Peer-facilitated Public Sessions as a Strategy to Increase Engagement in Advance Care Planning in British Columbia

Advance Care Planning (ACP) is a process whereby people reflect upon and share their values, beliefs and wishes for future healthcare with family, friends and healthcare providers. Knowing this information informs decision-making about the treatment and care options right for them. Despite many benefits, public awareness of, and engagement in, ACP is low in British Columbia (BC). As one approach aiming to address public ACP engagement, the BC Centre for Palliative Care partnered with community organisations from across the province to spread a community-delivered public education model; peer-facilitated public ACP sessions. The sessions are designed to inform public participants about the ACP process, and increase their comfort and readiness to engage in ACP, including sharing with their family and healthcare providers. In these interactive sessions, trained peers educate participants about ACP and stimulate conversations using stories and personal experiences. To assess the sessions' impact on public engagement in ACP, we collected survey data from participants at the end of sessions and 4-6 weeks later. Qualitative data was collected through focus groups and interviews to assess peer-facilitator and community organisation experience. In 40+ sessions attended by over 800 participants in 23 communities throughout BC, our results demonstrate that peers are well suited to this role; sessions were well received and effective at promoting ACP engagement. Within 4-6 weeks of attending the session almost all participants (97%) had thought about their personal values, beliefs and wishes, and two-thirds had had conversations with those close to them (a 76% increase from pre-workshop rates). There was also a 75% increase in conversations with healthcare providers, and a 69% increase in creation of ACP documents. All organisations have continued to deliver sessions demonstrating sustainability. Peer-facilitated ACP sessions are an effective strategy to increase ACP awareness and engagement among British Columbians.