Advance Care Planning among Chinese and Vietnamese Americans who Attend Churches

Few studies have examined completion of advance directives (AD) in Asian Americans. Little is known about advance care planning (ACP) among Asian Americans who attend churches. We describe AD completion and associated attitudes and beliefs among church-going older Chinese and Vietnamese American adults age 50 and older. A convenience sample of 140 Chinese (79% female, 96% immigrants) and 131 Vietnamese (27% female, 99% immigrants) adults age 50 and older who attended 2 Chinese and 2 Vietnamese Christian churches in Northern California answered a self-administered, paper survey. The survey assessed awareness and completion of AD (Living Will or Durable Power of Attorney for Health Care [DPOA]) and associated attitudes, beliefs, influences, and norms. Most respondents had never heard of a Living Will (50% Chinese, 78.6% Vietnamese) or DPOA (56.1% Chinese, 79% Vietnamese). Few (20.7% Chinese, 13.5% Vietnamese) had completed an AD. The most commonly reported influence on AD completion was family (51.4% Chinese, 50.8% Vietnamese), followed by church leaders or spiritual beliefs (38.6% Chinese, 29.4% Vietnamese). Fewer chose their physicians (17.1% Chinese, 11.9% Vietnamese) as an influence on AD completion. Over 80% of both Chinese and Vietnamese felt that ADs were compatible with their spiritual beliefs. Over 70% felt their church leaders supported ADs. AD awareness and completion rates were low among Chinese and Vietnamese American churchgoers. They perceived support from church leaders and compatibility with spiritual beliefs for AD completion. Church-based or family-based interventions to increase AD awareness and completion among Asian American church attendees may be effective.