1259 Integrating findings from a mixed method study to inform multi-level interventions for advance care planning

<h3>Aim</h3> To synthesize findings from a mixed method project to inform the design of a multilevel ACP intervention for community-dwellers (≥50 years old). <h3>Background</h3> A systematic findings synthesis can enhance an understanding of the key factors that drive behavior change in planning for future care (1). However, existing ACP interventions fail to build on findings from studies using such methodologies. This research aimed to address this gap by integrating findings from across three studies to inform an evidence-based solution. <h3>Method</h3> The study used an adapted Framework for Integration in a Mixed Methods Study (2,3), which included six staged: (a) data reduction, (b) data transformation, (c) data comparison, (d) data integration, (e) mapping, and (f) credibility checks. Using the ‘following the thread’ technique, the findings from a large-scale mixed research systematic review (n=187) were used as a base when considering the results of the analysis of population-based data from the Irish Longitudinal Study of Aging (TILDA) (n=2884) and the findings from three collective intelligence workshops (n=22). The levels of agreement, complementarity, dissonance, and silence were explored across the datasets. The integrated findings were mapped across the Conceptual Model of ACP Behaviors and Influencing Factors (2). <h3>Results</h3> Across the three phases of the mixed-methods study, 37 integrated findings were generated. They were further clustered into five higher-level patterns, each including a problem and a solution dimension. These meta-themes highlighted the need to: (A) Embrace Intersubjectivity within a Spatiotemporal Paradox; (B) Take a Life Course, Existential, and Multi-stakeholder Approach to Capacity Building; (C) Consider Vulnerability and Responsibility within a Mindful, Inclusive, and Empowering Stakeholders’ Interaction; (D) Account for all Stakeholders‘ Needs in the Co-production of an Innovative, Accessible, Evidence-based, and Patient-centered Solution; and (E) Embed Positive and Empowering Interventions within Transformed, Services, Societies, and Cultures. <h3>Discussion</h3> The meta-themes represent overarching patterns of ACP behaviors embedded in complex social contexts. The mapping of the integrated findings across a theoretical model highlighted that future ACP interventions should target factors at the intersection of individual, interpersonal, service and system levels. <h3>Implications for Policy and Practice</h3> The problem-solution lenses ensured an applied focus and facilitated specification of intervention development and policy recommendations. The findings point to the need to take a holistic approach and emphasize relational autonomy. <h3>Unique Contribution</h3> By using systematic integration techniques, the study enriched an understanding of the problem situation in the field of ACP and helped define requirements for a comprehensive ACP solution.