Development and evaluation of an educational video for advance care planning among Chinese university students

To develop a culturally appropriate an educational video for advance care planning (ACP) in China based on the Delphi-constructed training content for college students with regards to ACP and to investigate the efficacy of its application among college students.

A two-round Delphi consultation survey was carried out to collect feedback from experts with regards to the construction of a training content indicator system for ACP and college students. In addition, we performed a quasi-experimental study to investigate the effect of these videos on college students.

Training content was preliminarily determined by performing a literature review and assessing the needs of college students via a questionnaire survey. The Delphi technique was adopted to administer two questionnaires to 18 experts. Between June 2024 and July 2024, a total of 80 college students were recruited from two universities in Chongqing Municipality; these were grouped in the order of enrollment, with 40 students in each group. One group was trained online using the newly developed ACP educational video. The other group was trained offline through regular lectures. Before and after training, we used a questionnaire to compare the two student groups in terms of their readiness for ACP and knowledge score training efficacy.

The recovery rate of information from the two rounds was 100% and 94% respectively; the expert authority coefficients were 0.87 and 0.88 respectively, and the Kendall harmony coefficient was 0.201 and 0.220 respectively. The training content relating to ACP included four first-level indicators, nine second-level indicators and 27 third-level indices. The ACP education video featured six major themes and was developed based on the Delphi. Before training, the total ACP readiness scores for the video group and the control group were 86.15 ± 7.41 and 86.23 ± 10.70, respectively. After training, the total ACP readiness scores for the video group and the control group were 96.69 ± 10.34 and 91.82 ± 8.61, respectively. The total ACP readiness score for the video group was significantly higher than that of the control group (p < 0.05). The difference in the percentage of correctness for each entry of ACP knowledge between the two groups before and after training was statistically significant (p < 0.05). The scores for each entry in the video group were significantly higher than those of the control group after training (p < 0.05) for four entries: the content of ACP, the nature of living wills, the timing of activation of living wills, and the choice of decision-making agent.

The ACP educational videos developed in this study are culturally appropriate to China, comprehensive and scientifically based, and may provide key reference guidelines for the training of college students.