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

项目概要/摘要 提前护理计划（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 人们接受的医疗保健与他们的价值观、目标和偏好一致。ACP可能导致 确定医疗保健代理人并制定预先指令。性少数群体（例如，女同性恋/男同性恋），谁 在医疗环境中有歧视和耻辱的历史，在参与ACP时可能面临挑战。 早期负面的医疗保健经历和不同的社会结构可能会对ACP决策带来挑战- 制作。尽管与ACP相关的积极成果，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ACP的充分和一致的信息。鉴于这两个群体之间已知的差异， 到目前为止，还没有研究在性少数群体（SM）人群中检查ACP的种族差异。主要 这个项目的目的是调查老年男女同性恋者之间的种族差异。 关于ACP的行为和信念以及相关的护理偏好。本项目的数据将从 对50岁及以上的白色和黑人男女同性恋成年人进行的在线调查。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。Logistic 和逐步线性回归模型将用于检查：1）ACP讨论的差异， 种族群体之间的后续文件和2）对积极医疗的偏好差异 种族之间的待遇。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个体临终时的具体需求的调查， 在乎

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.