Facilitators and barriers to stakeholder engagement in advance care planning for older adults in community settings: a hybrid systematic review protocol

Monika Pilch; Victoria Lunt; Peter May; David Mockler; Stephen Thomas; Frank Doyle

doi:10.12688/hrbopenres.13082.2

Facilitators and barriers to stakeholder engagement in advance care planning for older adults in community settings: a hybrid systematic review protocol

HRB Open Res. 2021 Jun 11:3:38. doi: 10.12688/hrbopenres.13082.2. eCollection 2020.

Authors

Monika Pilch¹, Victoria Lunt², Peter May^{1

3}, David Mockler⁴, Stephen Thomas¹, Frank Doyle⁵

Affiliations

¹ Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, D2, Ireland.
² Beaumont Hospital and St Luke's Radiation Oncology Centre at Beaumont Hospital, Beaumont Hospital, Beaumont, Dublin, D9, Ireland.
³ The Irish Longitudinal study on Ageing (TILDA), Trinity College Dublin, Dublin, D2, Ireland.
⁴ The Library of Trinity College Dublin, Trinity College Dublin, University of Dublin, Dublin, D2, Ireland.
⁵ Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, D2, Ireland.

Abstract

Background: Poor stakeholder engagement in advance care planning (ACP) poses national and international challenges, preventing maximisation of its potential benefits. Conceptualisation of advance care planning as a health behaviour highlights the need to design innovative, evidence-based strategies that will facilitate meaningful end-of-life care decision-making. Aim: To review systematically and synthesise quantitative and qualitative evidence on barriers and facilitators to stakeholders` engagement in ACP for older adults (≥ 50 years old) in a community setting. Methods: A hybrid systematic review will be conducted, identifying studies for consideration in two phases. First, databases will be searched from inception to identify relevant prior systematic reviews, and assess all studies included in those reviews against eligibility criteria (Phase 1). Second, databases will be searched systematically for individual studies falling outside the timeframe of those reviews (Phase 2). A modified SPIDER framework informed eligibility criteria. A study will be considered if it (a) included relevant adult stakeholders; (b) explored engagement in ACP among older adults (≥50 years old); (c) employed any type of design; (d) identified enablers and/or barriers to events specified in the Organising Framework of ACP Outcomes; (e) used either quantitative, qualitative, or mixed methods methodology; and (f) evaluated phenomena of interest in a community setting (e.g., primary care or community healthcare centres). Screening, selection, bias assessment, and data extraction will be completed independently by two reviewers. Integrated methodologies will be employed and quantitative and qualitative data will be combined into a single mixed method synthesis. The Behaviour Change Wheel will be used as an overarching analytical framework and to facilitate interpretation of findings. The Joanna Briggs Institute (JBI) Reviewers` Manual and PRISMA-P guidelines have been used to inform this protocol development. Registration: This protocol has been submitted for registration on PROSPERO, registration number CRD42020189568 and is awaiting review.

Keywords: Advance care planning; behaviour change; community; systematic review.

Grants and funding

Health Research Board [SPHeRE-2018-1]. The Health Research Board (HRB) supports excellent research that improves people’s health, patient care and health service delivery. HRB aims to ensure that new knowledge is created and then used in policy and practice. In doing so, HRB supports health system innovation and create new enterprise opportunities.