# Developing a PREPARE for Your Care delivery system to enhance adoption by healthcare organizations

> **NIH NIH R43** · PEOPLE DESIGNS, INC. · 2022 · $257,978

## Abstract

PROJECT SUMMARY
Background: The population is aging, chronic illness is increasing, and millions of older adults lack preparation for
complex medical decision making, leading to uninformed decisions and care inconsistent with personal goals. The goal of
advance care planning (ACP) is to ensure that patients receive medical care aligned with their goals and preferences. Our
team has created the evidenced-based, interactive online PREPAREforYourCare.org (PREPARE) ACP program that
helps English and Spanish-speaking individuals develop the skills to clarify their values, communicate their wishes, and
make informed medical decisions. In trials, PREPARE helped 98% of English and Spanish-speaking older adults engage
in ACP and increased documentation of ACP decisions in the medical record up to 43%. Since 2013, PREPARE has had
over 350,000 unique users and the materials have been translated into multiple languages; yet reach and adoption by
healthcare systems remains low due to burdensome licensing and purchasing complexity, packaging of PREPARE
materials that may not meet organizations’ needs, and lack of guidance for how to integrate the materials into clinical
workflows. The objective of this proposal is to develop, refine, and evaluate an adopter-focused PREPARE Delivery
System (PDS) to ease the process of selecting, licensing, and implementing PREPARE within healthcare organizations.
The goal is to improve adoption and profitability of PREPARE and to position the team to apply for Phase II SBIR
funding to test adoption and implementation among varying types of healthcare and related organizations. Aim 1: We will
determine what PREPARE assets (i.e., website, advance directives, pamphlets, videos), are wanted by healthcare
organizations and how organizations want to access and license the assets. Aim 2: We will build a PDS prototype that
includes the desired assets and addresses stakeholder barriers to licensing and implementation. Aim 3: We will determine
the feasibility of the PDS by pilot testing among stakeholder potential adopters. Methods: We will conduct in-depth
interviews with healthcare stakeholders from a wide range of potential adopting organzations including community-based
hospitals, county hospitals, tertiary academic medical centers, and healthcare-based community organizations and analyze
the data using qualitative content analysis (Aims 1 and 2). We will also assess feasibility and satisfaction with the PDS
using validated surveys and in-depth interviews (Aim 3). We hypothesize that stakeholders will identify preferred
PREPARE assets and barriers to adoption, continue to provide feedback on needed refinements of the PDS over the
course of development, and report that the PDS is feasible and report high satisfaction with the deliveray system.
Relevance to NIH and public health: Widespread adoption and implementation of the evidenced-based PREPARE
program may reduce health disparities in ACP among culturally and linguistically diverse...

## Key facts

- **NIH application ID:** 10546110
- **Project number:** 1R43AG076047-01A1
- **Recipient organization:** PEOPLE DESIGNS, INC.
- **Principal Investigator:** David Farrell
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $257,978
- **Award type:** 1
- **Project period:** 2022-08-15 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10546110

## Citation

> US National Institutes of Health, RePORTER application 10546110, Developing a PREPARE for Your Care delivery system to enhance adoption by healthcare organizations (1R43AG076047-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10546110. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*