ArticleJournal of palliative medicine2016
Racial Differences in Outcomes of an Advance Care Planning Intervention for Dialysis Patients and Their Surrogates.
Article in Journal of palliative medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01259011 (A Randomized Controlled Trial of SPIRIT), which is not on this map. Cited by 21 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Controlled Trial of SPIRIT: A Representational Intervention to Promote Preparation for End-of-Life Decision Making
Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Interventions for interpersonal communication about end of life care between health practitioners and affected people.The Cochrane database of systematic reviews · 2022Pooled it
- Inequalities and outcomes: end stage kidney disease in ethnic minorities.BMC nephrology · 2019Pooled it
- Advance Care Planning With Patients Who Have End-Stage Kidney Disease: A Systematic Realist Review.Journal of pain and symptom management · 2018Pooled it
- Advance care planning for haemodialysis patients.The Cochrane database of systematic reviews · 2016Pooled it
- Pediatric Advance Care Planning and Adolescent Preparedness and Quality of Life: An RCT.Pediatrics · 2025Trial
- SPIRIT advance care planning intervention in early stage dementias: An NIH stage I behavioral intervention development trial.Contemporary clinical trials · 2018Trial
- Effects of Advance Care Planning on the Mental Health of Bereaved Families: A Systematic Review.Cureus · 2025Review
- Advance care planning for patients with end-stage kidney disease on dialysis: narrative review of the current evidence, and future considerations.Journal of nephrology · 2024Review
- Addressing Racial Injustice, Developing Cultural Humility, and Fostering Rapport-Building Communication Skills to Improve Disparities in End-of-Life Planning.Journal of pain and symptom management · 2023Article
- "We've Got to Bring Information to Where People Are Comfortable": Community-Based Advance Care Planning with the Black Community.Journal of general internal medicine · 2023Article
- Advance care planning among African American patients on haemodialysis and their end-of-life care preferences.Journal of renal care · 2021Article
- 'The Woman Gives': Exploring gender and relationship factors in HIV advance care planning among African American caregivers.Journal of clinical nursing · 2021Article
- Article
- Deconstructing the Complexities of Advance Care Planning Outcomes: What Do We Know and Where Do We Go? A Scoping Review.Journal of the American Geriatrics Society · 2021Article
- Underlying goals of advance care planning (ACP): a qualitative analysis of the literature.BMC palliative care · 2020Review
- Integrating Palliative Care into the Chronic Illness Continuum: a Conceptual Model for Minority Populations.Journal of racial and ethnic health disparities · 2019Review
- Chronic Pain, Functional Status, and Life Satisfaction Are Associated With Patients Living With HIV Discussing Advance Care Planning With Their Family or Friends.Journal of pain and symptom management · 2019Article
- End-of-Life Plans for African American Older Adults With Dementia.The American journal of hospice & palliative care · 2018Article
- Health Literacy Mediates Racial Disparities in Cardiopulmonary Resuscitation Knowledge among Chronic Kidney Disease Patients.Journal of health care for the poor and underserved · 2018Article
- Factors Associated with Surrogate Self-Efficacy in Decision-Making for Patients with End-Stage Renal Disease.Indian journal of palliative careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAfrican Americans' beliefs about end-of-life care may differ from those of whites, but racial differences in advance care planning (ACP) outcomes are unknown.
objectiveThe aim of this study was to compare the efficacy of an ACP intervention on preparation for end-of-life decision making and post-bereavement outcomes for African Americans and whites on dialysis.
methodA secondary analysis of data from a randomized trial comparing an ACP intervention (Sharing Patient's Illness Representations to Increase Trust [SPIRIT]) with usual care was conducted. There were 420 participants, 210 patient-surrogate dyads (67.4% African Americans), recruited from 20 dialysis centers in North Carolina. The outcomes of preparation for end-of-life decision making included dyad congruence on goals of care, surrogate decision-making confidence, a composite of the two, and patient decisional conflict assessed at 2, 6, and 12 months post-intervention. Surrogate bereavement outcomes included anxiety, depression, and post-traumatic distress symptoms assessed at 2 weeks, and at 3 and 6 months after the patient's death.
resultsSPIRIT was superior to usual care in improving dyad congruence (odds ration [OR] = 2.31, p = 0.018), surrogate decision-making confidence (β = 0.18, p = 0.021), and the composite (OR = 2.19, p = 0.028) 2 months post-intervention, but only for African Americans. SPIRIT reduced patient decisional conflict at 6 months for whites and at 12 months for African Americans. Finally, SPIRIT was superior to usual care in reducing surrogates' bereavement depressive symptoms for African Americans but not for whites (β = -3.49, p = 0.003).
conclusionSPIRIT was effective in improving preparation for end-of-life decision-making and post-bereavement outcomes in African Americans.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.