Assessment of Last Acts Program Provides Recommendations for Future Direction

In 1999 and 2000, Balch Associates of Oak Park, Ill., assessed the Robert Wood Johnson Foundation's (RWJF) Last Acts® campaign for improving end-of-life care so that RWJF and other Last Acts stakeholders might understand the components and dynamics of the campaign and consider ways to increase their effectiveness. RWJF funded the assessment.

Last Acts is a national communications campaign RWJF began in 1995 and ended in 2005. It was a coalition of more than 800 national health and consumer groups that work to:

  • Improve communication and decision making for consumers about their own death.
  • Change the culture of health care institutions.
  • Change American culture and attitudes toward death.

The project was part of the RWJF program, Targeted End-of-Life Projects Initiative, which supports projects to improve care at the end of life.

Key Findings

  • Balch Associates, a team of qualitative researchers, assessed the structures, strategies, products and processes of Last Acts to identify the kinds of impact they were having on end-of-life care. Key findings included the following:

    • Last Acts attained some promising milestones in raising professional awareness of and engagement in improving end-of-life care.
    • Partners saw Last Acts as an information resource on end-of-life issues, events, legislation and products; a connector with peer and complementary organizations; a community of people addressing the same issues; a catalyst for initiating or maintaining end-of-life efforts; and a coalition that gets the word out to improve end-of-life care.
    • Partners realized many benefits from Last Acts, including comprehensive, credible, convenient and up-to-date information; inspiration; a sense of community; support and reinforcement from others in the field; and legitimacy with their members and boards.


  • The evaluators recommended that Last Acts:

    • Maintain and build its network over the long term to change end-of-life care.
    • Develop a clear identity to convey what the program stands for.
    • Continue to strengthen its structure by creating a national program office.
    • Become more visible, especially to the public.

    RWJF made Last Acts a national program and set up a national program office in August 2000; the program ended in 2005.