Using Collective Intelligence to Develop Design Requirements for a Complex Intervention for Advance Care Planning in...

Area of Science:

• Gerontology
• Health Services Research
• Behavioral Science

Background:

• Advance care planning (ACP) engagement is a complex systemic issue requiring innovative approaches.
• A socioecological framework is essential for guiding behavioral and social change in ACP.

Purpose of the Study:

• To identify stakeholder perspectives on barriers to ACP engagement.
• To explore options for overcoming these barriers and define user needs.
• To inform the design of health behavior change interventions for older adults (50+) in ACP.

Main Methods:

• Utilized collective intelligence and scenario-based design methods for co-production and intervention design.
• Conducted systematic stakeholder analysis and recruited 22 participants for online collective intelligence sessions.
• Applied a socioecological perspective to frame integrated findings across individual, interpersonal, service, and system levels.

Main Results:

• Identified 109 barriers to ACP grouped into seven categories (Psychological, Literacy, Interpersonal, Service, Resources, Process, Cultural).
• Generated 222 options to overcome barriers and specified 230 user needs, highlighting the need for perception change, psychological readiness, and ACP literacy.
• Emphasized facilitating timely, meaningful interactions among ACP actors, co-designing need-based services, and requiring cultural/societal transformation.

Conclusions:

• Findings illuminate the complexity of ACP intervention design, identifying directions for context-specific interventions.
• Recommends design thinking methodologies for complex intervention development.
• Provides a roadmap for policymakers, practitioners, and researchers to design effective ACP interventions.