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Implementing an Advance Care Planning Intervention in Community Settings with Older Latinos: A Feasibility Study.
J Palliat Med. 2017 09; 20(9):984-993.JP

Abstract

BACKGROUND

Older Latinos with serious medical conditions such as cancer and other chronic diseases lack information about advance care planning (ACP). ACP Intervention (ACP-I Plan) was designed for informational and communication needs of older Latinos to improve communication and advance directives (ADs).

OBJECTIVE

To determine the feasibility of implementing ACP-I Plan among seriously ill, older Latinos (≥50 years) in Southern New Mexico with one or more chronic diseases (e.g., cancer, heart disease, renal/liver failure, stroke, hypertension, diabetes, chronic obstructive pulmonary disease, and HIV/AIDS).

DESIGN

We conducted a prospective, pretest/post-test, two-group, randomized, community-based pilot trial by using mixed data collection methods.

SETTING/SUBJECTS

Older Latino/Hispanic participants were recruited from community-based settings in Southern New Mexico.

METHODS

All participants received ACP education, whereas the intervention group added: (1) emotional support addressing psychological distress; and (2) systems navigation for resource access, all of which included interactive ACP treatment decisional support and involved motivational interview (MI) methods. Purposive sampling was guided by a sociocultural framework to recruit Latino participants from community-based settings in Southern New Mexico. Feasibility of sample recruitment, implementation, and retention was assessed by examining the following: recruitment strategies, trial enrollment, retention rates, duration of MI counseling, type of visit (home vs. telephone), and satisfaction with the program.

RESULTS

We contacted 104 patients, enrolled 74 randomized to usual care 39 (UC) and treatment 35 (TX) groups. Six dropped out before the post-test survey, three from TX before the post-test survey because of sickness (n = 1) or could not be located (n = 2), and the same happened for UC. Completion rates were 91.4% UC and 92.3% TX groups. All participants were Latino/Hispanic, born in the United States (48%) or Mexico (51.4%) on average in the United States for 25 years; majority were female, 76.5%; 48.6% preferred Spanish; and 31.4% had less than sixth-grade education. Qualitative data indicate satisfaction with the ACP-I Plan intervention.

CONCLUSIONS

Based on enrollment and intervention completion rates, time to completion tests, and feedback from qualitative post-study, follow-up interviews, the ACP-I Plan was demonstrated to be feasible and perceived as extremely helpful.

Authors+Show Affiliations

1 School of Social Work, New Mexico State University , Las Cruces, New Mexico .2 School of Social Work, University of South Florida , Tampa, Florida.1 School of Social Work, New Mexico State University , Las Cruces, New Mexico .1 School of Social Work, New Mexico State University , Las Cruces, New Mexico .3 Suzanne Dworak-Peck School of Social Work, University of Southern California , Los Angeles, California.1 School of Social Work, New Mexico State University , Las Cruces, New Mexico .4 School of Public Health, University of Washington , Seattle, Washington.5 School of Medicine, University of New Mexico , Albuquerque, New Mexico .

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

28467145

Citation

Nedjat-Haiem, Frances R., et al. "Implementing an Advance Care Planning Intervention in Community Settings With Older Latinos: a Feasibility Study." Journal of Palliative Medicine, vol. 20, no. 9, 2017, pp. 984-993.
Nedjat-Haiem FR, Carrion IV, Gonzalez K, et al. Implementing an Advance Care Planning Intervention in Community Settings with Older Latinos: A Feasibility Study. J Palliat Med. 2017;20(9):984-993.
Nedjat-Haiem, F. R., Carrion, I. V., Gonzalez, K., Quintana, A., Ell, K., O'Connell, M., Thompson, B., & Mishra, S. I. (2017). Implementing an Advance Care Planning Intervention in Community Settings with Older Latinos: A Feasibility Study. Journal of Palliative Medicine, 20(9), 984-993. https://doi.org/10.1089/jpm.2016.0504
Nedjat-Haiem FR, et al. Implementing an Advance Care Planning Intervention in Community Settings With Older Latinos: a Feasibility Study. J Palliat Med. 2017;20(9):984-993. PubMed PMID: 28467145.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Implementing an Advance Care Planning Intervention in Community Settings with Older Latinos: A Feasibility Study. AU - Nedjat-Haiem,Frances R, AU - Carrion,Iraida V, AU - Gonzalez,Krystyna, AU - Quintana,Alejandra, AU - Ell,Kathleen, AU - O'Connell,Mary, AU - Thompson,Beti, AU - Mishra,Shiraz I, Y1 - 2017/05/03/ PY - 2017/5/4/pubmed PY - 2018/5/19/medline PY - 2017/5/4/entrez KW - Latino/Hispanic KW - advance care planning KW - advance directives KW - healthcare provider communication KW - qualitative research KW - social work issues SP - 984 EP - 993 JF - Journal of palliative medicine JO - J Palliat Med VL - 20 IS - 9 N2 - BACKGROUND: Older Latinos with serious medical conditions such as cancer and other chronic diseases lack information about advance care planning (ACP). ACP Intervention (ACP-I Plan) was designed for informational and communication needs of older Latinos to improve communication and advance directives (ADs). OBJECTIVE: To determine the feasibility of implementing ACP-I Plan among seriously ill, older Latinos (≥50 years) in Southern New Mexico with one or more chronic diseases (e.g., cancer, heart disease, renal/liver failure, stroke, hypertension, diabetes, chronic obstructive pulmonary disease, and HIV/AIDS). DESIGN: We conducted a prospective, pretest/post-test, two-group, randomized, community-based pilot trial by using mixed data collection methods. SETTING/SUBJECTS: Older Latino/Hispanic participants were recruited from community-based settings in Southern New Mexico. METHODS: All participants received ACP education, whereas the intervention group added: (1) emotional support addressing psychological distress; and (2) systems navigation for resource access, all of which included interactive ACP treatment decisional support and involved motivational interview (MI) methods. Purposive sampling was guided by a sociocultural framework to recruit Latino participants from community-based settings in Southern New Mexico. Feasibility of sample recruitment, implementation, and retention was assessed by examining the following: recruitment strategies, trial enrollment, retention rates, duration of MI counseling, type of visit (home vs. telephone), and satisfaction with the program. RESULTS: We contacted 104 patients, enrolled 74 randomized to usual care 39 (UC) and treatment 35 (TX) groups. Six dropped out before the post-test survey, three from TX before the post-test survey because of sickness (n = 1) or could not be located (n = 2), and the same happened for UC. Completion rates were 91.4% UC and 92.3% TX groups. All participants were Latino/Hispanic, born in the United States (48%) or Mexico (51.4%) on average in the United States for 25 years; majority were female, 76.5%; 48.6% preferred Spanish; and 31.4% had less than sixth-grade education. Qualitative data indicate satisfaction with the ACP-I Plan intervention. CONCLUSIONS: Based on enrollment and intervention completion rates, time to completion tests, and feedback from qualitative post-study, follow-up interviews, the ACP-I Plan was demonstrated to be feasible and perceived as extremely helpful. SN - 1557-7740 UR - https://www.unboundmedicine.com/medline/citation/28467145/Implementing_an_Advance_Care_Planning_Intervention_in_Community_Settings_with_Older_Latinos:_A_Feasibility_Study_ L2 - https://www.liebertpub.com/doi/full/10.1089/jpm.2016.0504?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -