Die-logue Program for Community Dwelling Adults: A Randomized Controlled Trial

April 6, 2026 updated by: Ang Wei How Darryl, National University of Singapore

Effects of a Die-logue Program in Enhancing Community Dwelling Adults's Death Attitudes, Coping With Death and Readiness for Advance Care Planning: A Two-phase Study

The goal of this clinical trial is to evaluate whether the Die-logue program can improve attitudes toward death, coping with death, and readiness for advance care planning (ACP) among community-dwelling middle-aged adults aged 40-60 years who have not completed any advance directives and not diagnosed with any life limiting diseases.

This study aims to address the following research questions:

  • Does the Die-logue program improve community-dwelling middle-aged adults' attitudes towards death, ability to cope with death, readiness and uptake for Advanced Care Planning (ACP).
  • What are community-dwelling middle-aged adults' perceptions of advance care planning, death and dying, and their experiences of participation in the Die-logue program.

Researchers will compare participants who receive the Die-logue program (death conversation and online ACP education) with participants who receive only the online ACP education to see if informal death conversations improve attitudes toward death, coping with death, and readiness for ACP.

Participants will:

  • Complete online questionnaires measuring attitudes toward death, coping with death, and readiness for advance care planning.
  • Participate in a facilitator-led group discussion session about perceptions of death, coping with death, and readiness for ACP (intervention group only).
  • Complete an asynchronous online ACP education session consisting of short recorded videos and an online discussion forum (both intervention and control group).
  • Complete follow-up surveys, including a 6-month follow-up assessing whether they have undertaken advance care planning.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

148

Phase

  • 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 Locations

  • Singapore
      • Singapore, Singapore
        • National University of Singapore
        • Contact:

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

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Between the ages of 40 to 60 years
  • Able to comprehend the English language
  • Have not completed any form of advance directives
  • Able and willing to participate in the Die-logue programme and surveys

Exclusion Criteria:

  • Individuals diagnosed with any life limiting diseases
  • Individuals with self-reported history of mental health disorders or neurological disorders

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention Group

Participants in this arm will receive the two-session Die-logue Program.

Session 1 is an on site, facilitator-led group discussion lasting 2 hours, covering:

  1. Perceptions of death and dying.
  2. Coping with death.
  3. Readiness for Advance Care Planning (ACP).

Session 2 is an online asynchronous learning session with short videos on ACP with discussion forums.
Behavioral: Death Conversation
On site, facilitator-led group discussion lasting 2 hours, covering: 1) Perceptions of death and dying. 2) Coping with death. 3) Readiness for Advance Care Planning (ACP)
Behavioral: Online ACP Education
An online asynchronous learning session with short videos on ACP with discussion forums.
Active Comparator: Control Group
Participants in this arm will only receive the online ACP education component, identical to Session 2 of the Die-logue programme. No facilitator-led group discussions are provided.
Behavioral: Online ACP Education
An online asynchronous learning session with short videos on ACP with discussion forums.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Death Attitudes
Time Frame: Before intervention
Death Attitude Profile Revised Scale (DAP-R)
Before intervention
Death Attitudes
Time Frame: Immediately after intervention
Death Attitude Profile Revised Scale (DAP-R)
Immediately after intervention

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Coping with Death
Time Frame: Before intervention
Coping with Death Scale - Short Form (CDS-SF)
Before intervention
Coping with Death
Time Frame: Immediately after intervention
Coping with Death Scale - Short Form (CDS-SF)
Immediately after intervention
Coping with Death
Time Frame: 6 months after intervention
Coping with Death Scale - Short Form (CDS-SF)
6 months after intervention
Death Attitudes
Time Frame: 6 months after intervention
Death Attitude Profile Revised Scale (DAP-R)
6 months after intervention
Readiness for Advance Care Planning
Time Frame: Before intervention
Readiness for Advance Care Planning (RACP) Scale
Before intervention
Readiness for Advance Care Planning
Time Frame: Immediately after intervention
Readiness for Advance Care Planning (RACP) Scale
Immediately after intervention
Readiness for Advance Care Planning
Time Frame: 6 months after intervention
Readiness for Advance Care Planning (RACP) Scale
6 months after intervention
Uptake of Advance Care Planning
Time Frame: 6 months after intervention
Self-reported completion of Advance Care Planning Activities
6 months after intervention

Collaborators and Investigators

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

Sponsor

National University of Singapore

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 (Estimated)

April 1, 2026

Primary Completion (Estimated)

December 31, 2027

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

April 6, 2026

First Submitted That Met QC Criteria

April 6, 2026

First Posted (Actual)

April 13, 2026

Study Record Updates

Last Update Posted (Actual)

April 13, 2026

Last Update Submitted That Met QC Criteria

April 6, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NUS-IRB-2025-243
  • NUHSRO/2025/007/RO5+5/Seed-Sep (Other Grant/Funding Number: National University Health System)

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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