Advance Care PlanningChatACPNCT07448649
Chatbot-Assisted Advance Care Planning Education for Family Members
A study testing ChatACP - Messaging- and-Chatbot Assisted Nursing Consultation and ACP self- learning handout (Hong Kong Hospital Authority ACP education material) in people with Advance Care Planning, run by The University of Hong Kong.
Trial summary
The goal of this clinical trial is to learn if a messaging and chatbot program, called ChatACP, helps family members of people living in nursing homes take part in advance care planning. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Advance Care Planning
- What is being tested?
- ChatACP - Messaging- and-Chatbot Assisted Nursing Consultation and ACP self- learning handout (Hong Kong Hospital Authority ACP education material)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- No sites listed yet
- Study dates
- 30 Jun 2026to 30 Jun 2028
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- aged 18 years or older
- providing care for an older adult (age 65 or above) living in a care home as a family member (including the family members in the traditional sense and the guardian and persons close to or significant to the older adult)
- able to read, write and communicate in Cantonese or Mandarin
- the resident, care recipient, having a prefrail or frail status as defined by a score of 3 or above on the Clinical Frailty Scale (CFS)
- having a mobile device to receive instant messages and access to cellular network
- engaged in minimal or no prior EOL care discussions with the care home resident as defined by a self-reported status of pre contemplation/contemplation stage on ACP discussions with the resident using the ACP staging algorithm
Who cannot join
- suffering from moderate to severe cognitive impairment defined by an Abbreviated Mental Test score of 5 or less and unable to give consent
- suffering from communication problems (e.g., deafness or aphasia)
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Messaging-and-chatbot-assisted Nursing Consultation to Empower Family Members of Residents Living in Nursing Homes on Advance Care Planning (ChatACP)
The goal of this clinical trial is to learn if a messaging and chatbot program, called ChatACP, helps family members of people living in nursing homes take part in advance care planning.
The main questions this study aims to answer are:
Read more
- Does ChatACP help family members feel more ready to talk about future medical and personal care with their loved one?
- Does ChatACP help family members take part in advance care planning activities, such as having care discussions or completing planning documents?
- Is ChatACP easy to use and acceptable for family members?
Researchers will compare ChatACP to standard self-learning materials about advance care planning to see which approach works better.
Participants will:
- Receive short daily messages with pictures or videos about advance care planning and access to a chatbot specialized in ACP for 10 days
- Complete surveys at the start of the study, after the program ends, and again 3 months later
- Take part in an interview to share their experience with the program
- Conditions
- Advance Care Planning
- Being tested
- ChatACP - Messaging- and-Chatbot Assisted Nursing Consultation, ACP self- learning handout (Hong Kong Hospital Authority ACP education material)
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ChatACP - Messaging- and-Chatbot Assisted Nursing ConsultationBehavioural
The ChatACP for family members encompassed a digital education component and a care provider engagement component. The digital education component includes 10-day messages of ACP infographics, video clips, and a chatbot with specific content for ACP. The care provider engagement component includes one nurse-led telephone consultation.
ACP self- learning handout (Hong Kong Hospital Authority ACP education material)Behavioural
Participants in the control group will be provided with self-learning ACP education material created by the Hong Kong Hospital Authority for public education.
| Study group | Role | What they receive |
|---|---|---|
| ChatACP Group | Experimental | Not described Receives: Behavioral: ChatACP - Messaging- and-Chatbot Assisted Nursing Consultation |
| Control group (ACP self-learning) | Active comparator | Not described Receives: Behavioral: ACP self- learning handout (Hong Kong Hospital Authority ACP education material) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Recruitment feasibility
Recruitment rate will be assessed by calculating the percentage of eligible family members who provide study consent and actively participate in the study.
Measured: From enrollment to 3-month follow-ups
Retention rate
The proportion of participants who successfully complete all surveys and interview for outcome measures and intervention effect outcomes.
Measured: From enrollment to 3-month follow-ups
Percentage of Intervention Components Delivered in Compliance with the Intervention Protocol
Fidelity refers to the extent to which core intervention components were delivered as planned by the research team.
Delivery indicators include:
Provision of assigned infographics Provision of assigned educational videos Respondent to inquiries Completion of scheduled nurse consultation sessions
Fidelity will be calculated as:
(Number of intervention components delivered as planned ÷ Total planned intervention components) × 100%.
Higher percentages indicate greater adherence to the intervention protocol.
Progression criterion: The intervention will be considered feasible if ≥90% of core intervention components are delivered in accordance with the protocol.
Measured: From enrollment to 3-month follow-ups
Participant Engagement Measured by Messaging Platform Interaction Logs and Self-Reported Message Reading Percentage
Participant engagement will be assessed using automatically recorded conversation logs from the messaging platform and chatbot system, as well as participant self-reported message reading extent.
Engagement indicators include:
- Number of interactions (instant messages, phone calls, or chatbot) recorded in the messaging platform and chatbot logs;
- Self-reported percentage of daily intervention messages read (0% = did not read any messages; 100% = read all assigned messages).
Interaction frequency will be reported as counts per participant. Message reading extent will be reported as a percentage (0-100%). Higher interaction frequency and higher reading percentages indicate greater engagement with the intervention.
Progression criterion: The intervention will be considered feasible if ≥50% of participants have at least one recorded interaction (via instant message, phone call, or chatbot) and report reading ≥50% of the daily intervention messages.
Measured: assessed at post-intervention (T1, immediately after completion of the intervention), based on usage data collected during the intervention period
Mean Score of the Perceived Infographic Usability Scale (0-100% per Item)
The scale evaluates message-delivered infographics across eight domains:
Trustworthiness Clarity Risk of confusion Difficulty to follow Usefulness Informativeness Comprehensibility Simplicity
Each item is rated using a 0-100% sliding scale (0 = lowest perceived usability; 100 = highest perceived usability).
For each domain, the mean score will be calculated. Higher scores indicate better perceived usability of the infographic content.
Progression criterion: The infographic content will be considered usable if the mean score for each domain is ≥78%.
Measured: post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)
Proportion of Participants Reporting High Satisfaction (Score 4-5) on all three items of the Investigator-Developed Acceptability Survey (5-Point Likert Scale)
Intervention acceptability will be assessed using an investigator-developed satisfaction survey. The survey evaluates three domains:
- Form of delivery
- Availability of customized support for advance care planning (ACP) questions
- Degree to which the intervention met participants' needs
Each item is rated on a 5-point Likert scale:
- = Highly dissatisfied
- = Dissatisfied
- = Neither satisfied nor dissatisfied
- = Satisfied
- = Highly satisfied
Scores range from 1 to 5 for each item. Higher scores indicate greater satisfaction and acceptability.
Progression criterion: The intervention will be considered acceptable if ≥70% of participants score 4 or 5 on all three items
Measured: post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)
Intervention safety
Risk assessment will be conducted using self-reported adverse events.
Measured: From enrollment to 3-month follow-ups
Background questionnaire
The questionnaire includes demographics and care-related information.
Measured: at baseline (T0, prior to intervention)
Qualitative Findings on Feasibility and Acceptability of the Intervention Based on Semi-Structured Interviews
Semi-structured qualitative interviews will be conducted at 3-month follow-up using an interview guide developed by the Principal Investigator. Interviews aim to explore family caregivers' experiences with the intervention, including perceived acceptability, logistics, and suggestions for improvement.
Interviews will be audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Findings will be reported as identified themes and representative quotations.
Progression criteria: The intervention will be considered feasible if qualitative findings demonstrate overall positive perceptions regarding acceptability, logistics, and perceived usefulness of the intervention.
Measured: at 3-month post-intervention follow-up (T2)
Secondary outcomes (3)
Chinese Version of the 10-item Family Members' ACP Readiness Questionnaire (Total Score, 10-50)
The Chinese version of the 10-item Family Members' Advance Care Planning (ACP) Readiness Questionnaire assesses family members' self-reported ACP knowledge, readiness to discuss ACP with a loved one, self-efficacy in initiating ACP conversations, perceived barriers, emotional perceptions and attitudes toward ACP, and perceived communication tools for ACP discussions.
Each item is rated on a 5-point Likert scale (1-5). Total scores range from 10 to 50, calculated by summing all items. Higher scores indicate greater ACP readiness.
The instrument was developed based on key domains reported in adult ACP readiness measures and constructs identified in a systematic review of family members' roles in ACP. The Chinese version has demonstrated good internal consistency (Cronbach's α = 0.86-0.90).
Measured: at baseline (T0, prior to intervention), post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)
Chinese Version of the 17-item Advance Care Planning Engagement Survey for Surrogate Decision Makers (Total Score, 17-85)
The Chinese version of the 17-item Advance Care Planning Engagement Survey for Surrogate Decision Makers assesses caregivers' engagement in the advance care planning (ACP) process.
The instrument comprises 17 items rated on a 5-point Likert scale (1-5). Total scores range from 17 to 85, calculated by summing all items. Higher scores indicate greater engagement in the ACP process.
The scale includes three domains:
Serving as a surrogate decision maker (7 items), Contemplation (4 items), and Readiness (6 items).
The instrument was adapted from the original 55-item ACP Engagement Survey and has been validated among surrogates of patients with chronic illness. The Chinese version has demonstrated high internal consistency (Cronbach's α = 0.90-0.91).
Measured: at baseline (T0, prior to intervention), post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)
Number of Participants Reporting Completion of Each of Six Advance Care Planning Activities
Participants will report a binary response ("Yes" or "No") to six advance care planning (ACP) behaviors widely used to evaluate ACP outcomes:
- Completion of a health care proxy;
- Communication with the resident regarding views about life-sustaining treatment;
- Communication with the resident regarding quality versus quantity of life;
- Communication between the resident and healthcare providers regarding life-sustaining treatment;
- Communication between the resident and healthcare providers regarding quality versus quantity of life;
- Completion of end-of-life documentation, including documentation of ACP in medical records, Advance Medical Directive (AMD), or Do-Not-Attempt-Cardiopulmonary-Resuscitation (DNACPR) forms.
For each activity, results will be reported as the number and proportion of participants selecting "Yes." A "Yes" response indicates that the specified ACP activity has been completed. A "No" response indicates that the activity has not been completed.
Measured: at baseline (T0, prior to intervention), post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Mar 2026
- Study start30 Jun 2026 (estimated)
- Primary completion30 Jun 2028 (estimated)
- Study completion30 Jun 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Advance Care PlanningStudies of the same condition, open and under way.
- More trials run by The University of Hong KongThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- The University of Hong Kong
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Tongyao WANG, The University of Hong Kong
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07448649
- Sponsor's protocol ID
- UW25-567
- Acronym
- ChatACP
- Status last verified
- Feb 2026
- First submitted
- 8 Feb 2026
- Last updated
- 4 Mar 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Wang T, Chu HN, Chau PH, Zhou X, Lin CC. Messaging and Chatbot-Assisted Nursing Consultation (ChatACP) to Empower Family Members of Residents of Nursing Homes on Advance Care Planning: Protocol for a Mixed Methods Pilot Study. JMIR Res Protoc. 2026 Aug 12;15:e94883. doi: 10.2196/94883.
PubMed 42585665
Study at a glance
From the registry record, last updated by the sponsor on 4 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Messaging-and-chatbot-assisted Nursing Consultation to Empower Family Members of Residents Living in Nursing Homes on Advance Care Planning (ChatACP)
- ClinicalTrials.gov ID
- NCT07448649
- Acronym / sponsor ID
- ChatACP / UW25-567
- Conditions
- Advance Care Planning
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- The University of Hong KongUniversity, hospital or other
- Study start
- 30 Jun 2026 (estimated)
- Primary completion
- 30 Jun 2028 (estimated)
- Study completion
- 30 Jun 2028 (estimated)
- First posted
- 4 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to learn if a messaging and chatbot program, called ChatACP, helps family members of people living in nursing homes take part in advance care planning.
The main questions this study aims to answer are:
- Does ChatACP help family members feel more ready to talk about future medical and personal care with their loved one?
- Does ChatACP help family members take part in advance care planning activities, such as having care discussions or completing planning documents?
- Is ChatACP easy to use and acceptable for family members?
Researchers will compare ChatACP to standard self-learning materials about advance care planning to see which approach works better.
Participants will:
- Receive short daily messages with pictures or videos about advance care planning and access to a chatbot specialized in ACP for 10 days
- Complete surveys at the start of the study, after the program ends, and again 3 months later
- Take part in an interview to share their experience with the program
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| ChatACP Group | Experimental | Behavioral: ChatACP - Messaging- and-Chatbot Assisted Nursing Consultation |
| Control group (ACP self-learning) | Active comparator | Behavioral: ACP self- learning handout (Hong Kong Hospital Authority ACP education material) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- aged 18 years or older
- providing care for an older adult (age 65 or above) living in a care home as a family member (including the family members in the traditional sense and the guardian and persons close to or significant to the older adult)
- able to read, write and communicate in Cantonese or Mandarin
- the resident, care recipient, having a prefrail or frail status as defined by a score of 3 or above on the Clinical Frailty Scale (CFS)
- having a mobile device to receive instant messages and access to cellular network
Key exclusion criteria (2 listed)
- suffering from moderate to severe cognitive impairment defined by an Abbreviated Mental Test score of 5 or less and unable to give consent
- suffering from communication problems (e.g., deafness or aphasia)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| ChatACP - Messaging- and-Chatbot Assisted Nursing ConsultationThe ChatACP for family members encompassed a digital education component and a care provider engagement component. The digital education component includes 10-day messages of ACP infographics, video clips, and a chatbot with specific content for ACP. The care provider engagement component includes one nurse-led telephone consultation. | Behavioural | ChatACP Group |
| ACP self- learning handout (Hong Kong Hospital Authority ACP education material)Participants in the control group will be provided with self-learning ACP education material created by the Hong Kong Hospital Authority for public education. | Behavioural | Control group (ACP self-learning) |
Primary outcome
Recruitment feasibility
Time frame: From enrollment to 3-month follow-ups
Recruitment rate will be assessed by calculating the percentage of eligible family members who provide study consent and actively participate in the study.
Retention rate
Time frame: From enrollment to 3-month follow-ups
The proportion of participants who successfully complete all surveys and interview for outcome measures and intervention effect outcomes.
Percentage of Intervention Components Delivered in Compliance with the Intervention Protocol
Time frame: From enrollment to 3-month follow-ups
Fidelity refers to the extent to which core intervention components were delivered as planned by the research team. Delivery indicators include: Provision of assigned infographics Provision of assigned educational videos Respondent to inquiries Completion of scheduled nurse consultation sessions Fidelity will be calculated as: (Number of intervention components delivered as planned ÷ Total planned intervention components) × 100%. Higher percentages indicate greater adherence to the intervention protocol. Progression criterion: The intervention will be considered feasible if ≥90% of core intervention components are delivered in accordance with the protocol.
Participant Engagement Measured by Messaging Platform Interaction Logs and Self-Reported Message Reading Percentage
Time frame: assessed at post-intervention (T1, immediately after completion of the intervention), based on usage data collected during the intervention period
Participant engagement will be assessed using automatically recorded conversation logs from the messaging platform and chatbot system, as well as participant self-reported message reading extent. Engagement indicators include: 1. Number of interactions (instant messages, phone calls, or chatbot) recorded in the messaging platform and chatbot logs; 2. Self-reported percentage of daily intervention messages read (0% = did not read any messages; 100% = read all assigned messages). Interaction frequency will be reported as counts per participant. Message reading extent will be reported as a percentage (0-100%). Higher interaction frequency and higher reading percentages indicate greater engagement with the intervention. Progression criterion: The intervention will be considered feasible if ≥50% of participants have at least one recorded interaction (via instant message, phone call, or chatbot) and report reading ≥50% of the daily intervention messages.
Mean Score of the Perceived Infographic Usability Scale (0-100% per Item)
Time frame: post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)
The scale evaluates message-delivered infographics across eight domains: Trustworthiness Clarity Risk of confusion Difficulty to follow Usefulness Informativeness Comprehensibility Simplicity Each item is rated using a 0-100% sliding scale (0 = lowest perceived usability; 100 = highest perceived usability). For each domain, the mean score will be calculated. Higher scores indicate better perceived usability of the infographic content. Progression criterion: The infographic content will be considered usable if the mean score for each domain is ≥78%.
Proportion of Participants Reporting High Satisfaction (Score 4-5) on all three items of the Investigator-Developed Acceptability Survey (5-Point Likert Scale)
Time frame: post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)
Intervention acceptability will be assessed using an investigator-developed satisfaction survey. The survey evaluates three domains: 1. Form of delivery 2. Availability of customized support for advance care planning (ACP) questions 3. Degree to which the intervention met participants' needs Each item is rated on a 5-point Likert scale: 1. = Highly dissatisfied 2. = Dissatisfied 3. = Neither satisfied nor dissatisfied 4. = Satisfied 5. = Highly satisfied Scores range from 1 to 5 for each item. Higher scores indicate greater satisfaction and acceptability. Progression criterion: The intervention will be considered acceptable if ≥70% of participants score 4 or 5 on all three items
Intervention safety
Time frame: From enrollment to 3-month follow-ups
Risk assessment will be conducted using self-reported adverse events.
Background questionnaire
Time frame: at baseline (T0, prior to intervention)
The questionnaire includes demographics and care-related information.
Qualitative Findings on Feasibility and Acceptability of the Intervention Based on Semi-Structured Interviews
Time frame: at 3-month post-intervention follow-up (T2)
Semi-structured qualitative interviews will be conducted at 3-month follow-up using an interview guide developed by the Principal Investigator. Interviews aim to explore family caregivers' experiences with the intervention, including perceived acceptability, logistics, and suggestions for improvement. Interviews will be audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Findings will be reported as identified themes and representative quotations. Progression criteria: The intervention will be considered feasible if qualitative findings demonstrate overall positive perceptions regarding acceptability, logistics, and perceived usefulness of the intervention.
3 secondary outcomes
Chinese Version of the 10-item Family Members' ACP Readiness Questionnaire (Total Score, 10-50)
Time frame: at baseline (T0, prior to intervention), post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)
Chinese Version of the 17-item Advance Care Planning Engagement Survey for Surrogate Decision Makers (Total Score, 17-85)
Time frame: at baseline (T0, prior to intervention), post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)
Number of Participants Reporting Completion of Each of Six Advance Care Planning Activities
Time frame: at baseline (T0, prior to intervention), post-intervention (T1, within 1 week after completion of the intervention), and 3 months post-intervention (T2)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Mar 2026.
- Derived from this study: PubMed 42585665Wang T, Chu HN, Chau PH, Zhou X, Lin CC. Messaging and Chatbot-Assisted Nursing Consultation (ChatACP) to Empower Family Members of Residents of Nursing Homes on Advance Care Planning: Protocol for a Mixed Methods Pilot Study. JMIR Res Protoc. 2026 Aug 12;15:e94883. doi: 10.2196/94883.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A study testing ChatACP - Messaging- and-Chatbot Assisted Nursing Consultation and ACP self- learning handout (Hong Kong Hospital Authority ACP education material) in people with Advance Care Planning, run by The University of Hong Kong.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 4 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Tongyao Wang (85255968294, tongyao1@hku.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Recruitment feasibility (time frame: From enrollment to 3-month follow-ups). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07448649, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Mar 2026.