Exploring the Interaction Between Race and Sexual Orientation in Advance Care Planning

探索预先护理计划中种族与性取向之间的相互作用

• 批准号: 10527846
• 负责人: Mekiayla Singleton
• 金额: $ 6.48万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10527846
• 关键词: Achievement; Address; Adult; Advance Care Planning; Advance Directives; Age; Aging; Behavior; Behavioral Model; Belief; Black American; Black race; Caring; Chronic Disease; Data; Decision Making; Discrimination; Do Not Resuscitate Order; Documentation; Elderly; Ensure; Face; Fibrinogen; Fostering; Future; Gays; Goals; Health; Health Personnel; Health Services Research; Healthcare; Healthcare Power of Attorney; Healthcare Systems; Hispanic Populations; Impairment; Intubation; Investigation; Knowledge; Lead; Lesbian; Linear Regressions; Link; Literature; Living Wills; Logistics; Medical; Modeling; Motivation; Outcome; Participant; Persons; Process; Proxy; Quality of Care; Race; Recording of previous events; Religion and Spirituality; Reporting; Research; Research Personnel; Resuscitation; Sampling; Services; Sex Orientation; Sexual and Gender Minorities; Socioeconomic Status; Strategic Planning; Surveys; Time; Training; United States National Institutes of Health; Value of Life; adult of color; aggressive therapy; care preference; care systems; end of life; end of life care; experience; health care availability; health care quality; health care service; health care settings; health inequalities; health service use; higher education; improved; insight; loved ones; preference; racial difference; racial disparity; racial identity; recruit; sexual minority; sexual minority disparity; sexual minority group; skills; social stigma; social structure

Project Summary/Abstract Advance care planning (ACP) is “a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care” to ensure that people receive medical care that is consistent with their values, goals, and preferences. ACP may lead to identifying a health care proxy and developing an advance directive. Sexual minorities (e.g., lesbian/gay), who have a history of discrimination and stigma in healthcare settings, may face challenges in engaging in ACP. Early negative healthcare experiences and different social structures may present challenges in ACP decision- making. Despite the positive outcomes associated with ACP, research has shown that Black Americans are less likely to complete ACP due to mistrust of the healthcare system, religious/spiritual factors, and lack of adequate and congruent information regarding ACP. Given these known disparities among these two groups, no study to date has examined racial differences in ACP within the sexual minority (SM) population. The main objective of this proposed project is to investigate racial differences among older lesbian and gay adults’ behaviors and beliefs about ACP and relevant care preferences. Data for this project will be collected from online surveys of White and Black lesbian and gay adults ages 50 and older. Participants will be recruited through organizations/centers that serve older adults, SM older adults, and SM older adults of color. Logistic and stepwise linear regression models will be used to examine: 1) differences in ACP discussion and subsequent documentation between racial groups and 2) difference in preference for aggressive medical treatment between racial groups. Results from the proposed project will expand knowledge of ACP within the diverse SM population and foster future investigation into the specific needs of SM individuals for end-of-life- care.

项目摘要/摘要 预先护理计划（ACP）是“在任何年龄或健康阶段支持成人的过程 并分享他们的个人价值观，人生目标以及关于未来医疗的偏好”，以确保 人们获得与其价值观，目标和偏好一致的医疗服务。 ACP可能导致 确定医疗保健代理并制定预先指令。性少数群体（例如，女同性恋/同性恋），他 在医疗保健环境中有歧视和污名的历史，可能在参与ACP方面面临挑战。 早期的负面医疗体验和不同的社会结构可能会在ACP决策中提出挑战 - 制作。尽管ACP产生了积极的结果，但研究表明，黑人美国人是 由于医疗体系的不信任，宗教/精神因素以及缺乏，不太可能完成ACP 有关ACP的足够和一致的信息。考虑到这两个群体之间的这些已知差异， 迄今为止，还没有研究过性别少数群体（SM）中ACP的种族差异。主 这个拟议项目的目的是研究老年男女同性恋成年人的种族差异 行为并相信ACP和相关护理偏好。该项目的数据将从 在线调查白色和黑人女同性恋和同性恋成年人50岁及以上。参与者将被招募 通过为老年人，SM老年人和SM有色人种的组织/中心。逻辑 和逐步线性回归模型将用于检查：1）ACP讨论和 随后的种族群体和2）对积极医疗的偏爱差异 种族群体之间的治疗。拟议项目的结果将扩大ACP知识 SM种群的不同，并促进了对SM个人的特定需求的未来投资 关心。