Evidence map›Paper›PMID 26840850›Full record

ArticleJournal of palliative medicine2016

Racial and Ethnic Differences in Advance Directive Possession: Role of Demographic Factors, Religious Affiliation, and Personal Health Values in a National Survey of Older Adults.

Ivy A Huang, John M Neuhaus, Winston Chiong

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

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. Cited by 62 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Primary Palliative Care Improves Uptake of Advance Care Planning Among Patients With Advanced Cancers.Journal of the National Comprehensive Cancer Network : JNCCN · 2023
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  8. Study on edge villages based on cross-region healthcare-seeking behavior.International journal of health geographics · 2025
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2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Ivy A Huang1 Feinberg School of Medicine, Northwestern University , Chicago, Illinois.
John M Neuhaus2 Department of Epidemiology and Biostatistics, University of California , San Francisco, San Francisco, California.
Winston Chiong3 Department of Neurology, University of California , San Francisco, San Francisco, California.

Funding

Clinical and Transtional Science InstituteKL2TR000143 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$11.9M
Neuroeconomics of Framing Effects and Risk Attitudes in Early DementiaK23AG043553 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CHIONG, WINSTON · 2013 to 2017
$839k
NCATS NIH HHS KL2TR000143NIA NIH HHS K23 AG043553NIA NIH HHS K23AG043553
6 · The paper itself

Abstract

backgroundBlack and Hispanic older Americans are less likely than white older Americans to possess advance directives. Understanding the reasons for this racial and ethnic difference is necessary to identify targets for future interventions to improve advance care planning in these populations.

methodsThe aim of the study was to evaluate whether racial and ethnic differences in advance directive possession are explained by other demographic factors, religious characteristics, and personal health values. A general population survey was conducted in a nationally representative sample using a web-enabled survey panel of American adults aged 50 and older (n = 2154).

resultsIn a sample of older Americans, white participants are significantly more likely to possess advance directives (44.0%) than black older Americans (24.0%, p < 0.001) and Hispanic older Americans (29.0%, p = 0.006). Gender, age, retired or disabled employment status, educational attainment, religious affiliation, Internet access, preferences for physician-centered decision making, and desiring longevity regardless of functional status were independent predictors of advance directive possession. In fully adjusted multivariable models with all predictors included, black older Americans remained significantly less likely than white older Americans to have an advance directive (odds ratio [OR] = 0.42, 95% confidence interval [CI] = 0.24-0.75), whereas the effect of Hispanic ethnicity was no longer statistically significant (OR = 0.65, 95% CI = 0.39-1.1).

conclusionIn a nationally representative sample, black race is an independent predictor for advance directive possession. This association remains even after adjustment for other demographic variables, religious characteristics, and personal health values. These findings support targeted efforts to mitigate racial disparities in access to advance care planning.

Indexed as

Advance Care PlanningDemographyEthnicityRacial GroupsReligionAgedAged, 80 and overBlack or African AmericanFemaleHispanic or LatinoHumansMaleMiddle AgedSurveys and QuestionnairesWhite People

Identifiers

PMID26840850
PMCPMC4753625

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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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.