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Bazargan M, Cobb S, Assari S. Completion of advance directives among African Americans and Whites adults. Patient Educ Couns. 2021;104(11):2763-2771doi: 10.1016/j.pec.2021.03.031.
Bazargan, M., Cobb, S., & Assari, S. (2021). Completion of advance directives among African Americans and Whites adults. Patient education and counseling, 104(11), 2763-2771. https://doi.org/10.1016/j.pec.2021.03.031
Bazargan, Mohsen, et al. "Completion of advance directives among African Americans and Whites adults." Patient education and counseling vol. 104,11 (2021): 2763-2771. doi: https://doi.org/10.1016/j.pec.2021.03.031
Bazargan M, Cobb S, Assari S. Completion of advance directives among African Americans and Whites adults. Patient Educ Couns. 2021 Nov;104(11):2763-2771. doi: 10.1016/j.pec.2021.03.031. Epub 2021 Mar 31. PMID: 33840551; PMCID: PMC8481344.
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Patient Educ Couns. 2021 Nov;104(11):2763-2771. doi: 10.1016/j.pec.2021.03.031. Epub 2021 Mar 31.

Completion of advance directives among African Americans and Whites adults.

Patient education and counseling

Mohsen Bazargan, Sharon Cobb, Shervin Assari

Affiliations

  1. Department of Family Medicine, College of Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, USA; Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA; Department of Public Health, CDU, Los Angeles, CA, USA; Physician Assistant Program, CDU, Los Angeles, CA, USA. Electronic address: [email protected].
  2. School of Nursing, CDU, Los Angeles, CA, USA.
  3. Department of Family Medicine, College of Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, USA; Department of Public Health, CDU, Los Angeles, CA, USA.

PMID: 33840551 PMCID: PMC8481344 DOI: 10.1016/j.pec.2021.03.031

Abstract

OBJECTIVE: The primary purpose of this study was to analyze the completion of advance directives among African American and White adults and examine related factors, including demographics, socio-economic status, health conditions, and experiences with health care providers.

METHODS: This study used data from the Survey of California Adults on Serious Illness and End-of-Life 2019. We compared correlates of completion of advance directives among a sample of 1635 African American and White adults. Multivariate analysis was conducted.

RESULTS: Whites were 50% more likely to complete an advance directive than African Americans. The major differences between African Americans and Whites were mainly explained by the level of mistrust and discrimination experienced by African Americans and partially explained by demographic characteristics. Our study showed that at both bivariate and multivariate levels, participation in religious activities was associated with higher odds of completion of an advance directive for both African Americans and Whites.

CONCLUSION: Interventional studies needed to address the impact of mistrust and perceived discrimination on advance directive completion.

PRACTICAL IMPLICATIONS: Culturally appropriate multifaceted, theoretical- and religious-based interventions are needed that include minority health care providers, church leaders, and legal counselors to educate, modify attitudes, provide skills and resources for communicating with health care providers and family members.

Copyright © 2021 Elsevier B.V. All rights reserved.

Keywords: Advance directives; African Americans; Discrimination; Ethnicity/Race; Mistrust

Conflict of interest statement

Conflicts of interest The authors declare no conflicts of interest.

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