ArticleBMC public health2026
Latent profiles of advance care planning engagement among Chinese older adults.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAdvance Care Planning (ACP) enables older adults to document future care preferences while cognitively competent. In China, ACP adoption remains limited despite aging population pressures, associated with cultural taboos around death, family-centered decision norms, and socioeconomic disparities. RESEARCH GAPS: Existing research predominantly employs variable-centered approaches, potentially masking qualitatively distinct subgroups with different engagement patterns. Person-centered analytical methods are needed to identify heterogeneous ACP engagement profiles and inform targeted interventions.
objectiveThis study identified distinct latent profiles of ACP engagement among Chinese older adults using knowledge, attitudes, beliefs, and motivation as LPA indicators within the Knowledge-Attitude-Practice framework and examined sociodemographic and health-related factors associated with profile membership; ACP intention was treated as a distal outcome.
methodA cross-sectional survey was conducted among 1,776 community-dwelling older adults (aged ≥ 60) across multiple Chinese provinces between January and March 2025. Knowledge, attitudes, beliefs, and motivation were entered as LPA indicators; intention was excluded from profile formation and examined as a distal continuous outcome via BCH analysis. R3STEP multinomial logistic regression examined factors associated with profile membership.
resultsThree distinct profiles emerged: The Disengaged Group (33%), characterized by uniformly low scores across all four indicators; The Motivated Pioneers Group (26%), displaying above-average beliefs and motivation alongside below-average attitudes; and The Broadly Engaged Group (41%), exhibiting the highest scores across all indicators. Medical insurance type, hospitalization frequency, and bereavement experience were significantly associated with profile membership. BCH-adjusted intention differed significantly across profiles (Broadly Engaged: M = 19.44; Motivated Pioneers: M = 18.83; Disengaged: M = 15.66).
conclusionsChinese older adults exhibit heterogeneous ACP engagement patterns associated with distinct sociodemographic and experiential factors, supporting profile-tailored interventions: foundational ACP education for The Disengaged Group, decision aids and family communication scripts for the Motivated Pioneers, and system-level facilitation for The Broadly Engaged Group.
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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.