Innovative Faith-Based Education on Advance Directives in Asian American Communit

描述(由申请人提供)：摘要背景：亚裔美国人已被证明存在文化障碍，这可能会阻碍他们使用先进的医疗指令。这可能会阻止他们在生命结束时根据自己的价值观获得适当的医疗保健。目标：1)建立中国和越南教会、健康教育/促进组织和卫生保健组织之间的合作，以教育和推广使用先进指示2)开发、实施和评估在文化和精神上适当的干预措施，以提高对先进医疗指示的接受和使用。方法：我们将在全教会范围内进行调查，以评估中国和越南教会会众中提前指示的流行率。我们将使用以社区为基础的参与性研究方法和理性行动理论框架来确定使用先行指令的障碍和促进者。我们将与教会领袖和成员合作，开发一种在文化和精神上适当的干预措施，以增加对提前指示的使用。50岁或以上的中国和越南教会成员将被邀请参加一个关于提前护理计划的教育项目干预。将对参与者进行干预前和干预结束时的调查，以评估他们对预先指令的知识和态度。干预三个月后，将通过电话联系参与者，以确定他们是否完成了预先指令，或与家人或医疗保健提供者讨论了预先护理意愿。如果主要信息者和焦点小组访谈的结果表明情况并非如此，我们将修改干预设计。结果：我们将在中国和越南教会会众中提出提前指示的流行率估计。我们将比较干预前和干预后的调查反应，以衡量对预先指示的知识和态度的变化，并将报告已完成预先指示的会众的相对比例，以衡量干预的影响。结论/意义：该项目将填补目前文献中有关中国和越南成年人使用提前指令的空白。它将描述文化定制的基于信仰的干预措施的影响，以改善已知文化障碍人群的提前护理计划。 与公共卫生的相关性：关于卫生保健方面的公共卫生差距和文化障碍的研究的项目叙述影响表明，少数民族预先指示的完成率较低，从而降低了患者的生活质量，增加了卫生保健系统的经济负担。这项拟议的研究将为这一问题提供一个可行的解决方案，并为以信仰为基础的组织建立一个合作框架，与医疗保健提供者合作，为美国增长最快的人口之一-亚裔美国人-改善预先护理计划和临终关怀。

DESCRIPTION (provided by applicant): ABSTRACT Background: Asian Americans have been shown to have cultural barriers that can impede their use of advance medical directives. This can prevent them from receiving appropriate health care according to their values at the end of life. Objectives: 1) To establish collaborations between Chinese and Vietnamese churches, health education/promotion organizations, and health care organizations to educate and promote the use of advance directives 2) To develop, implement, and evaluate a culturally and spiritually appropriate intervention to increase the acceptance and use of advance medical directives. Methods: We will conduct a church-wide survey to assess the prevalence of advance directives among Chinese and Vietnamese church congregants. We will use the community-based participatory research approach and the Theory Reasoned Action theoretical framework to identify the barriers and facilitators to the use of advance directives. In collaboration with church leaders and members, we will develop a culturally and spiritually appropriate intervention to increase the use of advance directives. Chinese and Vietnamese church members who are 50 years or older will be invited to participate in an educational program intervention about advance care planning. A pre-intervention and end-of-intervention survey will be administered to participants to assess their knowledge and attitudes about advance directives. Three months after the intervention, participants will be contacted by phone to determine whether they had completed an advance directive or discussed advance care wishes with family members or health care providers. We will revise the intervention design if the findings from key informant and focus group interviews suggest otherwise. Results: We will present prevalence estimates for advance directives among Chinese and Vietnamese church congregants. We will compare pre-intervention and post-intervention survey responses to measure change in knowledge and attitudes about advance directives, and will report relative proportions of congregants who have completed advance directives as a measure of the impact of the intervention. Conclusions/ Significance: This project will fill a current gap in the literature about the use of advance directives among Chinese and Vietnamese adults. It will describe the impact of a culturally tailored faith-based intervention to improve advance care planning in populations with known cultural barriers. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE Impact of the study on public health Disparities in health care and cultural barriers have been shown to contribute to the low rates of completion of Advance Directives among ethnic minorities, thereby diminishing the quality of life in patients and adding to the economic burden of the health care system. The proposed study will provide a viable solution to the problem and build a collaborative framework for faith-based organizations to partner with health care providers to improve advance care planning and end of life care for one of the fastest growing population in the US - the Asian Americans.