Abstract
ACP is a process of behavior change with connections to the Transtheoretical Model of Behavior Change (TTM). This systematic review conducted a gap analysis of ACP interventions for clients with cancer by categorizing intervention components according to the TTM. PubMed, CINAHL Plus, MEDLINE, Cochrane Library, and Web of Science databases were searched for articles related to ACP and cancer. Intervention components were categorized using the TTM and outcomes evaluated.The search yielded 3,571 articles, with 20 meeting criteria. Most interventions were intended for the precontemplation and contemplation stages of change, with fewer intended for preparation, action, or maintenance. Multiple underutilized processes to engage ACP were identified. The majority of interventions were unsuccessful or neutral in engaging ACP. ACP interventions that are stage-matched, utilize diverse processes to engage ACP, address ACP as a process, and monitor engagement across the illness trajectory are needed.