Choosing an Effective Healthcare Spokesperson: An Interactive Intervention

项目概要/摘要 预先护理计划（ACP）是一个预先思考和阐明自己的 人们对未来医疗保健的偏好，长期以来一直被推广为人们接受医疗保健的一种方式。 治疗符合他们的价值观，目标和偏好。许多专家考虑“谁将 如果你不能为自己说话，还能为你做医疗决定吗？”成为最重要的组成部分 的ACP。即便如此，研究表明，代理人往往不准确地代表病人的愿望-这 提出了一个问题，即干预是否可以帮助患者更好地识别代言人， 准确表达患者意愿所需的品质。令人惊讶的是，没有干预（据我们所知） 已经明确设计，以帮助人们考虑他们选择的发言人的实际素质， 减少与这些发言人的接触，以确认他们能够准确地代表患者的意愿。 我们开发了一个名为“你会选择谁：严肃的乐趣”（WWYC）的“严肃游戏”干预， 帮助人们考虑医疗保健发言人应该具备的关键素质。干预使用旋转器， 卡片和骰子，沿着智能手机应用程序，以提示玩家（使用场景和隐喻）选择一个 发言人的素质最适合的作用。友好的竞争是鼓励有球员 回答正确的人可以得到分数，对自己的选择做出很好的解释可以得到额外的分数。结束时 在游戏中，玩家基于在玩游戏期间考虑的品质来识别现实生活中的代言人。然后， 使用相关的智能手机应用程序，干预将有助于激发玩家之间的沟通， 他们选择的代言人。 该项目有三个具体目标： 目标1.为了探索玩小说游戏“你会选择谁”如何影响人们对一个 发言人。使用定性方法，包括焦点小组和一对一访谈，我们将探讨 WWYC如何影响单个玩家选择代言人的思维过程，以及他们的选择是否 游戏的变化。 目标二。建立WWYC是一个可行的方式来帮助个人选择和聘请发言人。我们 如果：1）我们可以有效地招募100个人玩游戏; 2）>75%的游戏玩家，我会判断它是可行的 报告说，玩游戏有助于选择代言人; 3）>75%的游戏玩家赞同 游戏; 4）>75%的发言人在玩家请求后与WWYC互动（使用其在线界面）。 目标3：整合定性和定量数据，以解释玩游戏的体验如何关联 他们的发言人是否愿意参与我们假设一个积极的玩家体验与WWYC 将与他们的发言人成功接触有关。

Project Summary/Abstract Advance care planning (ACP) is the process of thinking through and articulating in advance one's preferences for future medical care, and has long been promoted as a way for people to receive medical treatment consistent with their values, goals, and preferences. Many experts consider the decision “Who will make medical decisions for you if you couldn't speak for yourself?” to be the single most important component of ACP. Even so, research has shown that surrogates often inaccurately represent patients' wishes –which raises the question whether an intervention can help patients do a better job identifying spokespersons with the qualities needed to accurately represent patients' wishes. Surprisingly, no interventions (to our knowledge) have been explicitly designed to help people consider the actual qualities of their chosen spokesperson, much less engage these spokespersons to confirm that they can accurately represent the patient's wishes. We developed a “serious game” intervention called “Who Would You Choose: Serious Fun” (WWYC) to help people consider the key qualities healthcare spokespersons should have. The intervention uses a spinner, cards, and dice, along with a smart-phone App to prompt players (using scenarios and metaphors) to choose a spokesperson whose qualities are best suited to the role. Friendly competition is encouraged by having players receive points for correct answers, and additional points for good explanations of their choices. At the end of the game, players identify a real-life spokesperson based on the qualities considered during game-play. Then, using an associated smart-phone App, the intervention will help spark communication between the player and their chosen spokesperson. The project has three specific aims: Aim 1. To explore how playing the novel game Who Would You Choose affects people's choice of a spokesperson. Using qualitative methods including focus groups and one-on-one interviews, we will explore how WWYC affects individual players' thought process for choosing a spokesperson, and whether their choice changes as a result of game-play. Aim 2. To establish that WWYC is a feasible way to help individuals choose and engage a spokesperson. We will judge it feasible if: 1) We can efficiently recruit 100 individuals to play the game; 2) >75% of game players report that playing the game is helpful for choosing a spokesperson; 3) >75% of game players endorse the game; 4) >75% of spokespersons engage with WWYC (using its online interface) following player request. Aim 3. To integrate qualitative and quantitative data to explain how the experience of playing the game relates to their spokesperson's willingness to engage. We hypothesize that a positive player experience with WWYC will be associated with successful engagement with their spokesperson.