Predicting Racial and Ethnic Disparities in Advance Care Planning Using the Integrated Behavioral Model

Colette A. McAfee, Timothy R. Jordan, Jiunn Jye (J J.). Sheu, Joseph A. Dake, Barbara A. Kopp Miller

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)

Abstract

Purpose: To explain and predict racial or ethnic disparities in advance care planning (ACP) behaviors among American adults by using the Integrated Behavioral Model (IBM) and the Precaution Adoption Process Model. Methods: A randomized, observational, nonexperimental, cross-sectional study design was used to survey American adults between 40 and 80 years of age (n = 386). Results: The majority of respondents (75%) had not completed ACP. Significant differences were found by race or ethnicity: 33% of Whites had completed ACP versus Hispanics (18%) and Blacks (8%). Whites had statistically significantly higher levels of most IBM constructs compared with Blacks and Hispanics. The IBM predicted 28% of the variance in behavioral intention. After controlling for sociodemographic variables, direct attitudes, indirect attitudes, and indirect perceived norms were significant predictors of behavioral intention. Conclusion: The IBM and the Precaution Adoption Process Model are useful frameworks for interventions designed to increase ACP among racial or ethnic minorities in the United States.

Original languageEnglish
Pages (from-to)369-389
Number of pages21
JournalOmega: Journal of Death and Dying
Volume78
Issue number4
DOIs
Publication statusPublished - 2019 Mar 1

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Critical Care and Intensive Care Medicine
  • Life-span and Life-course Studies

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