TY  - JOUR
AU  - Roberts, R Lynae
AU  - Cherry, Katelin D
AU  - Mohan, Desh P
AU  - Statler, Tiffany
AU  - Kirkendall, Eric
AU  - Moses, Adam
AU  - McCraw, Jennifer
AU  - Brown III, Andrew E
AU  - Fofanova, Tatiana Y
AU  - Gabbard, Jennifer
PY  - 2024
DA  - 2024/5/6
TI  - A Personalized and Interactive Web-Based Advance Care Planning Intervention for Older Adults (Koda Health): Pilot Feasibility Study
JO  - JMIR Aging
SP  - e54128
VL  - 7
KW  - advance care planning
KW  - ACP
KW  - digital health tools
KW  - system usability
KW  - gerontology
KW  - geriatric
KW  - geriatrics
KW  - older adult
KW  - older adults
KW  - elder
KW  - elderly
KW  - older person
KW  - older people
KW  - ageing
KW  - aging
KW  - adoption
KW  - acceptance
KW  - usability
KW  - digital health
KW  - platform
KW  - website
KW  - websites
AB  - Background: 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. Objective: This pilot study aimed to evaluate the reach, adoption, and usability of Koda Health, a web-based patient-facing ACP platform, among older adults. Methods: 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. Results: 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. Conclusions: 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. 
SN  - 2561-7605
UR  - https://aging.jmir.org/2024/1/e54128
UR  - https://doi.org/10.2196/54128
DO  - 10.2196/54128
ID  - info:doi/10.2196/54128
ER  -