Background: Asian Americans have been shown to have cultural barriers that can impede their use of advance medical directives. This can prevent them from receiving appropriate health care according to their values at the end of life. Objectives: 1) To establish collaborations between Chinese and Vietnamese churches, health education/promotion organizations, and health care organizations to educate and promote the use of advance directives 2) To develop, implement, and evaluate a culturally and spiritually appropriate intervention to increase the acceptance and use of advance medical directives. Methods: We will conduct a church-wide survey to assess the prevalence of advance directives among Chinese and Vietnamese church congregants. We will use the community-based participatory research approach and the Theory Reasoned Action theoretical framework to identify the barriers and facilitators to the use of advance directives. In collaboration with church leaders and members, we will develop a culturally and spiritually appropriate intervention to increase the use of advance directives. Chinese and Vietnamese church members who are 50 years or older will be invited to participate in an educational program intervention about advance care planning. A pre-intervention and end-of-intervention survey will be administered to participants to assess their knowledge and attitudes about advance directives. Three months after the intervention, participants will be contacted by phone to determine whether they had completed an advance directive or discussed advance care wishes with family members or health care providers. We will revise the intervention design if the findings from key informant and focus group interviews suggest otherwise. Results: We will present prevalence estimates for advance directives among Chinese and Vietnamese church congregants. We will compare pre-intervention and post-intervention survey responses to measure change in knowledge and attitudes about advance directives, and will report relative proportions of congregants who have completed advance directives as a measure of the impact of the intervention. Conclusions/ Significance: This project will fill a current gap in the literature about the use of advance directives among Chinese and Vietnamese adults. It will describe the impact of a culturally tailored faith-based intervention to improve advance care planning in populations with known cultural barriers.
PROJECT NARRATIVE Impact of the study on public health Disparities in health care and cultural barriers have been shown to contribute to the low rates of completion of Advance Directives among ethnic minorities, thereby diminishing the quality of life in patients and adding to the economic burden of the health care system. The proposed study will provide a viable solution to the problem and build a collaborative framework for faith-based organizations to partner with health care providers to improve advance care planning and end of life care for one of the fastest growing population in the US - the Asian Americans.
| Sun, Angela; Bui, Quynh; Tsoh, Janice Y et al. (2017) Efficacy of a Church-Based, Culturally Tailored Program to Promote Completion of Advance Directives Among Asian Americans. J Immigr Minor Health 19:381-391 |
