"Advocating for what we need": A CBPR approach to advance care planning in the Latinx older adult community.
Background: Advance care planning (ACP) is low among Latinx older adults. We used community‐based participatory research (CBPR) to identify ACP barriers/facilitators and design community‐based ACP events. Methods: In partnership with community‐based organizations, clinicians, and local government, w...
| Published in: | Journal of the American Geriatrics Society Vol. 71; no. 8; pp. 2601 - 2615 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | Article |
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Wiley-Blackwell
Aug2023
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| Subjects: | |
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=169783520&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 169783520 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00028614 20Q jtl: Journal of the American Geriatrics Society issn: 00028614 maglogo: Y pubinfo: dt: Aug2023 vid: 71 iid: 8 pid: 480 pub: Wiley-Blackwell artinfo: ui: 169783520 10.1111/jgs.18236 ppf: 2601 ppct: 14 formats: tig: atl: "Advocating for what we need": A CBPR approach to advance care planning in the Latinx older adult community. aug: au: Nouri, Sarah Tan, Charissa H. Rangel, Mirella Wertz, Molly Sanchez, Adriana Alvarado, Aurora Arreola, Erika Quinn, Mara Pantilat, Steven Z. Lyles, Courtney R. Ritchie, Christine S. Sudore, Rebecca L. affil: Division of Palliative Medicine, Department of Medicine, University of California San Francisco, San Francisco California,, USA John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu Hawaii,, USA Colibrí Collaborative, Oakland California,, USA Molly Wertz Consulting, San Francisco California,, USA Family Caregiver Alliance, San Francisco California,, USA MNC Inspiring Success, San Francisco California,, USA Thriving in Place, San Francisco California,, USA Division of General Internal Medicine, Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco California,, USA Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts,, USA Division of Geriatrics, Department of Medicine, University of California, San Francisco California,, USA su: Focus groups Hispanic Americans Advance directives (Medical care) Human services programs Patients' attitudes Documentation Action research Communication Caregiver attitudes Statistics Descriptive statistics Thematic analysis Data analysis sug: subj: Focus groups Hispanic Americans Advance directives (Medical care) Human services programs Patients' attitudes Documentation Action research Communication Caregiver attitudes Statistics Descriptive statistics Thematic analysis Data analysis keyword: advance care planning community‐based participatory research health disparities implementation science Latinx/Hispanic advance care planning community‐based participatory research health disparities implementation science Latinx/Hispanic ab: Background: Advance care planning (ACP) is low among Latinx older adults. We used community‐based participatory research (CBPR) to identify ACP barriers/facilitators and design community‐based ACP events. Methods: In partnership with community‐based organizations, clinicians, and local government, we formed a Latinx Community Committee (n = 13 community members). We then conducted 6 focus groups with Latinx‐identifying, English or Spanish‐speaking older adults (age ≥ 55), caregivers, and community leaders to assess ACP barriers/facilitators. We analyzed transcripts using thematic analysis and, based on these learnings, designed and implemented community‐based ACP events. Using a validated survey, we assessed acceptability and pre‐to‐post‐event ACP readiness (4‐point scale; 4 = most ready; 0.2 change considered meaningful) with Wilcoxon signed‐rank tests. Results: Focus groups included 10 Spanish‐speaking older adults, 8 caregivers, and 10 community leaders. Themes highlighted the importance of ACP (e.g., means of advocacy), barriers (e.g., how to start conversations), and facilitators (e.g., trusted community spaces) in the Latinx community. Ninety‐seven people attended 5 events targeting 3 Latinx populations (LGBTQI+, intergenerational, and older adults broadly). Overall pre‐to‐post‐event ACP readiness increased (2.62 (SD 0.97) to 2.95 (SD 0.93); p = 0.05). Readiness to document wishes increased significantly (2.44 (SD 1.0) to 2.98 (SD 0.95); p = 0.003). Most reported being comfortable attending events (85%) and would recommend them to others (90%). Conclusions: This study describes a feasible, acceptable, and effective CBPR ACP intervention. Co‐developed community events represent a promising approach to reducing disparities in ACP among the Latinx population. See related Editorial by Ronit Elk in this issue. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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