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Outcomes: 1. Summarize their understanding of how advance care planning can be implemented and studied in primary care using team-based and clinician-focused models 2. Articulate how they interpret results showing similar outcomes across the model and how this may have been impacted by the COVID-19 pandemic Advance care planning (ACP) has the potential to ensure that healthcare supports what is important to patients and families. Seven Practice-Based Research Networks (PBRNs) in the US and Canada conducted a cluster randomized trial comparing team-based to clinician-focused ACP. 42 practices were randomized. A 3-hour training and practice facilitation supported practice implementation. Patients completed questionnaires after initial ACP conversations and 6 months later. Primary outcomes were the patient-reported goal concordant care and days at home. 38 practices completed the study; 50% rural and 80% were family medicine. 448 staff completed training. 1,131 patients and family care partners consented. Data from 802 patients were included in the intention-to-treat analyses of 6-month outcomes. Patients reporting a high goal-concordant care were slightly, but not statistically significantly, lower in the team (57%) vs. the clinician arm (63%) [unadjusted OR 0.79(CI 0.53 to 1.18); adjusted OR 0.80, (CI 0.53-1.20)]. Days at home were high: 83% in the team-based arm vs. 85% in the clinician arm had less than 2 days spent in hospital, ED, or nursing home [Unadjusted OR 0.84 (CI 0.48-1.45); adjusted OR 0.90(CI 0.50 -1.64)]. In the clinician arm, high goal concordance was more frequent for patients enrolled after the COVID-19 pandemic, 71% versus 58%. The opposite effect was seen in the team arm; 61% before COVID and 3% after. Secondary outcomes included the PROMIS Anxiety and Depression scores; these were near established population means (49.8, for clinician and 50.8 for team arm) and did not changes from initial to 6 months. Patients reported high levels of goal concordant care 6 months after engaging in ACP. Differences between the team and clinician arm were not statistically significant, but outcomes were slightly better for the clinician arm. The COVID-19 pandemic may have disrupted team function, impacting the results. [ABSTRACT FROM AUTHOR]