ABSTRACT
Background: Advance directives (AD) allow patients to make cooperative health-care decisions with their health-care providers and family members and give patients a sense of control over critical health-care and life-sustaining choices. The primary intent of the AD is to improve end-of-life (EOL) by rendering care consistent with patient’s wishes, thus reducing anxiety and stress associated with EOL care. Although the completion of AD remains limited in the general population, African Americans (AAs) have the lowest rates of AD completion.
Purpose: The purpose of this project was to apply The Conversation Project (TCP) Toolkit in discussing with AAs about AD and encouraging EOL conversations among AAs in community faith-based settings.
Methods: Using a descriptive, cross-sectional design using a convenience sample of African Americans in three different African-American churches in North Carolina, I tested the effectiveness of TCP toolkit in changing attitudes about advance directives and the TCP influence on initiation of EOL discussions. I conducted three intervention groups between December 18th, 2017 and January 19th , 2018, and used the Advance Directive Attitude Survey (ADAS) in pre-and post-intervention group discussions to assess changes in attitude towards AD. I also administered a 2 –question survey pre-and post-intervention group discussion to assess the likelihood that participants will hold an end of life discussion with their loved ones or institute ADs.
Results: Mean ADAS score increased from 2.678 pre-intervention to 3.044 post intervention.
Conclusion: The TCP toolkit led to a positive change in attitude towards AD when used as an education tool for EOL discussion choices among AAs. The TCP toolkit can be used to inform African Americans about EOL choices and encourage AAs to initiate EOL discussions with other family members.