Mobile Health Application (PACT) to Improve Engagement in Advance Care Planning

Inclusion Criteria:

PATIENT: Diagnosis of poor prognosis advanced cancer defined as locally advanced or metastatic cancer (e.g., pancreaticobiliary, esophagogastric, hepatocellular carcinoma, lung, or gynecological cancer) and/or disease progression following at least first line chemotherapy.
PATIENT: Access to a mobile device; the principal investigator (PI) will ensure that those who have access to a mobile device have access to a mobile device with internet access to ensure they can complete study procedures.
PATIENT: The ability to provide informed consent.
PATIENT: Identification and enrollment of a loved one/informal caregiver.
PATIENT: 18 years of age or older.
CAREGIVER: The person (family member or friend) whom the patient indicates being an informal caregiver.
CAREGIVER: English speaking.
CAREGIVER: 18 years of age or older and able to provide informed consent.

Exclusion Criteria:

PATIENT: Not fluent in English.
PATIENT: Severely cognitively impaired (as measured by Short Portable Mental Status Questionnaire scores of >= 6) to be delivered by trained study research staff during screening.
PATIENT: Too ill or weak to complete the interviews (as judged by the interviewer).
PATIENT: Currently receiving hospice at the time of enrollment.
PATIENT: Children and young adults under age 18.