Influential Factors Affecting the Intention to Utilize Advance Care Plans (ACPs) in Thailand and Indonesia

Abstract

Demographic shifts resulting from population aging are evident globally, including in Southeast Asia, Thailand, and Indonesia. The relevance of advance care plans is becoming increasingly apparent as the worldwide demographic transforms due to aging. This study sought to investigate the factors influencing the use and implementation of advance care plans (ACPs) using the health belief model (HBM) and technology acceptance model (TAM). This study selected a sample of individuals aged 30–60 in Indonesia and Thailand based on established inclusion and exclusion criteria. The study utilized the purposive random sampling method, integrating aspects of purposive and random selection. A total of 532 questionnaires were distributed via an online form, and 472 were obtained after data cleaning. Most respondents to this survey came from Indonesia, comprising 238 out of 472 respondents (50.4%), and from Thailand, comprising 49.5%; most respondents were women who were between 36 and 40 years old, and most reported graduating with a bachelor’s degree. A significant construct influences the use of advance care plans, i.e., perceived barriers. The perceived barrier (PBA) construct included data security, accessibility, and language barriers. In summary, overcoming existing barriers can indirectly increase the benefits of advance care plans. The results show that perceived usefulness (β = 0.189, p < 0.001), perceived ease of use (β = 0.150, p < 0.01), perceived susceptibility (β = 0.153, p < 0.01), perceived severity (β = 0.105, p < 0.05), and perceived benefits (β = 0.241, p < 0.001) all had significant positive effects on behavioral intention. In contrast, health motivation (β = 0.073, p = 0.100) and perceived barriers (β = 0.034, p = 0.134) did not show significant relationships with behavioral intention in Indonesia and Thailand, offering insights into both countries’ development strategies and the promotion of advance care plans with media as the technology.