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      Engaging Diverse English- and Spanish-Speaking Older Adults in Advance Care Planning : The PREPARE Randomized Clinical Trial

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          Abstract

          Advance care planning improves the receipt of medical care aligned with patients' values; however, it remains suboptimal among diverse patient populations. To mitigate literacy, cultural, and language barriers to advance care planning, easy-to-read advance directives and a patient-directed, online advance care planning program called PREPARE For Your Care (PREPARE) were created in English and Spanish.

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          Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel.

          Rebecca Sudore, Hillary D. Lum, John J You … (2017)
          Despite increasing interest in advance care planning (ACP) and previous ACP descriptions, a consensus definition does not yet exist to guide clinical, research, and policy initiatives.
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            Current research findings on end-of-life decision making among racially or ethnically diverse groups.

            David Haley, Jung Kwak (2005)
            We reviewed the research literature on racial or ethnic diversity and end-of-life decision making in order to identify key findings and provide recommendations for future research. We identified 33 empirical studies in which race or ethnicity was investigated as either a variable predicting treatment preferences or choices, where racial or ethnic groups were compared in their end-of-life decisions, or where the end-of-life decision making of a single minority group was studied in depth. We conducted a narrative review and identified four topical domains of study: advance directives; life support; disclosure and communication of diagnosis, prognosis, and preferences; and designation of primary decision makers. Non-White racial or ethnic groups generally lacked knowledge of advance directives and were less likely than Whites to support advance directives. African Americans were consistently found to prefer the use of life support; Asians and Hispanics were more likely to prefer family-centered decision making than other racial or ethnic groups. Variations within groups existed and were related to cultural values, demographic characteristics, level of acculturation, and knowledge of end-of-life treatment options. Common methodological limitations of these studies were lack of theoretical framework, use of cross-sectional designs, convenience samples, and self-developed measurement scales. Although the studies are limited by methodological concerns, identified differences in end-of-life decision-making preference and practice suggest that clinical care and policy should recognize the variety of values and preferences found among diverse racial or ethnic groups. Future research priorities are described to better inform clinicians and policy makers about ways to allow for more culturally sensitive approaches to end-of-life care.
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              Outcomes That Define Successful Advance Care Planning: A Delphi Panel Consensus

              Rebecca Sudore, Daren K Heyland, Hillary D. Lum … (2018)
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                Author and article information

                Journal
                Title: JAMA Internal Medicine
                Abbreviated Title: JAMA Intern Med
                Publisher: American Medical Association (AMA)
                ISSN (Print): 2168-6106
                Publication date Created: December 01 2018
                Publication date (Print): December 01 2018
                Volume: 178
                Issue: 12
                Page: 1616
                Affiliations
                [1 ]Division of Geriatrics, Department of Medicine, University of California, San Francisco
                [2 ]Geriatrics, Palliative, and Extended Care, San Francisco Veterans Affairs Health Care System, San Francisco, California
                [3 ]Northern California Institute for Research and Education, San Francisco
                [4 ]Innovation and Implementation Center for Aging and Palliative Care, Division of Geriatrics, Department of Medicine, University of California, San Francisco
                [5 ]Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California
                [6 ]Department of Medicine, University of California, San Francisco
                [7 ]Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
                [8 ]Department of Epidemiology & Biostatistics, University of California, San Francisco
                [9 ]Department of Psychiatry, University of California, San Francisco
                Article
                DOI: 10.1001/jamainternmed.2018.4657
                PMC ID: 6342283
                PubMed ID: 30383086
                SO-VID: bdce35db-aa63-451f-8433-3952924a5818
                Copyright © © 2018
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