Trial reportJournal of the American Geriatrics Society2019
Health Literacy Matters More Than Experience for Advance Care Planning Knowledge Among Older Adults.
Trial report in Journal of the American Geriatrics Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
What it found
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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.
Who cites it
43 citing papers in PubMed.
- The effectiveness of microlearning-based education on medication adherence and health literacy in elderly individuals: a randomized controlled trial.Scientific reports · 2025Trial
- The PREPARE for Your Care program increases advance care planning engagement among diverse older adults with cancer.Cancer · 2021Trial
- Use of a Supportive Kidney Care Video Decision Aid in Older Patients: A Randomized Controlled Trial.American journal of nephrology · 2020Trial
- The Effect of Health Literacy on a Brief Intervention to Improve Advance Directive Completion: A Randomized Controlled Study.Journal of primary care & community healthTrial
- [Clinical and sociodemographic characterization of older adults with chronic diseases and advance directives].Revista medica del Instituto Mexicano del Seguro Social · 2026Observational
- Oncology physicians' and nurses' perspectives on barriers to advanced care planning for patients with cancer in Oman: A cross-sectional study.International journal of nursing sciences · 2026Article
- Advance Directive Completion Among Community-Dwelling Adults with Decompensated Cirrhosis.Digestive diseases and sciences · 2026Article
- Tree of peaches: exploring what matters most at the end-of-life among healthy older adults in Taiwan: a qualitative study.BMC palliative care · 2026Article
- Article
- Perspectives of Japanese Citizens on Advance Care Planning in Clinical Settings: Findings From a Focus Group Study.Journal of general and family medicine · 2026Article
- Barriers and Strategies to Effective Serious Illness Communication for Patients with End-Stage Liver Disease in the Intensive Care Setting.Journal of intensive care medicine · 2026Review
- Knowledge of CPR and Code Status Discussions in Traumatically Injured Older Adults: Does Health Literacy Matter?Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2025Article
- Relationship Between Social Determinants of Health and Domains of Care Addressed During Pediatric Palliative Care Visits for Children with Cancer.Children (Basel, Switzerland) · 2025Article
- Feasibility of Nurse-Facilitated Advance Care Planning Among Older Veterans in a Dialysis Unit and an Oncology Infusion Center.Military medicine · 2025Article
- Acceptance of advance care planning among older adults in Mainland China: a national cross-sectional study.BMC public health · 2025Article
- Do Socioeconomic Factors Influence Knowledge, Attitudes, and Representations of End-of-Life Practices? A Cross-Sectional Study.Journal of palliative care · 2025Article
- Understanding attitudes and preferences towards advance care planning in older adults: Insights from a cross-sectional study in primary care.Palliative care and social practice · 2025Article
- Acceptance of advance care planning and influencing factors from the perspective of the life cycle: a cross-sectional study.BMC palliative care · 2024Article
- Action plans increase advance care planning documentation and engagement among English and Spanish-speaking older adults.Journal of the American Geriatrics Society · 2024Article
- Comorbid Dementia and Cancer Therapy Decision-Making: A Scoping Review.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundAdvance care planning (ACP) engagement is low among vulnerable populations, including those with limited health literacy (LHL). Limited knowledge about ACP may be a modifiable mediator of the relationship between LHL and ACP. Our goal was to determine whether health literacy is associated with ACP knowledge.
designCross-sectional design.
settingA public health delivery system and Veterans Affairs Medical Center in San Francisco, CA.
participantsEnglish- and Spanish-speaking patients (N = 1400). MEASUREMENTS: ACP knowledge was assessed with seven validated multiple-choice questions. Health literacy was measured using a validated scale. Sociodemographic measures included age, sex, language, education, race, health status, and social support. Prior ACP experience was defined as having documented legal forms and/or goals-of-care discussions in the medical record. We used Kruskal-Wallis tests and linear regression to examine associations of ACP knowledge with LHL, prior ACP experience, and sociodemographic factors.
resultsMean age of participants was 65 (±10) years, 48% were women, 34% had LHL, 32% were Spanish speaking, 47% had high school education or less, and 70% were nonwhite. Mean 7-point knowledge scores were lower for those with limited vs adequate health literacy (3.8 [SD = 1.9 vs 5.5 (SD = 1.7); P < .001). In multivariable analysis, ACP knowledge scores were 1.0 point lower among those with LHL; 0.6 points lower among Spanish speakers and those with high school education or less; and 0.5 points lower among individuals of nonwhite race (P < .001 for all). Knowledge scores were 0.02 points lower per year of older age (P = .007) and 0.01 points higher per point of greater social support (P = .005). Prior ACP experience was not associated with knowledge after adjustment (P = .7).
conclusionsHealth literacy and sociodemographics are stronger predictors than prior ACP experience of ACP knowledge. This study suggests that providing easy-to-understand ACP materials is paramount and should be offered even if patients have previous experience with the ACP process. J Am Geriatr Soc 67:2151-2156, 2019.
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