Which online format is most effective for assisting Baby Boomers to complete advance directives? A randomised controlled trial of email prompting versus online education module

dc.contributor.authorBradley, Sandra L
dc.contributor.authorTieman, Jennifer
dc.contributor.authorWoodman, Richard John
dc.contributor.authorPhillips, Paddy Andrew
dc.date.accessioned2017-09-14T00:10:58Z
dc.date.available2017-09-14T00:10:58Z
dc.date.issued2017-08-29
dc.descriptionThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.description.abstractBackground: Completion of Advance Directives (ADs), being financial and healthcare proxy or instructional documents, is relatively uncommon in Australia. Efforts to increase completion rates include online education and prompting which past literature suggests may be effective. The aim of this randomized controlled trial was to assess computer-based online AD information and email prompting for facilitating completion of ADs by Australian Baby Boomers (b.1946–1965) as well as factors which may impede or assist completion of these documents by this generation when using the online environment. Methods: Two hundred eighty-two men and women aged 49–68 years at the time of the trial were randomly assigned to one of 3 intervention groups: education module only; email prompt only; email prompt and education module; and a control group with no education module and no email prompt. The randomized controlled trial was undertaken in participants’ location of choice. Randomization and allocation to trial group were carried out by a central computer system. The primary analysis was based on a final total of 189 participants who completed the trial (n = 52 education module only; n = 44 email prompt only; n = 46 email prompt and education module; and n = 47 control). The primary outcome was the number of individuals in any group completing any of the 4 legal ADs in South Australia within 12 months or less from entry into the trial. Frequency analysis was conducted on secondary outcomes such as reasons for non-completion. Results: Mean follow-up post-intervention at 12 months showed that 7% of overall participants completed one or more of the 4 legal ADs but without significant difference between groups (delta = 1%, p = .48 Prompt/Non-Prompt groups, delta = 5%, p = .44 education/non-education groups). Reasons offered for non-completion were too busy (26%) and/or it wasn’t the right time (21%). Conclusion: Our results suggest that neither email prompting nor provision of additional educational material online were sufficient to significantly impact AD completion rates for this generational cohort. Research with this cohort over longer periods of time exploring online preferences for engagement with ADs as they age may provide better insight into using this environment for ADs with this group. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12616000425493.en
dc.identifier.citationBradley, S. L., Tieman, J. J., Woodman, R. J., & Phillips, P. A. (2017). Which online format is most effective for assisting Baby Boomers to complete advance directives? A randomised controlled trial of email prompting versus online education module. BMC Palliative Care, 16(1). https://doi.org/10.1186/s12904-017-0225-9en
dc.identifier.doihttps://doi.org/10.1186/s12904-017-0225-9en
dc.identifier.issn1472-684X
dc.identifier.urihttp://hdl.handle.net/2328/37473
dc.language.isoen
dc.oaire.license.condition.licenseCC-BY
dc.publisherBioMed Centralen
dc.rights© The Author(s). 2017en
dc.rights.holderThe Author(s).en
dc.subjectBaby Boomers
dc.subjectAdvance care directives
dc.subjectEmail
dc.subjectOnline
dc.subjectEducation
dc.subjectRandomized controlled trial
dc.subjectCompletion rates
dc.titleWhich online format is most effective for assisting Baby Boomers to complete advance directives? A randomised controlled trial of email prompting versus online education moduleen
dc.typeArticleen
local.contributor.authorOrcidLookupTieman, Jennifer: https://orcid.org/0000-0002-2611-1900en_US
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