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

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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.