Using a Conversation Game to Engage Native American Washoe Tribe Members in Advance Care Planning: Preparation for a Clinical Trial
2 other identifiers
interventional
108
0 countries
N/A
Brief Summary
The goal of this study is to learn if a culturally adapted version of the Hello game, an advance care planning (ACP) conversation tool, is feasible and acceptable for use with members of the Washoe Tribe. The main questions it aims to answer are: Can the Hello game be successfully adapted to reflect the cultural values, beliefs, and storytelling traditions of the Washoe Tribe? Does playing the adapted Hello game increase ACP engagement and advance directive (AD) completion among Washoe Tribe members within 3 months? Participants will:
- Take part in talking circles at one of four Washoe reservations to share their beliefs, motivations, and experiences related to end-of-life care and advance care planning
- Complete brief questionnaires about their ACP attitudes and behaviors
- Play the culturally adapted Hello game in a group setting
- Complete follow-up measures of ACP engagement and advance directive completion 3 months after playing the game
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for not_applicable
Started Jun 2026
Typical duration for not_applicable
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
February 23, 2026
CompletedFirst Posted
Study publicly available on registry
February 27, 2026
CompletedStudy Start
First participant enrolled
June 1, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
September 1, 2028
ExpectedStudy Completion
Last participant's last visit for all outcomes
September 1, 2028
March 2, 2026
February 1, 2026
2.3 years
February 23, 2026
February 26, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (7)
Arm 1: Qualitative themes describing Advance Care Planning needs, motivations, and challenges
Participants will take part in qualitative focus groups, where they will verbally answer questions in a conversational format. These conversations will be audio recorded and qualitatively analyzed. Demographic information will be collected along with contact information. No validated survey measures will be used to collect data at this time point. Only qualitative data, demographics and contact information.
During qualitative focus groups (up to 2 hours)
Arm 2: Initial Enrollment Subject Numbers
Feasibility metric (Observed by Research Assistant) - How many participants actually enrolled.
RA Observed during participation in Hello game event (up to 1 hour)
Arm 2: Retention at 3-month follow-up
Feasibility metric (Observed by Research Assistant) - # of participants who attended the follow-up event.
RA Observed during 3-month follow-up event (up to 1 hour)
Arm 2: Acceptability Score
Feasibility metric; participants will fill out Conversation Acceptability measure to determine acceptability of playing the Hello game. The Acceptability measure consists of 3 items; 2 items on a Likert scale from 1-7 with 1 being Strongly Agree and 7 being Strongly Disagree, and 1 item indicating likelihood of recommending conversation activity to others on a scale of 0-10 with 0 being not likely at all and 10 being extremely likely.
During participation in Hello Game Event (up to 1 hour)
Arm 2: ACP engagement survey score Time 1
Participants will be asked to fill out the validated ACP engagement survey to determine engagement and readiness levels for ACP actions. The ACP engagement survey consists of 4 items asking questions related to readiness for ACP behaviors. 2 items are on a scale of 1-5 with 1 being "I have never thought about it" and 5 being "I already have done it". The other 2 items are on a scale of 1-6 with 1 being "I have never thought about it" and 6 being "I have already done it (more than 5 years ago)".
During participation in Hello Game Event (up to 1 hour)
Arm 2: ACP engagement survey score Time 2
Participants will be asked to fill out the validated ACP engagement survey to determine engagement and readiness levels for ACP actions. The ACP engagement survey consists of 4 items asking questions related to readiness for ACP behaviors. 2 items are on a scale of 1-5 with 1 being "I have never thought about it" and 5 being "I already have done it". The other 2 items are on a scale of 1-6 with 1 being "I have never thought about it" and 6 being "I have already done it (more than 5 years ago)".
3-months post game attendance (up to 1 hour)
Arm 2: ACP Behavior completion
Participants will be asked to fill out the questions related to ACP behaviors. 6-items will be asked with 1 having options of yes/no/not sure/did not answer; 2 being yes/no/N/A/did not answer; 2 with options yes/no/did not answer and 1 with options nursing home/long-term care/insurance/hospice or palliative/funeral planning/other/did not report/did not answer
3-months post game attendance (up to 1 hour)
Study Arms (2)
Advance Care Planning Talking Circles
OTHERArm 2: Modified Hello Game Play
OTHERInterventions
To expand study partnership with the Washoe tribe to further explore the needs, motivations, and barriers related to ACP and end-of-life decision-making for Tribal members and explore how findings converge or diverge from Western culture and across Washoe reservations. 2 talking circles (qualitative focus groups) will be conducted at each of the 4 Washoe reservations (n=8 groups, 48 individuals) along with brief questionnaires to: 1) explore beliefs about and motivations for ACP; 2) determine if and how storytelling plays a role in ACP; and 3) define meaningful and culturally appropriate ACP outcomes for the Washoe tribe.
Adapt and pilot test the Hello conversation game for use by the Washoe Tribe while establishing procedures for measuring the game's impact on ACP engagement. This objective includes: a) incorporating tribal recommendations to culturally adapt the game based on findings from objective 1, and b) conducting a feasibility and acceptability study of the modified game with 60 Washoe tribal members (15 from each reservation) using convergent mixed methods to assess preliminary outcomes and refine procedures for the future clinical trial.
Eligibility Criteria
You may qualify if:
- Age 18 years or older
- Member of the Washoe American Indian Tribe
- Able to attend in-person events
- Speaks, reads, and writes in English
- Able to provide informed consent
You may not qualify if:
- Under 18 years of age
- Non-Tribal member
- Non-English speaking
- Unable to provide informed consent
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Officials
- PRINCIPAL INVESTIGATOR
Lauren J Van Scoy, MD
Penn State University - Hershey
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- NON RANDOMIZED
- Masking
- SINGLE
- Who Masked
- INVESTIGATOR
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- SEQUENTIAL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Principal Investigator
Study Record Dates
First Submitted
February 23, 2026
First Posted
February 27, 2026
Study Start
June 1, 2026
Primary Completion (Estimated)
September 1, 2028
Study Completion (Estimated)
September 1, 2028
Last Updated
March 2, 2026
Record last verified: 2026-02
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, ICF
- Time Frame
- De-identified data will be made available upon request and written approval from the PI and Washoe Tribal Council following publication of research manuscripts and will remain available for the life of the repository (minimum 10 years for ScholarSphere; indefinitely for openICPSR), or for as long as contact can be made with the PI.
- Access Criteria
- Requests for de-identified individual participant data should be directed to the Principal Investigator. Access requires written approval from both the PI and the Washoe Tribal Council. Requestors should describe the purpose and proposed use of the data. Data will be provided in de-identified CSV format at no cost to the requestor.
De-identified individual participant data (IPD) collected during the study will be made available upon request following publication of research manuscripts. Data will include quantitative measures (demographics, social determinants of health, ACP engagement, intervention acceptability, and conversation satisfaction) and associated documentation. In alignment with Washoe Tribal sovereignty, all data sharing decisions require written approval from both the Principal Investigator and the Washoe Tribal Council, who retain ultimate authority over data access and reuse. Linkage sheets will not be shared and will be returned to the Washoe Tribe or destroyed upon study completion. Only de-identified data (identified by study ID only) will be shared in accordance with Penn State and NIH policies.