April Schweinhart, R Turner Goins, Elizabeth Anderson
{"title":"Results of a Culturally Tailored Advance Care Planning Intervention for American Indian Peoples: A Quasi-Experimental Waitlist-Controlled Trial.","authors":"April Schweinhart, R Turner Goins, Elizabeth Anderson","doi":"10.1093/geroni/igaf041","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>American Indian and Alaska Native peoples have disproportionately low rates of advance care planning (ACP). To address this problem, we culturally tailored and evaluated an intervention for ACP to the needs of a specific American Indian Tribe. The goal of our study was to examine the culturally tailored <i>Make Your Wishes About You</i> (MY WAY) ACP intervention with respect to 5 ACP outcomes: barriers, facilitators, readiness, self-efficacy, and notarized advance care plan completion.</p><p><strong>Research design and methods: </strong>We engaged Tribal community members in a quasi-experimental, waitlist-controlled trial design to test the effects of the program. Our sample included 2, self-selected groups totaling 113 participants. Data were collected via interviewer-administered surveys with participants on 3 occasions. The intervention group completed an intervention baseline survey, postprogram survey, and a follow-up survey 6 months after the intervention, and the waitlist comparison group completed a control baseline survey, intervention baseline survey, and postprogram survey.</p><p><strong>Results: </strong>Our results showed that, on average, ACP barriers decreased, and facilitators, readiness, self-efficacy, and notarized advance care plan completion increased postintervention for participants who completed the ACP program. These changes were significantly greater for the intervention group than the waitlist comparison group and were sustained at the 6-month follow-up for the intervention group. In total, 76 more individuals completed their notarized advance care plans by the end of program participation than at intervention baseline, a 79.1% increase.</p><p><strong>Discussion and implications: </strong>The culturally tailored program was found to increase readiness and self-efficacy for ACP and increased the likelihood of a participant having a notarized advance care plan postprogram. Our study affects clinical and public health practice by testing a program that is responsive to cultural values, beliefs, and practices and shown to increase ACP among American Indian peoples.</p><p><strong>Clinical trial registration: </strong>NCT05304117.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 6","pages":"igaf041"},"PeriodicalIF":4.9000,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166474/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Innovation in Aging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/geroni/igaf041","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives: American Indian and Alaska Native peoples have disproportionately low rates of advance care planning (ACP). To address this problem, we culturally tailored and evaluated an intervention for ACP to the needs of a specific American Indian Tribe. The goal of our study was to examine the culturally tailored Make Your Wishes About You (MY WAY) ACP intervention with respect to 5 ACP outcomes: barriers, facilitators, readiness, self-efficacy, and notarized advance care plan completion.
Research design and methods: We engaged Tribal community members in a quasi-experimental, waitlist-controlled trial design to test the effects of the program. Our sample included 2, self-selected groups totaling 113 participants. Data were collected via interviewer-administered surveys with participants on 3 occasions. The intervention group completed an intervention baseline survey, postprogram survey, and a follow-up survey 6 months after the intervention, and the waitlist comparison group completed a control baseline survey, intervention baseline survey, and postprogram survey.
Results: Our results showed that, on average, ACP barriers decreased, and facilitators, readiness, self-efficacy, and notarized advance care plan completion increased postintervention for participants who completed the ACP program. These changes were significantly greater for the intervention group than the waitlist comparison group and were sustained at the 6-month follow-up for the intervention group. In total, 76 more individuals completed their notarized advance care plans by the end of program participation than at intervention baseline, a 79.1% increase.
Discussion and implications: The culturally tailored program was found to increase readiness and self-efficacy for ACP and increased the likelihood of a participant having a notarized advance care plan postprogram. Our study affects clinical and public health practice by testing a program that is responsive to cultural values, beliefs, and practices and shown to increase ACP among American Indian peoples.
期刊介绍：
Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.
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