PDF(Pubmed)
Abstract：
UNASSIGNED: Advance care planning (ACP) is a process that involves patients expressing their personal goals, values, and future medical care preferences. Digital applications may help facilitate this process, though their use in older adults has not been adequately studied.
UNASSIGNED: This pilot study aimed to evaluate the reach, adoption, and usability of Koda Health, a web-based patient-facing ACP platform, among older adults.
UNASSIGNED: Older adults (aged 50 years and older) who had an active Epic MyChart account at an academic health care system in North Carolina were recruited to participate. A total of 2850 electronic invitations were sent through MyChart accounts with an embedded hyperlink to the Koda platform. Participants who agreed to participate were asked to complete pre- and posttest surveys before and after navigating through the Koda Health platform. Primary outcomes were reach, adoption, and System Usability Scale (SUS) scores. Exploratory outcomes included ACP knowledge and readiness.
UNASSIGNED: A total of 161 participants enrolled in the study and created an account on the platform (age: mean 63, SD 9.3 years), with 80% (129/161) of these participants going on to complete all steps of the intervention, thereby generating an advance directive. Participants reported minimal difficulty in using the Koda platform, with an overall SUS score of 76.2. Additionally, knowledge of ACP (eg, mean increase from 3.2 to 4.2 on 5-point scale; P<.001) and readiness (eg, mean increase from 2.6 to 3.2 on readiness to discuss ACP with health care provider; P<.001) significantly increased from before to after the intervention.
UNASSIGNED: This study demonstrated that the Koda Health platform is feasible, had above-average usability, and improved ACP documentation of preferences in older adults. Our findings indicate that web-based health tools like Koda may help older individuals learn about and feel more comfortable with ACP while potentially facilitating greater engagement in care planning.
UNASSIGNED: This pilot study aimed to evaluate the reach, adoption, and usability of Koda Health, a web-based patient-facing ACP platform, among older adults.
UNASSIGNED: Older adults (aged 50 years and older) who had an active Epic MyChart account at an academic health care system in North Carolina were recruited to participate. A total of 2850 electronic invitations were sent through MyChart accounts with an embedded hyperlink to the Koda platform. Participants who agreed to participate were asked to complete pre- and posttest surveys before and after navigating through the Koda Health platform. Primary outcomes were reach, adoption, and System Usability Scale (SUS) scores. Exploratory outcomes included ACP knowledge and readiness.
UNASSIGNED: A total of 161 participants enrolled in the study and created an account on the platform (age: mean 63, SD 9.3 years), with 80% (129/161) of these participants going on to complete all steps of the intervention, thereby generating an advance directive. Participants reported minimal difficulty in using the Koda platform, with an overall SUS score of 76.2. Additionally, knowledge of ACP (eg, mean increase from 3.2 to 4.2 on 5-point scale; P<.001) and readiness (eg, mean increase from 2.6 to 3.2 on readiness to discuss ACP with health care provider; P<.001) significantly increased from before to after the intervention.
UNASSIGNED: This study demonstrated that the Koda Health platform is feasible, had above-average usability, and improved ACP documentation of preferences in older adults. Our findings indicate that web-based health tools like Koda may help older individuals learn about and feel more comfortable with ACP while potentially facilitating greater engagement in care planning.
摘要：
■高级护理计划（ACP）是一个涉及患者表达其个人目标的过程，值,和未来的医疗保健偏好。数字应用可能有助于促进这一过程，尽管它们在老年人中的使用尚未得到充分研究。
■这项试点研究旨在评估覆盖范围，收养,以及KodaHealth的可用性，基于Web的面向患者的ACP平台，在老年人中。
■在北卡罗来纳州的学术医疗保健系统中拥有活跃的EpicMyChart帐户的老年人（50岁及以上）被招募参加。通过MyChart帐户发送了总共2850份电子邀请，并带有嵌入式超链接到Koda平台。同意参加的参与者被要求在通过KodaHealth平台导航之前和之后完成测试前和测试后的调查。主要结果是达到的，收养,和系统可用性量表(SUS)得分。探索性结果包括ACP知识和准备情况。
■共有161名参与者参加了研究并在平台上创建了一个帐户（年龄：平均63岁，SD9.3岁），这些参与者中有80％（129/161）继续完成干预的所有步骤，从而产生预先指令。参与者报告说，使用Koda平台的难度很小，整体SUS得分为76.2。此外,ACP知识(例如，在5分表上平均从3.2增加到4.2；P<.001)和准备(例如，在准备与卫生保健提供者讨论ACP时，平均从2.6增加到3.2；P<.001）从干预前后显着增加。
■这项研究表明，KodaHealth平台是可行的，具有高于平均水平的可用性，并改进了ACP对老年人偏好的记录。我们的研究结果表明，像Koda这样的基于网络的健康工具可以帮助老年人了解ACP并对其感到更舒适，同时有可能促进更多地参与护理计划。
■这项试点研究旨在评估覆盖范围，收养,以及KodaHealth的可用性，基于Web的面向患者的ACP平台，在老年人中。
■在北卡罗来纳州的学术医疗保健系统中拥有活跃的EpicMyChart帐户的老年人（50岁及以上）被招募参加。通过MyChart帐户发送了总共2850份电子邀请，并带有嵌入式超链接到Koda平台。同意参加的参与者被要求在通过KodaHealth平台导航之前和之后完成测试前和测试后的调查。主要结果是达到的，收养,和系统可用性量表(SUS)得分。探索性结果包括ACP知识和准备情况。
■共有161名参与者参加了研究并在平台上创建了一个帐户（年龄：平均63岁，SD9.3岁），这些参与者中有80％（129/161）继续完成干预的所有步骤，从而产生预先指令。参与者报告说，使用Koda平台的难度很小，整体SUS得分为76.2。此外,ACP知识(例如，在5分表上平均从3.2增加到4.2；P<.001)和准备(例如，在准备与卫生保健提供者讨论ACP时，平均从2.6增加到3.2；P<.001）从干预前后显着增加。
■这项研究表明，KodaHealth平台是可行的，具有高于平均水平的可用性，并改进了ACP对老年人偏好的记录。我们的研究结果表明，像Koda这样的基于网络的健康工具可以帮助老年人了解ACP并对其感到更舒适，同时有可能促进更多地参与护理计划。
