Can Playing an End-of-Life Conversation Game Motivate People to Engage in Advance Care Planning?

Lauren J. Van Scoy, Michael J. Green, Jean M. Reading, Allison M. Scott, Cynthia H. Chuang, Benjamin H. Levi

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Background: Advance care planning (ACP) involves several behaviors that individuals undertake to prepare for future medical care should they lose decision-making capacity. The goal of this study was to assess whether playing a conversation game could motivate participants to engage in ACP. Methods: Sixty-eight English-speaking, adult volunteers (n = 17 games) from communities around Hershey, Pennsylvania, and Lexington, Kentucky, played a conversation card game about end-of-life issues. Readiness to engage in 4 ACP behaviors was measured by a validated questionnaire (based on the transtheoretical model) immediately before and 3 months postgame and a semistructured phone interview. These behaviors were (1) completing a living will; (2) completing a health-care proxy; (3) discussing end-of-life wishes with loved ones; and (4) discussing quality versus quantity of life with loved ones. Results: Participants’ (n = 68) mean age was 51.3 years (standard deviation = 0.7, range: 22-88); 94% of the participants were caucasian and 67% were female. Seventy-eight percent of the participants engaged in ACP behaviors within 3 months of playing the game (eg, updating documents, discussing end-of-life issues). Furthermore, 73% of the participants progressed in stage of change (ie, readiness) to perform at least 1 of the 4 behaviors. Scores on measures of decisional balance and processes of change increased significantly by 3 months postintervention. Conclusion: This pilot study found that individuals who played a conversation game had high rates of performing ACP behaviors within 3 months. These findings suggest that using a game format may be a useful way to motivate people to perform important ACP behaviors.

Original languageEnglish
Pages (from-to)754-761
Number of pages8
JournalAmerican Journal of Hospice and Palliative Medicine
Issue number8
StatePublished - Sep 1 2017

Bibliographical note

Publisher Copyright:
© 2016, © The Author(s) 2016.


  • advance care planning
  • advance directives
  • communication
  • end-of-life care
  • health behavior
  • palliative care

ASJC Scopus subject areas

  • Medicine (all)


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