Use of a Computer Program for Advance Care Planning with African American Participants.
BACKGROUND
The authors wish to acknowledge the support and assistance of Dr. William Lawrence for his contribution to the M.A.UT model used in the decision aid, Making Your Wishes Known: Planning Your Medical Future (MYWK), Dr. Cheryl Dellasega for her leadership in focus group activities, Charles Sabatino for his review of legal aspects of MYWK, Dr. Robert Pearlman and his collaborative team for use of the advance care planning booklet "Your Life, Your Choices," Megan Whitehead for assistance in grant preparation and project organization, and the Instructional Media Development Center at the University of Wisconsin as well as JPL Integrated Communications for production and programming of MYWK.


BACKGROUND
For various cultural and historical reasons, African Americans are less likely than Caucasians to engage in advance care planning (ACP) for healthcare decisions.


OBJECTIVE
This pilot study tested whether an interactive computer program could help overcome barriers to effective ACP among African Americans.


METHODS
African American adults were recruited from traditionally Black churches to complete an interactive computer program on ACP, pre-/post-questionnaires, and a follow-up phone interview.


RESULTS
Eighteen adults (mean age =53.2 years, 83% female) completed the program without any problems. Knowledge about ACP significantly increased following the computer intervention (44.9% → 61.3%, p=0.0004), as did individuals' sense of self-determination. Participants were highly satisfied with the ACP process (9.4; 1 = not at all satisfied, 10 = extremely satisfied), and reported that the computer-generated advance directive accurately reflected their wishes (6.4; 1 = not at all accurate, 7 = extremely accurate). Follow-up phone interviews found that >80% of participants reported having shared their advance directives with family members and spokespeople.


CONCLUSIONS
Preliminary evidence suggests that an interactive computer program can help African Americans engage in effective advance care planning, including creating an accurate advance directive document that will be shared with loved ones.
Department of Humanities, The Pennsylvania State University, College of Medicine.
Sarah A
SA
Markham
Department of Humanities, The Pennsylvania State University, College of Medicine.
Benjamin H
BH
Levi
Department of Humanities, The Pennsylvania State University, College of Medicine.
Michael J
MJ
Green
Departments of Surgery and Medicine, The Pennsylvania State University, College of Medicine. Electronic address: jschubart@hmc.psu.edu.
Jane R
JR
Schubart
advance care planning; advance directive; computer program; decision support