Project Summary:
Community-Led Education for Advance Care Readiness (CLEAR) strengthens equitable access to advance care planning (ACP) across Milwaukee County by training community-based facilitators and embedding ACP services in trusted local settings. Although ACP ensures that healthcare decisions reflect individual values and wishes, participation remains low. Only 15.8% of Froedtert Health patients have a health care power of attorney (HCPOA) or an advance directive (AD) on record, and completion rates are even lower among Black, Hispanic, immigrant, and lower-income residents. These inequities are rooted in gaps in health literacy, access, and trust. CLEAR builds capacity within community health departments, dementia initiatives, libraries, and senior centers to provide culturally responsive ACP education and facilitation. Led by the North Shore Health Department Foundation in partnership with the North Shore Dementia Initiative and the Medical College of Wisconsin, CLEAR convenes a Community Advisory Board to guide project design, cultural adaptation, and outreach. Over two years, the project will train 20–25 facilitators in ACP law, dementia-sensitive communication, and cultural humility using validated instruments, including the Healthcare Provider Cultural Competence Instrument (HPCCI). Facilitators will host at least 25 community education sessions (including Spanish language), reaching a minimum of 750 participants and supporting 300 or more ACP completions or scheduled appointments. Evaluation, guided by the RE-AIM framework, will assess reach, effectiveness, adoption, implementation, and maintenance using both quantitative and qualitative data. CLEAR’s long-term goal is to establish a regional Advance Care Planning Collaborative that sustains and expands this work statewide, building trust, advancing equity, and strengthening Wisconsin’s community health workforce.