Encouraging Older Adults and Adults With Serious Illness to Designate a Health Care Proxy

August 27, 2026 updated by: Mireille Jacobson, University of Southern California

A Randomized Trial to Encourage Older Adults and Adults With Serious Illness to Designate a Health Care Proxy

This study is a Stage III randomized trial to encourage patients in advance of a health care appointment to designate a healthcare proxy. Patients will be randomly assigned to receive a mailer containing information about designating a healthcare proxy, or to not receive any mailer. For patients assigned to receive a mailer, the mailer will differ by the presence or absence of a patient pre-commitment prompt, and contain a personalized provider request or a generic health system request. The work will evaluate the randomized trial and identify factors that predict intervention effectiveness.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Enrolling by invitation

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
20000

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.
  • Name: Mireille Jacobson, PhD
  • Phone Number: 213-821-8296
  • Email: mireillj@usc.edu

Study Contact Backup

Study Locations

  • United States
    • California
      • Martinez, California, United States, 94553
        • Contra Costa Regional Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • No EHR-documented healthcare proxy at enrollment
  • Age ≥ 55 years OR age ≥ 18 years and listed in the health system's cancer, CHF, or CKD registries

Exclusion Criteria:

  • Primary care provider not assigned at time of randomization.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
No Intervention: No Mailer Control
Patients will not receive a mailer.
Experimental: Provider Mailer with a Pre-commitment Prompt
Patients will receive a mailer containing a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by their primary care provider.
Behavioral: Mailer
Patient mailers will ask the patient to name a healthcare proxy at their next primary care visit.
Behavioral: Pre-commitment Prompt
Patient mailers will contain a box that asks the patient to bring a form with their choice for a healthcare proxy to their next primary care visit.
Behavioral: Provider Request
Patient mailers will be sent from and signed by the patient's provider for their next scheduled primary care visit.
Experimental: Health System Mailer with a Pre-commitment Prompt
Patients will receive a mailer containing a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the health system
Behavioral: Mailer
Patient mailers will ask the patient to name a healthcare proxy at their next primary care visit.
Behavioral: Pre-commitment Prompt
Patient mailers will contain a box that asks the patient to bring a form with their choice for a healthcare proxy to their next primary care visit.
Experimental: Provider Mailer without a Pre-commitment Prompt
Patients will receive a mailer, but it will not contain a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the patient's provider.
Behavioral: Mailer
Patient mailers will ask the patient to name a healthcare proxy at their next primary care visit.
Behavioral: Provider Request
Patient mailers will be sent from and signed by the patient's provider for their next scheduled primary care visit.
Experimental: Health System Mailer without a Pre-commitment Prompt
Patients will receive a mailer, but it will not contain a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the health system.
Behavioral: Mailer
Patient mailers will ask the patient to name a healthcare proxy at their next primary care visit.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Proportion of patients with EHR-documented healthcare proxy
Time Frame: From randomization through 30 days after the patient's scheduled index primary care visit date
Documentation in the electronic health record of a healthcare proxy
From randomization through 30 days after the patient's scheduled index primary care visit date

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Proportion of patients with legal advance care planning documentation
Time Frame: From randomization through 30 days after the patient's scheduled index primary care visit date
Documentation in the electronic health record of any legal advance care planning document, including an advance directive or power of attorney
From randomization through 30 days after the patient's scheduled index primary care visit date
Proportion of patients that attended scheduled visit
Time Frame: On the date of the patient's scheduled index primary care visit
Patient attended the scheduled primary care visit
On the date of the patient's scheduled index primary care visit
Proportion of patients with EHR-documented healthcare proxy through 90 days
Time Frame: From randomization through 90 days after the patient's scheduled index primary care visit date
Documentation in the electronic health record of a healthcare proxy
From randomization through 90 days after the patient's scheduled index primary care visit date
Proportion of patients with legal advance care planning documentation through 90 days
Time Frame: From randomization through 90 days after the patient's scheduled index primary care visit date
Documentation in the electronic health record of any legal advance care planning document, including an advance directive or power of attorney
From randomization through 90 days after the patient's scheduled index primary care visit date
Proportion of patients with primary care visit through 90 days
Time Frame: From randomization through 90 days after the patient's scheduled index primary care visit date
Patient attended a primary care visit
From randomization through 90 days after the patient's scheduled index primary care visit date

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Southern California

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
National Institute on Aging (NIA)
Contra Costa Health

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Mireille Jacobson, PhD, University of Southern California

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
July 15, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 13, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
December 12, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 17, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 18, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 1, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 27, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • UP-23-01203
  • P30AG024968 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified IPD used for results publication may be shared upon request and with approval by the health system.

IPD Sharing Time Frame

IPD will be available after the study publication date.

IPD Sharing Access Criteria

IPD access criteria will be governed by a data use agreement signed by both parties.

IPD Sharing Supporting Information Type

  • SAP
  • ANALYTIC_CODE

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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