Management, SECI Model

Knowledge, attitude and practice of advance care planning among nursing interns: A mixed-methods approach

AimTo investigate the knowledge, attitudes and practice of advance care planning and confirm their influencing factors among nursing interns in China. BackgroundDue to a lack of standardized courses on advance care planning (ACP) in China, nursing interns do not possess the knowledge of ACP and cannot apply it to clinical practice. DesignA convergent parallel mixed-methods design. Methods382 nursing interns aged > 18 years were recruited using convenience sampling. Quantitative data were collected using the General Demographic Characteristics Questionnaire and the Advance Care Planning Knowledge, Attitude and Practice Questionnaire. Thirteen nursing interns were drawn from the quantitative phase and their interviews were thematically analyzed. Results: The ACP attitudes and practice scores of nursing students were 48.85 ± 6.39 and 32.23 ± 4.58, respectively, with a high level, while their ACP knowledge score was 6.89 ± 2.70, with a medium level. The significant promotive factors included positive attitude toward death and the nursing major and experience in clinical rescues and palliative care training; The key hindrance factors included the lack of ACP education and the limitations of the working environment. ConclusionsThe study highlighted the importance of delivering systematic palliative care training and integrating the practice of ACP into routine nursing practice. Doing this can help expand advance care planning knowledge, establish positive attitudes and meet the practical needs of nursing interns for their ACP clinical practice.

Health information technology to support cancer survivorship care planning: A systematic review.

The study sought to conduct a systematic review to explore the functions utilized by electronic cancer survivorship care planning interventions and assess their effects on patient and provider outcomes. Based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, studies published from January 2000 to January 2020 were identified in PubMed, CINAHL, EMBASE, PsychINFO, Scopus, Web of Science, and the ACM Digital Library . The search combined terms for cancer, survivorship, care planning, and health information technology (HIT). Eligible studies evaluated the effects of a HIT intervention on usability, knowledge, process, or health-related outcomes. A total of 578 abstracts were reviewed, resulting in 60 manuscripts describing 40 studies. Thematic analyses were used to define meta-themes of system functions, and Fisher's exact tests were used to examine associations between functions and outcomes. Patients were the target end users for 18 interventions, while 12 targeted providers and 10 targeted both groups. Interventions used patient-reported outcomes collection (60%), automated content generation (58%), electronic sharing (40%), persistent engagement (28%), and communication features (20%). Overall, interventions decreased the time to create survivorship care plans (SCPs) and supported care planning knowledge and abilities, but results were mixed for effects on healthcare utilization, SCP sharing, and provoking anxiety. Persistent engagement features were associated with improvements in health or quality-of-life outcomes (17 studies, P = .003). Features that engaged users persistently over time were associated with better health and quality-of-life outcomes. Most systems have not capitalized on the potential of HIT to share SCPs across a care team and support care coordination.

Differences in advance care planning among nursing home care staff.

A team-based approach has been advocated for advance care planning in nursing homes. While nurses are often put forward to take the lead, it is not clear to what extent other professions could be involved as well. To examine to what extent engagement in advance care planning practices (e.g. conversations, advance directives), knowledge and self-efficacy differ between nurses, care assistants and allied care staff in nursing homes. Survey study. The study involved a purposive sample of 14 nursing homes in Flanders, Belgium. Nurses, care assistants and allied care staff (e.g. social workers, physical therapists) completed a survey. The study was approved by the University Hospital of Brussels (B.U.N. 143201834759), as part of a cluster randomized controlled trial (clinicaltrials.gov NCT03521206). One hundred ninety-six nurses, 319 care assistants and 169 allied staff participated (67% response rate). After adjusting for confounders, nurses were significantly more likely than care assistants to have carried out advance care planning conversations (odds ratio 4; 95% confidence interval 1.73-9.82; p < 0.001) and documented advance care planning (odds ratio 2.67; 95% confidence interval 1.29-5.56; p < 0.001); differences not found between allied staff and care assistants. Advance care planning knowledge total scores differed significantly, with nurses (estimated mean difference 0.13 (score range 0-1); 95% confidence interval 0.08-0.17; p < 0.001) and allied staff (estimated mean difference 0.07; 95% confidence interval 0.03-0.12; p < 0.001) scoring higher than care assistants. We found no significant differences regarding self-efficacy. While nursing home nurses conducted more advance care planning conversations and documentation than allied care staff and care assistants, these two professional groups may be a valuable support to nurses in conducting advance care planning, if provided with additional training. Allied care staff and care assistants, if trained appropriately, can be involved more strongly in advance care planning to enhance relational and individual autonomy of nursing home residents, alongside nurses. Future research to improve and implement advance care planning should consider this finding at the intervention development stage.

Community-Based Advance Care Planning Interventions for Minority Older Adults: A Systematic Review.

Racial/ethnic minority older adults in the United States often experience access, language, and cultural barriers to advance care planning. For the current study, a systematic review was conducted to summarize and appraise the current science on community-based interventions aimed at increasing advance care planning in racial/ethnic minority older adults. Five articles met the inclusion criteria, which represented four unique interventions in Asian American (n = 2) and Hispanic (n = 2) communities. Two interventions were nurse-led workshops and two were one-onone social worker-led sessions. Outcomes measured were intention to or completion of advance directive or advance care planning discussion; and improvement in advance directive knowledge, beliefs, attitudes, and comfort related to advance care planning. Interventions increased intention to or completion of advance directives and improved advance care planning knowledge, beliefs, and attitudes. Results were inconclusive regarding promoting advance care planning discussions. Further research is needed to address the diverse needs of racial/ethnic minority older adults and barriers to advance care planning. [Journal of Gerontological Nursing, 47(5), 26-36.].

Effectiveness of a video-based advance care planning intervention in hospitalized elderly patients: A randomized controlled trial.

This study aimed to develop a video-based advance care planning intervention, and examine the effectiveness of the intervention on knowledge, behavioral intentions and advance directive signing among older patients admitted to a geriatric unit in Taiwan. This randomized controlled trial was carried out in two geriatric wards of a medical center in northern Taiwan, between June 2014 and June 2015. The participants were randomly assigned to the intervention (n=39) or control (n=43) group. Participants in the intervention group watched a 5-min video regarding advance care planning. The control group received usual care. Structured questionnaires on advance care planning knowledge and behavioral intentions were administered to both groups before and after the intervention. Advance directive signing was carried out until 2 weeks after hospital discharge through a chart review. The intervention group showed a significantly higher advance care planning knowledge score and behavioral intention score than the control group post-intervention. The rate of advance directive signing was 33.3% in the intervention group and 9.3% in the control group (P=0.01). This study showed the effectiveness of video-based interventions in increasing advance care planning knowledge, behavioral intention and advance directive signing among hospitalized older patients. Geriatric wards could use our model to promote advance care planning among older patients. Geriatr Gerontol Int 2021; 21: 478-484.

Community-Based Interventions to Increase Use of Advance Care Planning in Racial/Ethnic Minority Older Adults: A Systematic Review (SCI957)

1.Compare the community-based advance care planning interventions for racial/ethnic minority older adults.2.Appraise the community-based advance care planning interventions aimed at increasing engagement in racial/ethnic minorities. Racial/ethnic minority older adults in the United States (US) often experience access, language, and cultural barriers to advance care planning. Our aim was to summarize and appraise the current science on interventions aimed at increasing advance care planning in racial/ethnic minority, community-dwelling older adults. We systematically searched PubMed, CINAHL, and Embase databases until April 2020. We included articles representing interventional, community-based, primary research in the US for racial/ethnic minority older adults in the US. We excluded studies that targeted caregiver, family, or surrogates due to wide variation in demographics. Following PRISMA guidelines, two researchers independently screened articles identified in the systematic search, reviewed eligible articles, and abstracted data using a standardized data extraction form. Two reviewers appraised the quality of the included articles using the Downs and Black checklist and a third reviewer settled discrepancies. 1823 abstracts and titles were reviewed, five met the inclusion criteria, which represented four unique interventions. Interventions were conducted in Asian American (n=2) and Hispanic (n=2) communities. Interventions included educational nurse-led workshops (n=2) and one-on-one social worker-led sessions (n=2). Quality appraisal identified methodological weaknesses including convenience samples and self-reported outcomes. Outcomes measured were intention to complete or completion of advance directive or advance care planning discussion, an improvement in advance directive knowledge, beliefs, and attitudes toward and comfort with end-of-life care planning. The interventions increased intention to or completion of an advance directive and improved advance care planning knowledge, beliefs, and attitudes. However, Results were inconclusive regarding promoting advance care planning discussions with family and health care providers. Existing literature on interventions to increase advance care planning in US racial/ethnic minority older adults is limited and specific to certain populations. Although the Results from these studies were promising, high-quality interventions that reflect the diverse needs and barriers to advance care planning are needed.

Understanding the Role of Knowledge in Advance Care Planning Engagement

ContextAdvance care planning remains underutilized. A better understanding of the role of education in promoting engagement is needed. ObjectivesTo examine advance care planning knowledge and its relationship to engagement in middle-aged and older adults. MethodsThis cross-sectional study utilized baseline data from 921 participants age ≥55 years enrolled in the STAMP randomized controlled trial, including a knowledge scale consisting of seven questions regarding the purpose and mechanisms of advance care planning and measures of participation. ResultsOnly 11.9% of participants answered all 7 questions correctly, and 25.6% of participants answered ≤3 correctly (defined as “low knowledge”). Low knowledge was independently associated with male gender (odds ratio [OR] 2.1, 95% confidence interval [CI]: 1.5, 3.0), non-white race (OR 1.5, 95% CI: 1.1, 2.2), older age (OR 2.2, 95% CI: 1.4, 3.4), lower income (OR 1.5, 95% CI: 1.1, 2.1), and lower education level (OR 2.9, 95% CI: 2.0, 4.1). Higher knowledge was independently associated with communicating with a loved one about quality versus quantity of life (OR 1.7, 95% CI: 1.2, 2.4) and with living will completion (OR 1.6, 95% CI: 1.0, 2.5), but not with healthcare agent assignment. Factors including race and education remained associated with engagement after accounting for knowledge. ConclusionKnowledge deficits regarding advance care planning are common and associated with the same sociodemographic factors linked to other healthcare disparities. While improving knowledge is an important component of intervention, it is unlikely sufficient in and of itself to increase engagement.

Improving Care Experiences for Patients and Caregivers at End of Life: A Systematic Review.

End-of-life care is increasing as the US population ages. Approaches to providing high-quality end-of-life care vary across setting, diseases, and populations. Several data collection tools measure patient and/or caregiver care experiences at end of life and can be used for quality improvement. Previous reviews examined palliative care improvements or available measures but none explicitly on improving care experiences. We reviewed literature on improving patient and/or caregiver end-of-life care experiences. We searched U.S. English-language peer-reviewed and grey literature after 2000 on adult end-of-life care experiences. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for quantitative studies, Enhancing Transparency in Reporting the Synthesis of Qualitative Research approach for qualitative studies, and Assessment of Multiple Systematic Reviews tool for the literature reviews. Palliative and hospice care. Full-text abstraction of 84 articles, identifying 16 articles. Patient and/or caregiver end-of-life care experiences (captured through administrative data or direct report). Articles examined palliative care experiences across settings; none studied hospice care experiences. Patients and/or caregivers assessed overall care experiences, clinician-staff interactions, provider communication, respect and trust, timeliness of care, spiritual support, caregiver knowledge of care plans, or bereavement support. Efforts aimed at improving end-of-life care experiences are limited and show mixed results. Literature on improving patient and/or caregiver end-of-life care experiences is emerging and focused on palliative care experiences. Evidence on improving hospice care experiences is lacking. Research on strategies for improving end-of-life care experiences should go beyond overall care experiences to include specific aspects of palliative and hospice care experiences.

Care Plans, Care Teams, and Quality of Life for People with Disabilities.

Massachusetts One Care was the first program approved among the Centers for Medicare & Medicaid Financial Alignment Demonstrations for dually eligible beneficiaries. The only program focusing on dually eligible beneficiaries ages 21-64, One Care espouses an independent living philosophy for persons with disabilities. Researchers engaged with enrollees to develop new measures of enrollee quality of life and health to understand changes experienced in this new model of care. To examine whether enrollee knowledge of care plans and care teams predicts improvements in enrollee reported quality of life outcomes. We engaged with people with disabilities to develop and implement a longitudinal survey in One Care in Massachusetts. This analysis presents the self-reported outcomes of a panel of 315 enrollees' experiences with key plan features in Massachusetts One Care enrollees. Knowledge of care plan, care team, and long-term services and supports (predictors); overall health, improved control, improved quality of health care, and improved hope for the future (outcomes). Enrollee-reported knowledge of a care plan and a care team over 2 years of enrollment in Massachusetts One Care was associated with increased odds of reporting more control over health (OR 2.58, CI 1.33, 5.03), improved health care quality (OR 3, CI 1.27, 7.06), and overall health (OR 2.07, CI 1.05, 4.08). Access to new services or equipment to live independently was associated with increased odds of reporting all four positive outcomes, notably for improved perceptions of hope (OR 2.33, CI 1.56, 5.39), overall health (OR 5.03, CI 2.44, 10.39), and improved quality of care (OR 4.22, CI 1.85, 9.62). Engagement of persons with disabilities in care teams and care planning, as well as quality measurement, can improve their experiences of quality of life and health care.

Transitional care planning: A pilot study to explore patient, hospital, and primary care perspectives

The care plan aims to align key stakeholders via the exchange of meaningful, timely, and actionable patient care information during transitions of care. This exploratory study used a qualitative approach that includes field observations and semi-structured interviews to further understand the barriers and current process of care planning. A thematic analysis identified clinician strategies in addition to barriers at system, care-team, and patient levels. Specific themes included limited time and resources to establish value-based care, inconsistent/vague role definitions across settings, disconnections in care team communication, inconsistent care planning definitions and goals, patients’ lack of knowledge of care planning, and social behavioral determinants that prevent patients from engaging in their care planning. Further research is necessary to gain a deeper understanding of these barriers and clinician strategies to support a clearer definition of the care planning process.

Health Literacy Matters More Than Experience for Advance Care Planning Knowledge Among Older Adults

Advance care planning (ACP) engagement is low among vulnerable populations, including those with limited health literacy (LHL). Limited knowledge about ACP may be a modifiable mediator of the relationship between LHL and ACP. Our goal was to determine whether health literacy is associated with ACP knowledge. Cross-sectional design. A public health delivery system and Veterans Affairs Medical Center in San Francisco, CA. English- and Spanish-speaking patients (N = 1400). ACP knowledge was assessed with seven validated multiple-choice questions. Health literacy was measured using a validated scale. Sociodemographic measures included age, sex, language, education, race, health status, and social support. Prior ACP experience was defined as having documented legal forms and/or goals-of-care discussions in the medical record. We used Kruskal-Wallis tests and linear regression to examine associations of ACP knowledge with LHL, prior ACP experience, and sociodemographic factors. Mean age of participants was 65 (±10) years, 48% were women, 34% had LHL, 32% were Spanish speaking, 47% had high school education or less, and 70% were nonwhite. Mean 7-point knowledge scores were lower for those with limited vs adequate health literacy (3.8 [SD = 1.9 vs 5.5 (SD = 1.7); P < .001). In multivariable analysis, ACP knowledge scores were 1.0 point lower among those with LHL; 0.6 points lower among Spanish speakers and those with high school education or less; and 0.5 points lower among individuals of nonwhite race (P < .001 for all). Knowledge scores were 0.02 points lower per year of older age (P = .007) and 0.01 points higher per point of greater social support (P = .005). Prior ACP experience was not associated with knowledge after adjustment (P = .7). Health literacy and sociodemographics are stronger predictors than prior ACP experience of ACP knowledge. This study suggests that providing easy-to-understand ACP materials is paramount and should be offered even if patients have previous experience with the ACP process. J Am Geriatr Soc 67:2151-2156, 2019.