Table 2.

Common Themes

Themes	Quotes
Barriers to delivering an ACP community-based initiative	“Barriers were… we just really had to get them interested in wanting to hear about an advance care directive, because, you know, ‘obviously we don't think about this until we're sick or our family member is sick,’ and I think just to get them to be able to focus and just hear us out. That was a big hurdle just to get them there.”
	“Part of it is just having patients see a navigator as someone that is more like them than unlike. If I come in from the university and I feel it, and I hadn't asked them exactly what they feel, but like this ivory tower thing comes to mind. I can sit and say to the end of days like, ‘this is important, you should do this.’ Whereas someone who they see as like, oh, you live in the mountains too… and you're saying it's important and you've done it, I'm listening now.”
Strategies used to build “buy-in”	“Basically, we broke it down to networking. I would go out to community meetings that they [local organizations] have, and I did get connected with a couple of people-business organizations were a great one. We had a senior community center where we presented and that was a great opportunity because at the same time, HR was going over insurance and we kind of jumped on that loop, and that was kind of like an extra benefit for them. It gave a positive spin on [it]; we're helping them, and they were helping us at the same time.”
	“I tried to make it personal. I would say, like for instance, ‘before I started working this kind of work, I did not think about an advance care directive. I didn't even know what it was. Now once I found out about it and got myself educated on it, then it was easier for me to be able to provide the services.”
	“I think what worked well was having the questions and the answers [to] like ‘what should I do with this form after? Why should I have an advance care directive? What do I do with an advance care directive?’ Those kinds of questions, everything incorporated together.”
	“When I went to talk to the senior citizens, I think they were having fun with it. They were just such a crack up, I feel like they love to joke about that. And so, I think just even talking about somebody else making those decisions for you, but again, you bring it back, ‘well that's why we have advance directives, and that's why you appoint somebody as your healthcare agent.’ I just loved playing back off of that.”
	“I tried to make it as casual, not so military, just getting people's attention and maybe cracking a joke here and there. You just got to… anything to break the ice.”
Measuring success	“I did have a couple individuals come up and say, I speak Spanish and it's so good to talk to somebody and just speak about advance care planning. They even asked for extra advance directives, which is awesome. I really liked the advance directives because they're bilingual, if you flip, one page is in Spanish, and that really helped a lot.”
	“This elderly couple were like, should we take this to our lawyers? And I know that they wanted to talk to their doctor because they did have kind of like specialized questions that we've talked about. And [I] just kind of go back to the basics and tell them…. definitely go talk to your medical provider about those, and so that was just a great way to engage them in starting to get that conversation going.”
	“I did receive phone calls every once in a while, and that was mostly like, ‘hey, I was in your session, could you please send me more advance directives?’ And I definitely sent those out to them, or even dropped them off at their house.”
	“Just local people that I knew before even I was doing the presentations, people that are my friends that went to my session…. well, when I've seen them, I'm like, ‘hey, did you fill out your advance care directive? Yes or no?’ They looked at me and they are like, ‘oh, we haven't done it yet.’ But at least they have it there, you know?”
	“Spent a few nights out on the road, because the sessions would be like three days in a row, I would have maybe 9 or 10 different sessions, which was great…. I mean, that's a long drive, just exhausting.”