ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2022
"Don't Talk to Them About Goals of Care": Understanding Disparities in Advance Care Planning.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
What it found
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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.
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Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Muslims and End-of-Life Healthcare in Non-Muslim Majority Nations: A Systematic Literature Review.Journal of pain and symptom management · 2024Pooled it
- Pooled it
- How does ethnicity affect presence of advance care planning in care records for individuals with advanced disease? A mixed-methods systematic review.BMC palliative care · 2023Pooled it
- Provider Interaction With an Electronic Health Record Notification to Identify Eligible Patients for a Cluster Randomized Trial of Advance Care Planning in Primary Care: Secondary Analysis.Journal of medical Internet research · 2023Trial
- 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
- Health System Policies Following State Abortion Restrictions in the US.JAMA network open · 2026Article
- A Large Language Model-Driven System for Advance Care Planning Training Among Health Care Providers in the Chinese Context: Development and Technical Evaluation.Journal of medical Internet research · 2026Article
- Supporting Advance Care Planning Among Mandarin and Cantonese Speaking Communities: A Qualitative Exploratory Study.Current oncology (Toronto, Ont.) · 2026Article
- Feasibility and Acceptability of Symptom Management Research in Black Advanced Lung Cancer Patients.Journal of pain and symptom management · 2026Observational
- A Multidimensional Narrative Review of Disparities in Hospice Care Use.The American journal of hospice & palliative care · 2026Article
- Advance care planning knowledge, attitudes, and experiences among hospital healthcare professionals: A survey.Palliative & supportive care · 2026Article
- Perspectives on advanced care planning of adolescent and young adult cancer patients, families, and healthcare providers: A qualitative study based on the health belief model.Asia-Pacific journal of oncology nursing · 2025Article
- Pitfalls in the conceptualization of primary palliative care and the WHO public palliative care framework.Palliative & supportive care · 2025Article
- Patient Safety Event Risk and Language Barriers: A Scoping Review.Joint Commission journal on quality and patient safety · 2025Article
- Article
- Multidisciplinary clinician perceptions on utility of a machine learning tool (ALERT) to predict 6-month mortality and improve end-of-life outcomes for advanced cancer patients.Cancer medicine · 2025Article
- Advance care planning readiness, barriers, and facilitators among seriously ill Black older adults and their surrogates: A mixed methods study.Palliative & supportive care · 2025Article
- Ethical reflection: The palliative care ethos and patients who refuse information.Palliative care and social practice · 2025Article
- Essential Advance Care Planning Intervention Features in Low-Income Communities: A Qualitative Study.Journal of pain and symptom management · 2025Article
- Advance care planning and hospice utilization among Japanese Americans: a scoping review.Proceedings (Baylor University. Medical Center) · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundStructurally marginalized groups experience disproportionately low rates of advance care planning (ACP). To improve equitable patient-centered end-of-life care, we examine barriers and facilitators to ACP among clinicians as they are central participants in these discussions.
methodIn this national study, we conducted semi-structured interviews with purposively selected clinicians from 6 diverse health systems between August 2018 and June 2019. Thematic analysis yielded themes characterizing clinicians' perceptions of barriers and facilitators to ACP among patients, and patient-centered ways of overcoming them.
resultsAmong 74 participants, 49 (66.2%) were physicians, 16.2% were nurses, and 13.5% were social workers. Most worked in primary care (35.1%), geriatrics (21.1%), and palliative care (19.3%) settings. Clinicians most frequently expressed difficulty discussing ACP with certain racial and ethnic groups (African American, Hispanic, Asian, and Native American) (31.1%), non-native English speakers (24.3%), and those with certain religious beliefs (Catholic, Orthodox Jewish, and Muslim) (13.5%). Clinicians were more likely to attribute barriers to ACP completion to patients (62.2%), than to clinicians (35.1%) or health systems (37.8%). Three themes characterized clinicians' difficulty approaching ACP (preconceived views of patients' preferences, narrow definitions of successful ACP, and lack of institutional resources), while the final theme illustrated facilitators to ACP (acknowledging bias and rejecting stereotypes, mission-driven focus on ACP, and acceptance of all preferences).
conclusionsMost clinicians avoided ACP with certain racial and ethnic groups, those with limited English fluency, and persons with certain religious beliefs. Our findings provide evidence to support development of clinician-level and institutional-level interventions and to reduce disparities in ACP.
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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.