1. Right to Make Decisions about EOL Care End-of-Life Care Challenge from the California HealthCare Foundation: Catalyzing Communication about End-of-Life Care

2. 2  Patients are able to speak for themselves  Peace of mind for loved ones  Improve EOL care and QOL  Avoid unnecessary suffering, confusion and conflicts  Learning and empowerment Good communication and education about end of life is an essential part of healthy aging (Neimeyer, Wittkowski, Moser, 2004). Advance Care Planning

3. 3  System factors  Cultural differences  Personal factors  Confusion and myths http://www.cdc.gov/aging/pdf/advanced-care-planning-critical-issue-brief.pdf http://coalitionccc.org/documents/FinalChapterDeathDying.pdf

5. 5 Systematic review (Tamayo-Velazquez, 2010) of AD promotional interventions: Most effective : The combination of informative material, provider initiation, repeated counseling and update

6.  California nation's largest Asian- American population  Between 2000 and 2010, the Asian American population of California grew 34 percent.  Chinese born immigrants represented the second-largest immigrant group (after the foreign born from Mexico), and accounted for 4.5 percent of the total foreign-born population.  Culturally and linguistically appropriate resources are limited for Asian and Chinese-American populations.

7.  Hispanics, Asians are most-likely Smartphone owners in the U.S.  US has reached 55% smartphone penetration for the age of 18 and above.  Seven in ten seniors own a cell phone, up from 57% in 2011  Low income discounted mobile service available in California California low income discounted mobile service http://www.nielsen.com/content/dam/corporate/us/en/microsites/publicaffai rs/StateoftheAsianAmericanConsumerReport.pdf

8. Patients Family / Caregivers Other audience Providers 8 English/Chinese Glossary developed by CACCC Chinese POLST & Easy AD Form Translated & Modified by CACCC English-Chinese EOL Materials & Video developed by CACCC Exiting Bilingual Line Support by CACCC Onsite AD Workshops Exiting Bilingual Line Support by CACCC Onsite AD Workshops

9. 9  Pilot project targeted to one of the fastest growing underserved minority populations  Large scale nationwide mHealth EOL education and support services  Provide handy resources, tips, updates, support and referrals  Mobile interface design (easy icon) for low-literacy and senior populations  Linguistically and culturally tailored materials  Interactive sessions and media for effective learning  Online social network/support opportunities, email updates  Increase accessibility of EOL care planning and services  Create valuable partnership opportunities  mHealth provides a cost-effective solution supplementing interpersonal outreach and intervention

10. 10 Incorporate Campaign and/or Education Material to Increase Engagement Bilingual Support Click-To-Call Hotline Text-To-Speech Mobile Forum for Resource and Encourage Discussion

11. Patients Family / Caregivers Other audience Providers 11 Culturally Appropriate Regional EOL Resource Guides Online/Mobile Continued Medical Education Research project: Partner with academic institute Research project: Partner with academic institute Other language versions: Partner with other community based organizations Other language versions: Partner with other community based organizations

12. 12  Advance care planning and education is a process, not a single event.  The problems with and barriers to advance care planning are multi- faceted.  Multi-pronged strategies are necessary to outreach various target audiences.  mHealth has been proven to be effective in the field of health behavior change.  mHealth can reach out to the fastest growing mobile users, multi- level population.  mHealth provides a cost-effective solution, supplementing interpersonal outreach and intervention.

13. Right to Make Decisions about EOL Care Mr. Samuel Sung