Background With increasing recognition of Advance Care Planning (ACP) as a public health issue with the potential to benefit all individuals and is relevant throughout the life cycle, Woodlands Health (WH), a new integrated health campus set to open progressively from 2024 onwards embarked on its mission to support Singapore’s national ACP movement from its pre-operational phase with the formation of its pioneering ACP team in 2022. We describe the approach taken and proposed strategy to build the foundation for a vibrant ACP culture at the population level, within the community.
Methods Adopting a public health approach, we applied insights from the understanding of ACP as a process of health behavior change using the Transtheoretical Model (TTM) to the broad framework provided by the Socio-Ecological Model (SEM) which considers the complex interplay among individual, interpersonal, community and societal determinants. Appropriate interventions were identified through stakeholders engagement and the Behavioural Change Wheel (BCW) model.
Results A multipronged strategy was contextualized for the community under WH’s care, describing the specific behaviours to be targeted by the interventions, stakeholders categorization and management, intervention messages and functions targeting capability, opportunity or motivation, as well as modes of delivery tailored to population segments based on their readiness for engagement.
Conclusion With the hospital gearing up for operationalization in the new campus, the pre-operations phase presents a timely opportunity for a new organization like WH to channel its focus on strengthening community engagements to normalize and move ACP conversations upstream and into the community, setting the right culture for the right outcomes to follow.
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