Online Program

336043
Factors associated with advance directive completion in an older African American population


Tuesday, November 3, 2015

Tanya Troy, MPH, Public Health Sciences, Henry Ford Health System, Detroit, MI
Megan Brady, MPH, MSW, Institute of Multicultural Health, Henry Ford Health System, Detroit, MI
Denise White Perkins, MD, PhD, Institute on Multicultural Health, Henry Ford Health System, Detroit, MI
The Patient Self-Determination Act (PSDA) enacted in 1991 was meant to increase completion of advance directives (ADs) and allow patient’s wishes for care at the end of life to be expressed and documented. Although mandated, completion rates have been less than 25% and even lower for African American patients.

27 Semi-structured, qualitative, face to face interviews were conducted at the Henry Ford Health System Detroit Northwest and Troy clinics in metro Detroit, MI with African American patients aged 50- 85 years old from June- September 2014.

Framework method analysis was utilized to uncover respondents’ range of views regarding knowledge of the AD, attitudes and beliefs about importance, faith, race and communication regarding the AD. Findings confirm previous research reports of discussion and knowledge as important factors in decision making regarding the AD. Discussion was an important factor for respondents; family and loved ones were described as key people for discussion. Respondents also indicated that although open to it, most have not had discussion about the AD with their providers. Knowledge, as previous research suggests is a factor in AD completion however, on its own did not lead to an increase in the completion of the AD. Study participants spoke of the AD as important in minimizing conflict and stress for the family. Emergent themes of intention, burden and perceptions of self, health and time were also expressed.

These findings suggest areas for future study and possible points of intervention to improve the rate of completion for African American patients.

Learning Areas:

Assessment of individual and community needs for health education
Public health or related research

Learning Objectives:
Identify attitudes and barriers to advance directive completion in older african americans Discuss end of life care issues with an older african american population

Keyword(s): End-of-Life Care, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: While completing the MPH Program at Wayne State University I worked for the Department of Urban Studies and Planning on a grant to teach nutrition an physical activity session to seniors in the Midtown Detroit area. I have also worked with the Institute on Multicultural Health on projects related to health and health care disparities. My interests are in research on health disparities and inequities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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