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

基本信息

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
项目类别：
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

项目摘要

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.

项目概要/摘要预先护理计划 (ACP) 是“一个支持任何年龄或健康阶段的成年人了解并分享他们的个人价值观、生活目标和对未来医疗保健的偏好”，以确保人们接受符合其价值观、目标和偏好的医疗护理可能会导致 ACP。确定医疗保健代理人并制定预先指示。在医疗机构中有过歧视和耻辱的历史，可能在参与 ACP 方面面临挑战。早期负面的医疗保健经历和不同的社会结构可能会给 ACP 决策带来挑战 - 尽管 ACP 取得了积极成果，但研究表明美国黑人正在这样做。由于对医疗保健系统的不信任、宗教/精神因素以及缺乏鉴于这两个群体之间已知的差异，有关 ACP 的充分且一致的信息。迄今为止，还没有研究考察性少数群体 (SM) 中 ACP 的种族差异。该拟议项目的目标是调查老年男女同性恋者之间的种族差异有关 ACP 的行为和信念以及相关护理偏好的数据将从以下位置收集。将招募 50 岁及以上的白人和黑人男女同性恋参与者进行在线调查。通过为老年人、SM 老年人和 SM 有色人种老年人提供服务的组织/中心。逐步线性回归模型将用于检查：1）ACP 讨论和种族群体之间的后续记录以及 2) 对侵袭性药物的偏好差异拟议项目的结果将扩大对 ACP 的了解。多样化的 SM 人群，并促进未来对 SM 个体临终特定需求的调查关心。