Promoting advance care planning via mediated health resources: A systematic mixed studies review

Objective: This systematic review aims (a) to analyze the message design of mediated advance care planning (ACP) interventions targeted at adults from a social marketing and health communication perspective, (b) to identify associations between message design and ACP outcomes, and (c) to illuminate gaps in the literature and highlight needs for future research. Methods: A systematic mixed studies review was conducted. Empirical articles on mediated ACP interventions were systematically searched by using nine scientific databases with keywords related to ACP and mediated health communication. Data were synthesized using a sequential explanatory approach. Results: A total of 11,824 titles were identified, of which 36 studies were included. Interventions disseminated ACP messages via video (36%), digital channels (22%), print (19%), a combination of channels (19%), and mass media (3%). The interventions used generic (42%), targeted (33%), and tailored (25%) communication. Overall, the evidence suggests that mediated ACP resources positively impact ACP Process and Action outcomes. Conclusion: This study has shown that mediated ACP interventions use various contents, formats, and structures to influence patient-centered ACP outcomes. Most message design techniques were associated with positive ACP outcomes. Practice implications: Mediated ACP resources are a promising approach to encourage ACP among adults. (c) 2021 The Author(s). Published by Elsevier B.V. CC_BY_NC_ND_4.0

Automated summary

This systematic review examines the message design of mediated advance care planning (ACP) interventions targeted at adults, and highlights the positive impact of mediated ACP resources on ACP outcomes. Most message design techniques were associated with positive ACP outcomes.