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?

The older Alaska Native/American Indian (ANAI) population is increasing at twice the rate of the general population with a higher burden of serious illness. Older ANAI adults with serious illness are half as likely to have advance directives (AD), indicating a need for improved access to and utilization of advance care planning (ACP) to ensure that medical care aligns with the values, goals, and preferences of ANAI patients and their families throughout the illness trajectory. The major goals of this cluster randomized trial (CRT) are to (1) evaluate the comparative effectiveness of usual care and JUMPSTART- ANAI, a culturally tailored ACP communication intervention, for prompting patient-driven ACP conversations between ANAI adults and primary care providers and to (1) identify key factors to successfully implement the intervention in health systems serving ANAI adults with serious illness.

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 data supports the effectiveness of the treatment 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, as seen in studies with severe respiratory disease and older adults using similar programs. ^{1 2 3 4 5}

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

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

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

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. United States 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. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Empowering patients with the PREPARE advance care planning program results in reciprocal clinician communication. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Integration of Advance Care Planning Into Clinical Practice: A Quality Improvement Project for Leaders. [2020]

4. United States pubmed.ncbi.nlm.nih.gov

Empowering Older Adults to Discuss Advance Care Planning During Clinical Visits: The PREPARE Randomized Trial. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Initial Efficacy Testing of an Autobiographical Memory Intervention on Advance Care Planning for Patients With Terminal Cancer. [2019]