ADVANCE CARE PLANNING UTILIZATION AMONG NON-WHITE INDIVIDUALS WITH HEART DISEASE AND CANCER USING HEALTH RETIREMENT STUDY (HRS) DATA

Year of Publication
2025
Author
Academic Department
Nursing
Degree
Doctor of Philosophy in Nursing
Abstract

Advance Care Planning (ACP) is a critical component of patient-centered care, yet its utilization remains disproportionately low among Non-White populations in the United States, particularly among individuals with chronic illnesses such as heart disease and cancer. This article explores racial disparities in ACP engagement using secondary analysis of the 2018 and 2020 waves data from the Health and Retirement Study (HRS), guided by Bandura’s self-efficacy theory (SET). The study examines how race, disease type, comorbidity, and survey year predict ACP service utilization, defined as completing five key ACP components: a legal will, a medical care discussion, surrogate assignment (DPOA), a written living will, and limited care preferences. The analytic sample (n = 2,011) was drawn from a nationally representative cohort of adults aged 50 and older. The study's findings recommend targeted interventions, including culturally sensitive communication training for healthcare providers, standardization of ACP policies, and the integration of digital tools to enhance ACP accessibility. By identifying modifiable barriers and predictors, this research advances health equity and improves end-of-life care outcomes for underserved populations.

URL
https://mavmatrix.uta.edu/nursing_dissertations/139/
University
University of Texas at Arlington
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