JUMPSTART-ANAI for Advance Care Planning

Overseen By John Trainor, PhD, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Southcentral Foundation

Disqualifiers: Cognitive impairment, Unable to complete visit

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

400 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to enhance how Alaska Native and American Indian adults with serious illnesses plan their future healthcare. It compares usual care with a special communication tool called JUMPSTART-ANAI, which helps patients discuss their healthcare wishes with their doctors. The trial seeks participants who are at least 40 years old, have a serious illness like cancer or COPD, and have visited their primary care doctor at least twice in the past year. Participants should not already have an advance directive, which is a document outlining a person's healthcare preferences. As an unphased trial, this study offers a unique opportunity to contribute to improving healthcare communication for future patients.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that the JUMPSTART-ANAI intervention is safe for advance care planning?

Research has shown that JUMPSTART-ANAI is a tool designed to initiate conversations about advance care planning (ACP) while respecting cultural differences. No evidence has indicated any negative effects from using this tool. This study does not test a new drug or medical treatment, so the risks differ from those in studies involving experimental medicines. Instead, it seeks to enhance discussions about medical care preferences, which is generally safe. Without traditional side effects, it is considered a low-risk option for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about JUMPSTART-ANAI because it tackles advance care planning in a fresh, interactive way. Unlike traditional methods that might involve static discussions or standard directives, JUMPSTART-ANAI includes questionnaires designed to dive into personal experiences, preferences, and concerns. This approach not only engages patients more actively but also provides feedback for both patients and providers, potentially leading to more personalized and effective care planning. By focusing on these dynamic interactions, JUMPSTART-ANAI aims to enhance communication and understanding in advance care planning, paving the way for better patient-centered outcomes.

What evidence suggests that the JUMPSTART-ANAI intervention is effective for advance care planning in the ANAI population?

Research has shown that advance care planning (ACP) activities, such as JUMPSTART-ANAI, increase discussions and documentation about future medical care among patients. These activities ensure healthcare aligns with patients' preferences and values. Although some studies have shown mixed results, the general trend suggests ACP improves communication between patients and healthcare providers. In this trial, participants may receive either the Jumpstart 1 or Jumpstart 2 intervention, both tailored to the cultural needs of Alaska Native and American Indian communities, potentially enhancing the planning's effectiveness. By encouraging these discussions, JUMPSTART-ANAI aims to better meet the healthcare needs of older adults in these communities. ^{1 2 3 6 7}

Who Is on the Research Team?

Jennifer Shaw, PhD

Principal Investigator

University of Alaska Fairbanks

Are You a Good Fit for This Trial?

This trial is for older Alaska Native/American Indian adults with serious illnesses who have not yet engaged in advance care planning. It aims to help ensure their medical care aligns with personal values and preferences.

Inclusion Criteria

I have been diagnosed with a serious illness like cancer or kidney disease.

Has made 2 or more visits to primary care in the last 12 months

I am 40 years old or older.

Exclusion Criteria

Cognitive impairment (≥ 2 errors) as assessed by the validated Short Portable Mental Status Questionnaire

I cannot do a 30-minute visit by phone or in person.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive the JUMPSTART-ANAI intervention, a culturally tailored ACP communication intervention

12 months

Baseline, 3 months, 6 months, 12 months

Follow-up

Participants are monitored for the presence of an advance directive in the electronic health record

12 months

What Are the Treatments Tested in This Trial?

Interventions

• JUMPSTART-ANAI

Trial Overview

The study compares usual healthcare practices with JUMPSTART-ANAI, a program designed specifically for ANAI people to encourage discussions about future medical care between patients and doctors.

How Is the Trial Designed?

Group I: Jumpstart 1 Experimental Treatment 1 Intervention

Questionnaire on advance care planning experiences, preferences, and concerns

Group II: Jumpstart 2 Active Control 1 Intervention

Questionnaire on advance care planning experiences, preferences, and concerns plus feedback form (patient and provider)

Group III: Usual care Active Control 1 Intervention

Who Is Running the Clinical Trial?

Southcentral Foundation

Lead Sponsor

Trials

10

Recruited

8,000+

University of Arkansas

Collaborator

Trials

500

Recruited

153,000+

University of Washington

Collaborator

Trials

1,858

Recruited

2,023,000+

University of Colorado, Denver

Collaborator

Trials

1,842

Recruited

3,028,000+

Alaska Native Tribal Health Consortium

Collaborator

Trials

20

Recruited

9,600+

University of Alaska Fairbanks

Collaborator

Trials

10

Recruited

14,100+

Published Research Related to This Trial

A nurse-led facilitated advance care planning (ACP) intervention for patients with severe respiratory disease did not improve self-reported satisfaction, health-related quality of life, or 12-month mortality rates among the 149 participants studied.

However, the intervention was associated with fewer outpatient consultations and a reduced length of stay in acute hospital settings, suggesting a shift in healthcare utilization patterns during the final 90 days of life.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of a Nurse-Led Advance Care Planning Intervention on Satisfaction, Health-Related Quality of Life, and Health Care Utilization Among Patients With Severe Respiratory Disease: A Randomized Patient-Preference Trial. Sinclair, C., Auret, KA., Evans, SF., et al.[2021]

Citations

1.

clinicaltrials.gov

clinicaltrials.gov/study/NCT06538493

Jumpstarting Advance Care Planning With ANAI People

It identifies the role of the intervention that participants receive. Types of arms include experimental arm, active comparator arm, placebo comparator arm, ...

2.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/41001527/

Collaborative Implementation Planning to Jumpstart ...

We conducted a qualitative study to gather feedback from customer-owners and employees to inform implementation of Jumpstart AN/AI within ...

3.

withpower.com

withpower.com/trial/phase-advance-care-planning-2025-81925

JUMPSTART-ANAI for Advance Care Planning

Research shows that advance care planning (ACP) interventions, like JUMPSTART-ANAI, are effective in increasing ACP discussions and documentation among patients ...

4.

journal.ilpnetwork.org

journal.ilpnetwork.org/articles/10.31389/jltc.225

The Effectiveness of Advance Care Planning (ACP) ...

This is an update of a prior review, published in 2021, of ACP education interventions for healthcare professionals in care homes.

5.

publichealth.jhu.edu

publichealth.jhu.edu/2024/new-study-reveals-mixed-results-in-advance-care-planning-for-older-adults

New Study Reveals Mixed Results in Advance Care Planning ...

A recent study published December 2 on JAMA Network aimed at improving end-of-life planning for adults over 65 has shown mixed results.

6.

researchgate.net

researchgate.net/publication/397271528_Advance_Care_Planning_Motivators_Among_Adults_With_Serious_Illness

Advance Care Planning Motivators Among Adults With ...

Data were analyzed May 2023 to February 2025). Exposure Having a serious illness. Main Outcomes and Measures Three domains of ACP engagement: ...

7.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12405694/

Evaluating outcomes of advance care planning interventions ...

To utilise published reviews to explore the efficacy of current advance care planning interventions, including how they are evaluated, and ...