Exploring Uncertainty in Advance Care Planning in African Americans

2011 ◽  
Vol 28 (7) ◽  
pp. 495-500 ◽  
Author(s):  
Lolita Melhado ◽  
Angeline Bushy
Keyword(s):  
Health Literacy ◽  
African Americans ◽  
Advance Care Planning ◽  
Mortality Rates ◽  
Health Needs ◽  
Care Planning ◽  
Patient Relationship ◽  
Uncertainty In Illness ◽  
Low Health Literacy ◽  
Advance Care

African Americans over 65 represent 3.5 of the 35.6 million Americans. Morbidity and mortality rates are highest among this group; associated with lack of resources and awareness of health problems. But health needs are the same at end of life, yet care is less than optimal. African Americans are less likely to have advance directives nonetheless desire communication, information, respect, and a trusting doctor-patient relationship. Low health literacy may contribute to this disparity. This scholarly review examines the health literacy in advance care planning and refines concepts of uncertainty in illness theory deriving a model for advance care planning in African Americans.

scholarly journals Have You Talked about It: Advance Care Planning among African Americans Living with HIV in Baltimore

2017 ◽  
Vol 94 (5) ◽  
pp. 730-745 ◽  
Author(s):  
Allysha C. Maragh-Bass ◽  
Yiqing Zhao ◽  
Sarina R. Isenberg ◽  
Mary M. Mitchell ◽  
Amy R. Knowlton
Keyword(s):  
African Americans ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care ◽  
Living With Hiv

scholarly journals Advance Care Planning Outcomes in African Americans: An Empirical Look at the Trust Variable

2019 ◽  
Vol 22 (4) ◽  
pp. 442-451 ◽  
Author(s):  
Esther R. Laury ◽  
Meredith MacKenzie-Greenle ◽  
Salimah Meghani
Keyword(s):  
African Americans ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care

scholarly journals The Role of Health, Social Network, and Race in Advance Care Planning Among Medicare Beneficiaries

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 69-70
Author(s):  
Jung Kwak ◽  
Heehyul Moon ◽  
Soonhee Roh
Keyword(s):  
Older Adults ◽  
Social Network ◽  
African Americans ◽  
Advance Care Planning ◽  
Living Will ◽  
Individual Characteristics ◽  
Care Planning ◽  
Medicare Beneficiaries ◽  
Advance Care

Abstract Advance care planning (ACP) is linked with high-quality end-of-life outcomes. However, ACP engagement level among older adults varies significantly by demographic, social, and health characteristics. In this study, we sought to identify characteristics associated with informal and formal ACP, in order to inform development of targeted education and outreach efforts that are tailored to diverse groups of older adults. The data came from a nationally representative study of Medicare beneficiaries living in communities, the National Health and Aging Trends Study (Round 8, N= 5,547). Multivariable logistic regressions were conducted to identify individual characteristics (i.e., race/ethnicity, age, gender, income, functional disability, cognitive function, perceived health, and numbers of people in social networks) associated with ACP engagement. Rates of informal ACP (talking to someone), and formal ACP, completing a healthcare power of attorney (HPOA) and a living will (LW), were 56%, 60.5%, and 56% accordingly. Logistic regression showed that individuals who were married or had a larger social network, and had higher functional impairment and health needs were significantly more likely to engage in both informal and formal ACP. However, individuals with memory problems (only informal ACP) and African Americans and Hispanics were significantly less likely to engage in both informal and formal ACP. African Americans without dementia were more likely to have completed HPOA compared with Whites. Findings suggest an important role of social network, and functional and cognitive health in ACP with implications for developing targeted outreach efforts in faith-based or social group settings, and healthcare settings.

A Pilot Feasibility Intervention to Increase Advance Care Planning among African Americans in the Deep South

2016 ◽  
Vol 19 (2) ◽  
pp. 164-173 ◽  
Author(s):  
Chao-Hui Sylvia Huang ◽  
Martha Crowther ◽  
Rebecca S. Allen ◽  
Jamie DeCoster ◽  
Giyeon Kim ◽  
...  
Keyword(s):  
African Americans ◽  
Advance Care Planning ◽  
Care Planning ◽  
Deep South ◽  
Advance Care

scholarly journals Health Literacy Matters More Than Experience for Advance Care Planning Knowledge Among Older Adults

2019 ◽  
Vol 67 (10) ◽  
pp. 2151-2156 ◽  
Author(s):  
Sarah S. Nouri ◽  
Deborah E. Barnes ◽  
Aiesha M. Volow ◽  
Ryan D. McMahan ◽  
Margot Kushel ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Literacy ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care ◽  
Planning Knowledge

The acceptability to African-Americans of a structured conversation guide to improve advance care planning in the setting of cancer: A focus-group study.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 11-11 ◽  
Author(s):  
Justin J Sanders ◽  
Katherine W. Sterba ◽  
Dee Ford ◽  
Susan Block
Keyword(s):  
African Americans ◽  
Advance Care Planning ◽  
Community Outreach ◽  
Care Planning ◽  
Focus Group Study ◽  
Serious Illness ◽  
Patient Goals ◽  
Advance Care ◽  
The Individual ◽  
The Impact

11 Background: African-Americans are less likely than whites to participate in advance care planning (ACP), which may contribute to disparities in the receipt of goal-concordant care. Literature points to multiple factors: the impact of religion, mistrust, different preferences for life-sustaining measures, family-decision making styles and poor knowledge about ACP. Early ACP conversations are associated with improved outcomes at the end of life, including goal-concordant care. A systematically-developed, serious illness conversation guide (“guide”) for oncologists, embedded in a systems-based approach to improving illness care, has demonstrated more frequent, higher-quality, and earlier ACP conversations in a predominantly white and middle class cohort of cancer patients. This study aimed to explore the acceptability and need for modification of the guide in more diverse populations. Methods: We conducted a series of focus groups with panels of clinicians and researchers, African-American church members, and seriously ill patients and their caregivers to assess barriers to ACP and preferences concerning modifications to the guide. We used template analysis to code themes at the individual, interpersonal and systems levels. Results: At the individual level, participants confirmed the importance of religion and the impact of perceived discrimination (e.g., receipt of inferior care) and superstition (e.g., talking about death may make it happen). Interpersonal-level factors influencing ACP included family, trust, and concerns about provider abandonment. Participants confirmed systems-level barriers of access and mistrust in the healthcare system and highlighted community outreach as a key part of the process. Participants reported positive responses to the tone and content of the guide and found the guide to be acceptable when it included a question that elicited coping mechanisms, including religion. Conclusions: Participants in our study found the use of a serious illness conversation guide to identify patient goals and priorities acceptable, and emphasized the importance of adding a question focused on coping and religion.

Sign in / Sign up

Export Citation Format

Share Document