Intention to Engage in Advance Care Planning Among Community Dwelling Adults: A Quasi-Experimental Study

Aims To explore whether intention, knowledge, contemplation, self-efficacy, and readiness related to advance care planning change over time following advance care planning education, and to examine how sociodemographic factors help predict engagement in advance care planning among community-dwelling adults. Design A quasi-experimental, one group, pre-test, post-test study was conducted with 78 community-dwelling adults in the United States between November 2024 and March 2025. Methods The validated Advance Care Planning Engagement Survey measured intention, knowledge, contemplation, self-efficacy, and readiness at baseline, 2-weeks, and 3-months following use of The Conversation Project Starter Guide. Sociodemographic predictors included age, race, gender, marital status, education, employment, insurance, chronic illness, and zip code. Data were analyzed using descriptive statistics, repeated measures ANOVA, chi-square, and binary logistic regression. Results Advance care planning education positively influenced both the intention to engage (commitment to making a change soon) and readiness to engage in advance care planning among community-dwelling adults. The Conversation Project Starter Guide had a significant impact on intention to engage scores over time, with the most dramatic change observed between baseline and 2-weeks post-education. Chronic illness was a significant predictor of advance care planning engagement among community-dwelling adults. Conclusion Findings suggest that implementing advance care planning education may positively enhance engagement in awareness and readiness to engage in advance care planning.