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

项目摘要/摘要 高级护理计划(ACP)是一个支持任何年龄或健康阶段的成年人理解的过程 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 人们接受与他们的价值观、目标和偏好一致的医疗服务。机场核心计划可能会导致 确定医疗保健代理人并制定先行指令。性少数群体(例如，女同性恋/男同性恋)，谁 在医疗保健环境中有歧视和污名的历史，在参与非加太计划方面可能面临挑战。 早期的负面医疗经历和不同的社会结构可能会对机场核心计划的决策构成挑战- 制作。尽管ACP带来了积极的结果，但研究表明，美国黑人 由于对医疗保健系统的不信任、宗教/精神因素以及缺乏 关于机场核心计划的充分和一致的信息。鉴于这两个群体之间的这些已知差异， 到目前为止，还没有研究在性少数(SM)人群中检查ACP的种族差异。主 这项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。 对急性胰腺炎及相关护理偏好的行为和信念。此项目的数据将从以下位置收集 对50岁及以上的白人和黑人男女同性恋者进行的在线调查。参与者将被招募 通过为老年人、SM老年人和有色人种SM老年人服务的组织/中心。物流 逐步线性回归模型将被用来检验：1)机场核心计划讨论的差异和 种族群体之间的后续文件和2)对侵略性医疗的偏好差异 不同种族之间的待遇。拟议项目的结果将扩大对机场核心计划的了解 多样化的SM人群，并促进未来对SM个人临终时的特定需求的调查- 关心。

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.