Jumpstarting Advance Care Planning With ANAI People

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.

Inclusion Criteria: Age 40 or older with a qualifying serious illness condition (e.g., COPD) OR Age 65 or older (regardless of diagnosis) AND Alaska Native and/or American Indian AND Empaneled to a primary care provider AND 2 or more to primary care in last 12 months AND No advance directives documented in electronic health record Exclusion Criteria: Unable to provide informed consent AND/OR Not able to complete 30-minute study visit by phone, video call, or in person